| Abstract: | Allergen immunotherapy results in protection against allergen challenge and in the production of allergen specific antibodies. We investigated the reaction to bee sting exposure and its relationship to the subclass of IgG-antibodies produced. 23 patients who had a history of systemic allergic reactions to bee stings were given 2-5 years courses of venom immunotherapy. 19 individuals tolerated a sting challenge 1, 2, and 3 years after the start of treatment, and after immunotherapy was discontinued. Four patients with persisting systemic reactions and 6 bee keepers served as controls. All detectable IgG-antibodies were restricted to subclass 1 and 4. In successfully treated patients the mean rise of IgG-subclass was 273%, and of IgG4 703%, compared to pretreatment levels. IgG4-antibodies were maintained at high levels in protected individuals when immunotherapy was discontinued. On the contrary, in non-protected individuals low IgG4-levels were observed. Specific IgG4-antibodies most closely reflect clinical protection from stings provided by immunotherapy or a repeated antigenic stimulation. |
