Monitoring honeybee venom immunotherapy in children with the basophil activation test

Pediatr Allergy Immunol. 2012 Mar;23(2):166-72. doi: 10.1111/j.1399-3038.2011.01233.x. Epub 2011 Dec 4.

Abstract

Background: New in vitro methods are essential for developing better follow-up criteria for venom immunotherapy (VIT).

Methods: Thirty-one children with a history of honeybee venom-induced systemic anaphylaxis were included in this prospective, single-blinded study. The basophil CD63 activation test (BAT) was assessed before starting VIT, at the end of the build-up phase (day 5), 6 months later, and after 2-4 yr of VIT.

Results: Basophil CD63 activation test allowed identification of the culprit insect in 74% of honeybee venom-allergic children. In comparison, IgE reactivity was single positive in only 52% of children. Five days after starting VIT, BAT was highly comparable to before VIT. However, after 6 months and further after 2-4 yr of VIT, a significant and approximately fourfold decrease was demonstrated in CD63 response at sub-maximal 0.1 μg/ml allergen concentration, which mainly represents cellular sensitivity. No such differences were found at a higher 1 μg/ml of allergen concentration. Person-to-person analyses showed that after 2-4 yr of VIT, a marked CD63 decrease was evident in 85% of children. In addition, elevated basophil sensitivity measured before VIT was associated with the appearance of side effects observed during the build-up phase of VIT.

Conclusion: Basophil CD63 allergen-specific sensitivity seems to be a promising tool for monitoring protective immune response in honeybee VIT.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anaphylaxis / etiology
  • Anaphylaxis / immunology
  • Anaphylaxis / prevention & control
  • Animals
  • Basophil Degranulation Test / methods*
  • Bee Venoms / adverse effects*
  • Bee Venoms / immunology
  • Bees / immunology
  • Child
  • Child, Preschool
  • Desensitization, Immunologic*
  • Female
  • Humans
  • Insect Bites and Stings / immunology
  • Male
  • Sensitivity and Specificity

Substances

  • Bee Venoms