Department of Immunology and Allergy, Gulhane Training and Research Hospital, Ankara, Turkey.
Ann Med. 2022 Dec;54(1):2321-2325. doi: 10.1080/07853890.2022.2112969.
Venom immunotherapy (VIT) is an effective treatment in the patients at high risk of anaphylaxis or life-threatening systemic reactions due to Hymenoptera venom allergy. But, systemic and large local reactions can be observed, especially during the build-up phase of VIT. We evaluated the safety of conventional and ultra-rush build-up protocols.
Two protocols in 71 patients (39 conventional and 32 ultra-rush protocols) with honeybee and wasp venom allergy were evaluated retrospectively. Patients were diagnosed and selected for VIT according to the criteria established by the European Academy of Allergy and Clinical Immunology. The severity of systemic reactions was evaluated according to the criteria of Mueller.
Build-up phases were tolerated in 66.2% ( = 47) without any reaction. Allergic adverse reactions were observed in 33.8% ( = 24): large local reactions 22.5% ( = 16) and systemic reactions 11.3% ( = 8). There was no significant difference in the number of adverse reactions comparing patients receiving conventional and ultra-rush protocol. In addition, no association was found between allergic adverse reactions and the following factors: sex, previous systemic sting reactions, honeybee and wasp venom extract.
We found that both protocols were tolerated in patients with honeybee and wasp venom allergy. Ultra-rush protocol will be preferred for patients and clinicians because of its advantages in terms of time and costs.KEY MESSAGESVIT is the only curative treatment method that reduces the risk of severe reactions after a bee sting and improves the quality of life in patients with Hymenoptera venom allergy.Ultra-rush VIT protocol has advantages such as few injection and time savings.Both ultra-rush and conventional VIT are safe treatments to prevent potentially life-threatening reactions in patients with honeybee and wasp venom allergy.
毒液免疫疗法（VIT）是治疗因蜂类毒液过敏而有发生过敏反应或危及生命的全身性反应风险的高危患者的有效方法。但是，特别是在 VIT 的递增阶段，可能会观察到全身性和局部大反应。我们评估了常规和超快速递增方案的安全性。
对 71 例（39 例常规方案和 32 例超快速方案）患有蜜蜂和黄蜂毒液过敏的患者进行回顾性评估。根据欧洲过敏与临床免疫学会制定的标准，对患者进行诊断和选择进行 VIT。根据 Mueller 的标准评估全身性反应的严重程度。
66.2%（=47）的递增阶段无任何反应，耐受性良好。33.8%（=24）观察到过敏不良反应：局部大反应 22.5%（=16）和全身性反应 11.3%（=8）。比较接受常规和超快速方案的患者，不良反应的数量没有差异。此外，过敏不良反应与以下因素之间没有关联：性别、以前的全身性蜇伤反应、蜜蜂和黄蜂毒液提取物。
我们发现常规和超快速方案均能被蜜蜂和黄蜂毒液过敏患者耐受。由于其在时间和成本方面的优势，超快速方案将优先用于患者和临床医生。
VIT 是唯一能降低蜜蜂蜇伤后发生严重反应风险并改善蜂类毒液过敏患者生活质量的治愈性治疗方法。超快速 VIT 方案具有注射次数少和节省时间等优点。超快速和常规 VIT 都是安全的治疗方法，可以预防蜜蜂和黄蜂毒液过敏患者潜在危及生命的反应。
