Document Detail


Sublingual desensitization in patients with wasp venom allergy: preliminary results.
MedLine Citation:
PMID:  18831935     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this paper is to assess in an open prospective pilot case-control study the tolerability, safety and efficacy of an ultra-rush sublingual immunotherapy (SLIT) protocol with Vespula venom in wasp allergic patients compared to subcutaneous immunotherapy (SCIT). Forty-one wasp allergic patients were treated with sublingual (SLIT group) or subcutaneous (SCIT group) ultrarush immunotherapy with Vespula venom extract. All patients underwent skin tests and serum specific IgE and IgG4 detection before enrollment and after 6, 12 and 24 months of immunotherapy. The SLIT group consisted of 21 (6 females and 15 males) patients who received increasing doses of Vespula venom (Aquagen, ALK-Abellò) until the final dose of 30 drops of extract in 3 hours, containing 100,000 SQ-U/ml. The maintenance dose was of 10 drops of pure venom extract 3 times a week, for a total dose of 100,000 SQ-U weekly (corresponding to 100 microgram of venom extract). The SCIT group consisted of 20 patients (16 males and 4 females) who were treated with subcutaneous ultrarush immunotherapy with Vespula venom extract (Pharmalgen, Alk-Abellò). Patients received 101.1 microgram of Vespula venom in 3 hours and were treated with 100 microgram of wasp venom monthly. During the ultrarush sublingual treatment 2 patients (9.5%) experienced mild side-effects. Specific IgE and specific IgG to wasp venom did not show any significant modification. Four patients were field-stung by a wasp during the treatment (for a total of 6 stings). Two patients (3 stings), with a previous clinical history of a grade III and IV reaction, did not experience any reaction. One patient, with a previous grade II reaction, showed a large local reaction. The fourth patient, with a previous grade III reaction, was re-stung twice (after 12 and 24 months) with two systemic reactions (SR) (mild throat constriction). During the ultrarush SCIT phase, 3 (15%) patients experienced side-effects: 2 of them showed a large local reaction and 1 had headache and stomach ache. Specific IgE showed a significant (P = 0.001) increase after 6 months of treatment and then returned to baseline levels while specific IgG showed a significant (P = 0.001) increase after 6, 12 and 24 months in comparison with baseline. Nine patients were field-stung during the treatment: 8 of them experienced large local reactions; one patient (11%) experienced an SR (dizziness). Our results, even if in a small number of patients, suggest that in patients with Hymenoptera sting allergy SLIT could be efficacious with a good tolerability profile when compared to SCIT. Larger studies are needed to assess efficacy, safety and tolerability profile of wasp venom SLIT.
Authors:
G Patriarca; E Nucera; C Roncallo; A Aruanno; C Lombardo; M Decinti; L Pascolini; M Milani; A Buonomo; D Schiavino
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of immunopathology and pharmacology     Volume:  21     ISSN:  0394-6320     ISO Abbreviation:  Int J Immunopathol Pharmacol     Publication Date:    2008 Jul-Sep
Date Detail:
Created Date:  2008-10-03     Completed Date:  2008-11-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8911335     Medline TA:  Int J Immunopathol Pharmacol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  669-77     Citation Subset:  IM    
Affiliation:
Department of Allergology, Catholic University, Rome, Italy. allergologia@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Administration, Sublingual
Adolescent
Adult
Aged
Case-Control Studies
Desensitization, Immunologic*
Female
Humans
Hypersensitivity, Immediate / therapy*
Insect Bites and Stings / immunology
Male
Middle Aged
Pilot Projects
Prospective Studies
Wasp Venoms / immunology*
Chemical
Reg. No./Substance:
0/Wasp Venoms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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