Clinical and immunologic effects of H1 antihistamine preventive medication during honeybee venom immunotherapy

Müller, Ulrich R; Jutel, Marek; Reimers, Andrea; Zumkehr, Judith; Huber, Clarissa; Kriegel, Carola; Steiner, Urs; Haeberli, Gabrielle; Akdis, Mübeccel; Helbling, Arthur; Schnyder, Benno; Blaser, Kurt; Akdis, Cezmi (2008). Clinical and immunologic effects of H1 antihistamine preventive medication during honeybee venom immunotherapy. Journal of allergy and clinical immunology, 122(5), 1001-1007.e4. St. Louis, Mo.: Mosby 10.1016/j.jaci.2008.08.007

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BACKGROUND: H1 antihistamines increase safety during allergen-specific immunotherapy and might influence the outcome because of immunoregulatory effects. OBJECTIVE: We sought to analyze the influence of 5 mg of levocetirizine (LC) on the safety, efficacy, and immunologic effects of ultrarush honeybee venom immunotherapy (BVIT). METHOD: In a double-blind, placebo-controlled study 54 patients with honeybee venom allergy received LC or placebo from 2 days before BVIT to day 21. Side effects during dose increase and systemic allergic reactions (SARs) to a sting challenge after 120 days were analyzed. Allergen-specific immune response was investigated in skin, serum, and allergen-stimulated T-cell cultures. RESULTS: Side effects were significantly more frequent in patients receiving placebo. Four patients receiving placebo dropped out because of side effects. SARs to the sting challenge occurred in 8 patients (6 in the LC group and 2 in the placebo group). Seven SARs were only cutaneous, and 1 in the placebo group was also respiratory. Difference of SARs caused by the sting challenge was insignificant. Specific IgG levels increased significantly in both groups. Major allergen phospholipase A(2)-stimulated T cells from both groups showed a slightly decreased proliferation. The decrease in IFN-gamma and IL-13 levels with placebo was not prominent with LC, whereas IL-10 levels showed a significant increase in the LC group only. Decreased histamine receptor (HR)1/HR2 ratio in allergen-specific T cells on day 21 in the placebo group was prevented by LC. CONCLUSIONS: LC reduces side effects during dose increase without influencing the efficacy of BVIT. LC modulates the natural course of allergen-specific immune response and affects the expression of HRs and cytokine production by allergen-specific T cells.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology, Clinical Immunology and Allergology

UniBE Contributor:

Steiner, Urs Christian; Helbling, Arthur and Schnyder, Benno

ISSN:

0091-6749

ISBN:

18845330

Publisher:

Mosby

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:04

Last Modified:

17 Mar 2015 22:17

Publisher DOI:

10.1016/j.jaci.2008.08.007

PubMed ID:

18845330

Web of Science ID:

000260940100021

URI:

https://boris.unibe.ch/id/eprint/27648 (FactScience: 109794)

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