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

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

Research output: Contribution to journalArticlepeer-review

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 - Sep 1992

Keywords

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

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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