Early markers for protective mechanisms during rush venom immunotherapy


  • Edited by: Hans-Uwe Simon

Prof. Dr. med. Natalija Novak, Department of Dermatology and Allergy, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany.
Tel.: +49 228 287 15370
Fax: +49 228 287 14333
E-mail: Natalija.Novak@ukb.uni-bonn.de


To cite this article: Bussmann C, Xia J, Allam J-P, Maintz L, Bieber T, Novak N. Early markers for protective mechanisms during rush venom immunotherapy. Allergy 2010; 65: 1558–1565.


Background:  Allergen-specific venom immunotherapy (VIT) represents the only rational-based option to treat allergic sensitizations against bee and wasp venom. So far, there is not much knowledge about early induction of protective and tolerogenic pathways during VIT.

Objectives:  To identify the earliest markers for protective mechanisms against allergic reactions in the peripheral blood during the build-up phase of VIT.

Methods:  PBMC and monocytes were isolated, and serum samples were taken before and during a five day build-up phase from 65 hymenoptera venom allergic patients. Expression level of tolerogenic markers was analyzed on mRNA and protein level. Serum levels of different soluble tolerogenic factors were measured.

Results:  We observed significantly enhanced tryptophan degradation, elevated ILT4 expression of monocytes as well as IL-10 production of CD3+ T cells only a few hours after the first injection on day 1, followed by increased IL-10 serum levels, monocyte apoptosis and elevated intracellular cAMP levels of monocytes on day 3 combined with a higher ILT3 protein expression and IL-10 secretion of monocytes on day 5.

Conclusion:  From these data, we conclude that tryptophan depletion, ILT3/4-mediated inhibition, higher IL-10 production as well as intracellular cAMP might contribute to early induction of protective mechanisms against allergic reactions during the build-up phase of VIT.