Kalogeromitros D, Makris M, Koti I, Chliva C, Mellios A, Avgerinou G, Theoharides T C
Allergy Clinical Research Center, Allergy Unit, Attikon University Hospital, Medical School, University of Athens, Greece.
Allergol Immunopathol (Madr). 2010 Mar-Apr;38(2):69-73. doi: 10.1016/j.aller.2009.08.002. Epub 2009 Oct 22.
Venom immunotherapy (VIT) is the only effective treatment for hymenoptera hypersensitivity, but conventional protocols require a few weeks.
We present the safety of a 3-day "rush" protocol that requires only 7 injections and 255 mgr cumulative dose before the 100 microg maintenance dose.
Forty-nine patients (33 males, 16 females) of mean age 43.57+/-12.9 yrs received "rush" VIT. Only 7 injections were required until the maintenance dose of 100 mgr was reached on Day 5. On Day 1, four injections were administered with initial dose of 5 mgr and total dose of 75 microg. On Day 3 a cumulative dose of 180 mgr was administered in three injections (40 mgr, 60 mgr and 80 mgr). A dose of 100 mgr was administered on Day 5. Twenty-nine individuals were treated with Honey-Bee venom; 18 with Common wasp; 5 with Paper Wasp; while 13 patients received Mixed Vespid preparation. Inclusion criteria were documented IgE-mediated allergy with intradermal sensitivity to < or =0.1 mgr/ml venom concentration and concomitant detection of specific venom IgE > or =0.35 kU/l.
All patients reached the maintenance dose. Forty-nine patients received 65 immunotherapy courses, resulting in 1520 injections. Thirty-three systemic reactions: 7 during building phase (1.5%); and 26 in the maintenance dose (2.4%) were observed in 9 patients. The percentage of reactions/total injection number was 2.2%; all reactions were mild-to-moderate. Fourteen patients reported documented field stings at least two months after VIT onset with only one reported mild systemic reaction.
We propose a simple "rush" VIT protocol in an outpatient setting as an easy-to-perform alternative option for VIT induction phase.
毒液免疫疗法（VIT）是治疗膜翅目昆虫过敏的唯一有效方法，但传统方案需要数周时间。
我们介绍一种为期3天的“快速”方案的安全性，该方案在100微克维持剂量前仅需7次注射，累积剂量为255毫克。
49例患者（33例男性，16例女性），平均年龄43.57±12.9岁，接受“快速”VIT治疗。在第5天达到100毫克维持剂量之前，仅需7次注射。第1天，注射4次，初始剂量为5毫克，总剂量为75微克。第3天，分3次注射累积剂量180毫克（40毫克、60毫克和80毫克）。第5天给予100毫克剂量。29例患者用蜜蜂毒液治疗；18例用普通黄蜂毒液治疗；5例用造纸黄蜂毒液治疗；13例患者接受混合胡蜂制剂治疗。纳入标准为有记录的IgE介导的过敏，皮内敏感性对毒液浓度≤0.1毫克/毫升，同时检测到特异性毒液IgE≥0.35千单位/升。
所有患者均达到维持剂量。49例患者接受了65个免疫治疗疗程，共注射1520次。观察到9例患者出现33次全身反应：7次在剂量递增阶段（1.5%）；26次在维持剂量阶段（2.4%）。反应次数/总注射次数的百分比为2.2%；所有反应均为轻度至中度。14例患者报告在VIT开始至少两个月后有野外蜇伤记录，仅1例报告有轻度全身反应。
我们提出一种在门诊环境中简单的“快速”VIT方案，作为VIT诱导期易于实施的替代选择。
