PDF(Pubmed)
Abstract：
BACKGROUND: Allergen immunotherapy remains a widely recognized and widely used method for the treatment of selected allergic diseases. Currently, according to the European Academy Of Allergy and Clinical Immunology (EAACI) guidelines, venom immunotherapy (VIT) may be considered for patients over 60. Nevertheless, no separate studies have confirmed the efficacy and safety of this therapy. This study aimed to evaluate the short-term effectiveness of VIT against wasp allergens in an ultra-rush protocol for older patients compared to young patients.
METHODS: Among the 113 patients included in this study, 51 were older than 60 years (Group A), and 62 formed the control \"young group\" (age range: 18-35 years). All patients were desensitized to wasp venom using the ultra-rush protocol according to Muller and aqueous solutions of vaccines containing wasp venom. A basophil activation test (Basotest, Orpegen Pharma, Germany) and intracutaneous tests with dilutions of wasp allergen and specific IgE to extract wasp venom were performed at the start and after six months of VIT. The safety of VIT was assessed on the basis of the international Mueller scale.
RESULTS: One hundred and eleven patients with confirmed wasp allergies completed six months of VIT: 51 participants over 60 years of age (Group A) and 60 young people (Group B). No systemic adverse reactions were observed during the VIT induction phase. However, large local reactions were noted in 17% of older patients and 20% of young patients at a similar level (p > 0.05). During maintenance VIT, two mild grade I systemic reactions were confirmed in young patients. These symptoms resolved spontaneously. There were no such reactions in older patients. The effectiveness of VIT was tested using BAT. There was a statistically significant reduction in CD63 reactivity in 86% of patients in Group A, and a comparable and substantial decrease in 84% of young patients in Group B. According to the BAT test, the mean reductions in the area under the curve (AUC) after six months of VIT were significant (p < 0.05) and comparable between Groups A and B: -6.52 vs. 7.21.
CONCLUSIONS: VIT against wasp venom is safe and effective in short-term observation, and is comparable to that used for young patients.
METHODS: Among the 113 patients included in this study, 51 were older than 60 years (Group A), and 62 formed the control \"young group\" (age range: 18-35 years). All patients were desensitized to wasp venom using the ultra-rush protocol according to Muller and aqueous solutions of vaccines containing wasp venom. A basophil activation test (Basotest, Orpegen Pharma, Germany) and intracutaneous tests with dilutions of wasp allergen and specific IgE to extract wasp venom were performed at the start and after six months of VIT. The safety of VIT was assessed on the basis of the international Mueller scale.
RESULTS: One hundred and eleven patients with confirmed wasp allergies completed six months of VIT: 51 participants over 60 years of age (Group A) and 60 young people (Group B). No systemic adverse reactions were observed during the VIT induction phase. However, large local reactions were noted in 17% of older patients and 20% of young patients at a similar level (p > 0.05). During maintenance VIT, two mild grade I systemic reactions were confirmed in young patients. These symptoms resolved spontaneously. There were no such reactions in older patients. The effectiveness of VIT was tested using BAT. There was a statistically significant reduction in CD63 reactivity in 86% of patients in Group A, and a comparable and substantial decrease in 84% of young patients in Group B. According to the BAT test, the mean reductions in the area under the curve (AUC) after six months of VIT were significant (p < 0.05) and comparable between Groups A and B: -6.52 vs. 7.21.
CONCLUSIONS: VIT against wasp venom is safe and effective in short-term observation, and is comparable to that used for young patients.
摘要：
背景：变应原免疫疗法仍然是一种广泛认可和广泛使用的用于治疗所选择的变应性疾病的方法。目前,根据欧洲过敏和临床免疫学会（EAACI）指南，对于60岁以上的患者，可以考虑使用毒液免疫疗法（VIT）。然而，没有单独的研究证实该疗法的有效性和安全性.这项研究旨在评估VIT对黄蜂过敏原的短期有效性，与年轻患者相比，老年患者的超急治疗方案。
方法：本研究纳入的113例患者中，51人年龄超过60岁（A组），62人组成对照“年轻组”（年龄范围：18-35岁）。根据Muller和含有黄蜂毒液的疫苗水溶液，所有患者均使用超快方案对黄蜂毒液脱敏。嗜碱性粒细胞激活试验(Basotest，OrpegenPharma,德国）和在VIT开始和六个月后进行了黄蜂过敏原和特异性IgE稀释以提取黄蜂毒液的皮内测试。VIT的安全性是根据国际穆勒量表进行评估的。
结果：111名确认黄蜂过敏的患者完成了六个月的VIT：51名60岁以上的参与者（A组）和60名年轻人（B组）。在VIT诱导阶段未观察到全身不良反应。然而,在17%的老年患者和20%的年轻患者中发现了类似水平的大的局部反应(p>0.05).在维护VIT期间，在年轻患者中证实了2例轻度I级全身反应.这些症状自发缓解。老年患者没有此类反应。使用BAT测试了VIT的有效性。在A组中，有86%的患者的CD63反应性在统计学上显著降低，根据BAT测试，B组中84％的年轻患者出现了相当大的下降，VIT六个月后曲线下面积（AUC）的平均减少是显着的（p<0.05），并且在A组和B组之间具有可比性：-6.52vs.7.21.
结论：VIT对黄蜂毒液的短期观察是安全有效的，与年轻患者的情况相当。
方法：本研究纳入的113例患者中，51人年龄超过60岁（A组），62人组成对照“年轻组”（年龄范围：18-35岁）。根据Muller和含有黄蜂毒液的疫苗水溶液，所有患者均使用超快方案对黄蜂毒液脱敏。嗜碱性粒细胞激活试验(Basotest，OrpegenPharma,德国）和在VIT开始和六个月后进行了黄蜂过敏原和特异性IgE稀释以提取黄蜂毒液的皮内测试。VIT的安全性是根据国际穆勒量表进行评估的。
结果：111名确认黄蜂过敏的患者完成了六个月的VIT：51名60岁以上的参与者（A组）和60名年轻人（B组）。在VIT诱导阶段未观察到全身不良反应。然而,在17%的老年患者和20%的年轻患者中发现了类似水平的大的局部反应(p>0.05).在维护VIT期间，在年轻患者中证实了2例轻度I级全身反应.这些症状自发缓解。老年患者没有此类反应。使用BAT测试了VIT的有效性。在A组中，有86%的患者的CD63反应性在统计学上显著降低，根据BAT测试，B组中84％的年轻患者出现了相当大的下降，VIT六个月后曲线下面积（AUC）的平均减少是显着的（p<0.05），并且在A组和B组之间具有可比性：-6.52vs.7.21.
结论：VIT对黄蜂毒液的短期观察是安全有效的，与年轻患者的情况相当。
