Monitoring honeybee venom immunotherapy in children with the basophil activation test

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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.

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