|
|
 |
It's SLIT's-ville for HoneyBee Allergy
Sublingual immunotherapy for large local reactions caused by honeybee sting: A double-blind, placebo-controlled trial
Maurizio G. Severino, MD, Gabriele Cortellini, MD, Patrizia Bonadonna, MD, Elisabetta Francescato, PhD, Ilaria Panzini, PhD, Donatella Macchia, MD, Paolo Campi, MD, Igino Spadolini, MD, Walter G. Canonica, MD, and Giovanni Passalacqua, MD
Venom from biting insects, such as bees, wasps, hornets or fire ants, sometimes causes painful allergic swelling around the sting. Larger, local allergic reactions will often involve almost the entire hand, foot, arm, leg or other area of the sting. The risk of a systemic reaction in patients who experience large local reactions is no more than 5% to 10%. For a small number of people who are very allergic to venom, insect stings can be life-threatening. In such serious reactions, anaphylactic episodes account for at least 40 deaths each year in the United States.
The authors of this study, published in the July 2008 issue of the Journal of Allergy and Clinical Immunology, break new ground by offering a proof-of-concept clinical trial evaluating the potential effects of sublingual immunotherapy (SLIT) on large local reactions caused by honeybee sting. Seeking to assess whether SLIT might potentially be beneficial in treating hymenoptera allergy, a sting challenge was used to test this hypothesis in patients who had had large local reactions (LLRs) and were at a lower risk of systemic or life-threatening reactions.
The surprising thing about this study is not the effect of SLIT on LLRs caused by honeybee stings, but that people volunteered to be stung by bees as part of the study! The bees were captured while foraging for food (to reduce their aggressive behavior) and chilled for 1-2 days to slow them down a bit. Within 60 seconds of re-warming, they become fully active for the sting challenge. The bee sting was applied with a device used for this very purpose and once stinging had occurred the insect was held in that position for 10 seconds and then removed. Ouch!
In this small study, the patients receiving active SLIT therapy showed a significant reduction in the extent of large local reactions compared to those receiving placebo. Because the reduction of LLR was clear-cut, this outcome suggests that SLIT might potentially also be of benefit in Hymenoptra/Venom Allergy. Although encouraging, the results of this study that uses an experimental model represent only a first step. There is so far no study assessing the effects of SLIT in systemic IgE-mediated reactions, and trials in dose-ranging and systemic reactions are needed.
<back>
|
Contact
Home
