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Related Experiment Videos

Long-term IgG4 determinations in hymenoptera-sensitive treated patients.

M J Gentlesk1, G M Halpern, H C Mansmann

  • 1Division of Allergy and Clinical Immunology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania.

Annals of Allergy
|October 1, 1987
PubMed
Summary

Long-term venom immunotherapy for Hymenoptera stings shows that venom-specific IgG4 antibody levels plateau then decline after three years. Despite low IgG4, patients remained clinically protected, suggesting different mechanisms for short-term and long-term immunity.

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Area of Science:

  • Immunology
  • Allergy and Clinical Immunology
  • Pharmacology

Background:

  • Honey bee and vespid venom immunotherapy are established treatments for Hymenoptera stings.
  • Previous research has focused on the short-term effects of venom immunotherapy.
  • The long-term immunological response to venom immunotherapy requires further investigation.

Purpose of the Study:

  • To evaluate the long-term effects of venom immunotherapy on venom-specific IgG4 antibody levels.
  • To determine if venom-specific IgG4 levels correlate with clinical protection over extended periods.
  • To investigate potential differences in mechanisms of short-term versus long-term immunity.

Main Methods:

  • Prospective study of 46 patients (ages 3-67) with Hymenoptera sensitivity.

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  • Intradermal skin testing with venom extracts at varying concentrations.
  • Measurement of venom-specific IgE and IgG4 antibody levels over time (up to 6.5 years).

    • Main Results:

    • All patients showed an increase in venom-specific IgG4 during the first year of immunotherapy, followed by a plateau.
    • After three years of continuous immunotherapy, 30 patients exhibited a gradual decline in IgG4 levels.
    • Six patients with very low IgG4 levels remained clinically protected after accidental stings.

    Conclusions:

    • Long-term immunity following venom immunotherapy may not be solely mediated by sustained high levels of venom-specific IgG4.
    • The immunological mechanisms underlying long-term protection might differ from those responsible for short-term effects.
    • Further research is needed to elucidate the precise mechanisms of sustained clinical protection.