Clinical correlation of the venom-specific IgG antibody level during maintenance venom immunotherapy.

Abstract

Allergen immunotherapy is associated with a significant increase of specific IgG antibodies that have been suggested as a mechanism of action and as a marker of efficacy for immunotherapy. The value of venom-specific IgG antibody determinations as a measure of clinical protection against sting anaphylaxis has been difficult to prove in individual patients. We performed 211 insect sting challenges in 109 patients over a 4-year period to determine the significance of venom IgG levels 3 micrograms/ml or lower. Systemic symptoms occurred in only 1.6% of those with venom IgG more than 3 micrograms/ml, but in 16% of those with less than 3 micrograms/ml IgG, and notably in 26% of patients with low venom IgG who had received less than 4 years of treatment. The venom IgG level had no predictive value in patients who had received more than 4 years of therapy. Honeybee sting data were inconclusive because of the small number of subjects. We conclude that low venom-specific IgG levels are associated with an elevated risk of treatment failure during the first 4 years of immunotherapy with yellow jacket or mixed vespid venoms.

• Authors: D B Golden, I D Lawrence, R H Hamilton, A Kagey-Sobotka, M D Valentine, L M Lichtenstein
• Journal: The Journal of allergy and clinical immunology (J Allergy Clin Immunol) Vol. 90 Issue 3 Pt 1 Pg. 386-93 (Sep 1992) ISSN: 0091-6749 [Print] United States
• PMID: 1527321 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Bee Venoms
• Immunoglobulin G
• Wasp Venoms

Topics

• Adult
• Bee Venoms (immunology, therapeutic use)
• Desensitization, Immunologic
• Humans
• Immunoglobulin G (analysis)
• Insect Bites and Stings (immunology, therapy)
• Middle Aged
• Risk
• Wasp Venoms (immunology, therapeutic use)