Clinical & Experimental Allergy

Tryptase and histamine release due to a sting challenge in bee venom allergic patients treated successfully or unsuccessfully with hyposensitization *

Authors


  • *

    This study was presented in part at the 49th annual Meeting of the American Academy of Allergy and Immunology, March 6–11, 1992, Orlando, USA.

Dr B. Eberlein-König, Dermatologische Klinik und Poliklinik der Ludwig-Maximilians-Universitat München, Frauenlobstraße 9–11, 80337 München, Germany.

Summary

Background: Hyposensitization with bee venom leads to full protection in most, but not all patients with IgE-mediated systemic reactions to bee stings.

Objective: To determine the relationship of clinical reactivity to the release of mediators and to changes of antibody concentrations in the peripheral circulation at a bee sting challenge test.

Methods: Blood was sampled before (0 min) and at 15, 60 and 180 min after a sting challenge from 19 patients on hyposensitization. Of these, six still reacted and 13 were protected. Histamine, mast cell tryptase, bee venom-specific IgE and IgG in the serum, and histamine release from peripheral blood leucocytes (PBL) upon exposure to bee venom were determined.

Results: Tryptase above the detection level was found only at 15 (60)min in 4/6 (1/6) patients who reacted. After the sting challenge there was a significant increase of the histamine levels in patients who reacted at 15 min (P < 0.05) and in patients who did react at 60 and 180 min (P < 0.01). The total histamine content of PBL was significantly decreased after 15 and 60 min in patients who reacted (P < 0.01) and in those that did not (P < 0.05). Bee venom-induced histamine release was significantly reduced in patients reacting and those that did not at 15 min (P / 0.05), and was significantly decreased in reactors also at 60 and 180 min (P < 0.05/0.01). Specific IgG antibodies showed a minor decrease (P < 0.05) after the sting challenge in both groups, whereas specific IgE did not change significantly.

Conclusion: These results indicate that bee venom anaphylaxis is associated with the release of mediators from both mast cells as well as basophils. Successful hyposensitization does not induce a state of immunological non-reactivity, but rather alters the magnitude and the pattern of mediator release.

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