Basophil response and the induction of a tolerance in venom immunotherapy: a long-term sting challenge study

Allergy. 2012 Jun;67(6):822-30. doi: 10.1111/j.1398-9995.2012.02817.x. Epub 2012 Apr 3.

Abstract

Background: There is no in vitro test to predict the induction of long-term tolerance in patients treated with venom immunotherapy (VIT). The aim of this study was to investigate whether immunotherapy-induced changes in basophil responsiveness reflect a state of protection and the induction of a tolerance.

Methods: Twenty-three patients with allergic reaction after Hymenoptera sting (11 wasp and 12 honeybee) were treated with VIT. In all patients, a CD63 basophil activation test was performed before the beginning of immunotherapy, after 1 year and after completing 4-6.5 years of immunotherapy (approximately 1 year after stopping). The tolerance was then evaluated by a sting challenge test. The basophil activation test was repeated 3-6 months after the challenge.

Results: Twenty-two subjects showed a negative sting challenge, and one subject, a positive sting challenge. Allergen-specific basophil response remained unchanged after 1 year of immunotherapy. However, after immunotherapy, a significant and approximately fourfold decrease was demonstrated in all tolerant subjects mainly in response to submaximal 0.1 μg/ml allergen concentration. This depression was sustained and did not change with the sting challenge test. In a nontolerant patient with a positive sting challenge, basophil response did not change.

Conclusions: Our results suggest that the depression of allergen-specific basophil response seems to be associated with the induction of a tolerance after completing a course of VIT.

MeSH terms

  • Adult
  • Aged
  • Arthropod Venoms / immunology*
  • Basophil Degranulation Test
  • Basophils / immunology*
  • Basophils / metabolism
  • Desensitization, Immunologic*
  • Female
  • Humans
  • Hypersensitivity / immunology
  • Hypersensitivity / prevention & control*
  • Immune Tolerance / immunology*
  • Insect Bites and Stings / immunology*
  • Male
  • Middle Aged

Substances

  • Arthropod Venoms