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

David B K Golden, Ira D. Lawrence, Robert G Hamilton, Anne Kagey-Sobotka, Martin D. Valentine, Lawrence M. Lichtenstein

Research output: Contribution to journalArticle

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 μg/ml or lower. Systemic symptoms occurred in only 1.6% of those with venom IgG more than 3 μg/ml, but in 16% of those with less than 3 μg/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.

Original languageEnglish (US)
Pages (from-to)386-393
Number of pages8
JournalThe Journal of Allergy and Clinical Immunology
Volume90
Issue number3 PART 1
DOIs
StatePublished - 1992

Fingerprint

Venoms
Immunotherapy
Immunoglobulin G
Maintenance
Antibodies
Bites and Stings
Wasp Venoms
Insect Bites and Stings
Immunologic Desensitization
Wasps
Anaphylaxis
Treatment Failure
Therapeutics

Keywords

  • anaphylaxis
  • Hymenoptera
  • IgG antibodies
  • immunotherapy
  • Insect-sting allergy
  • venom

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy

Cite this

Clinical correlation of the venom-specific IgG antibody level during maintenance venom immunotherapy. / Golden, David B K; Lawrence, Ira D.; Hamilton, Robert G; Kagey-Sobotka, Anne; Valentine, Martin D.; Lichtenstein, Lawrence M.

In: The Journal of Allergy and Clinical Immunology, Vol. 90, No. 3 PART 1, 1992, p. 386-393.

Research output: Contribution to journalArticle

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