Jutel M, Pichler W J, Skrbic D, Urwyler A, Dahinden C, Müller U R
Ziegler Hospital, Bern, Switzerland.
J Immunol. 1995 Apr 15;154(8):4187-94.
The mechanisms of bee venom immunotherapy (VIT) are largely unknown. The aim of this study was to follow the changes of T cell cytokine secretion during the course of VIT. Ten bee venom-allergic patients with a history of severe systemic reactions, positive skin tests, and bee venom (BV)-specific serum IgE Abs were treated as follows: on the first day, a cumulative dose of 111 micrograms, starting with 0.1 microgram, was administered s.c. under intensive care conditions. Further injections of 100 micrograms BV were given on day 7, day 21, and thereafter at intervals of 4 wk. Blood samples were obtained just before the initiation of VIT, after the last injection on the same day, and before the subsequent BV injections on days 7, 21, and 50 of VIT. Peripheral blood mononuclear cells (PBMC) were stimulated with phospholipase A (PLA), the major BV allergen, or with a control Ag tetanus toxoid (TT). Cytokine secretion was measured 24 h after restimulation of the cultures with solid-phase bound OKT3 F(ab')2 mAbs after 7 days of culture. In PLA-stimulated cultures, VIT resulted in decreased IL-4 and IL-5 and increased IFN-gamma secretion. In TT-stimulated cultures, we observed similar levels of cytokines before and during VIT. We conclude that ultra-rush VIT changes allergen-specific T cell reactivity.
蜂毒免疫疗法（VIT）的机制在很大程度上尚不清楚。本研究的目的是追踪VIT过程中T细胞细胞因子分泌的变化。十名有严重全身反应史、皮肤试验阳性且有蜂毒（BV）特异性血清IgE抗体的蜂毒过敏患者接受如下治疗：第一天，在重症监护条件下皮下注射累积剂量为111微克，起始剂量为0.1微克。在第7天、第21天以及此后每隔4周注射100微克BV。在VIT开始前、同一天最后一次注射后以及VIT第7天、第21天和第50天后续BV注射前采集血样。用主要的BV变应原磷脂酶A（PLA）或对照抗原破伤风类毒素（TT）刺激外周血单核细胞（PBMC）。培养7天后，用固相结合的OKT3 F(ab')2单克隆抗体再次刺激培养物，24小时后测量细胞因子分泌。在PLA刺激的培养物中，VIT导致IL-4和IL-5分泌减少，IFN-γ分泌增加。在TT刺激的培养物中，我们观察到VIT之前和期间细胞因子水平相似。我们得出结论，超快速VIT改变了变应原特异性T细胞反应性。
