Background and Objective. Various venom immunotherapy (VIT) protocols are available for Hymenoptera allergy. Although adverse reactions (ADRs) to VIT are widely reported, controlled trials are still needed. We conducted a randomized prospective study to evaluate ADRs and the efficacy of three VIT regimens. Methods. 76 patients with Hymenoptera allergy, aged 16–76 years, were randomized to receive an ultrarush protocol (group A: 27 patients), a rush protocol (group B: 25), or a slow protocol (group C: 24). Aqueous venom extract was used in incremental phase and an adsorbed depot in maintenance phase. ADRs and accidental Hymenoptera stings during VIT were used to evaluate efficacy. Results. During incremental treatment, ADRs occurred in 1.99%, 3.7%, and 3.9% of patients in groups A, B, and C, and in 0.99%, 1.46%, and 2.7%, respectively, during maintenance. ADRs were significantly fewer in group A (incremental + maintenance phase) than in group C (1.29% versus 3.2%; P = 0.013). Reactions to accidental Hymenoptera stings did not differ among groups (1.1%, 1.2%, and 1.1%). Conclusion. Ultrarush was as effective as the rush and slow protocols and was associated with a low incidence of reactions to stings. This study indicates that ultrarush VIT is a valid therapeutic option for Hymenoptera allergy.

Oxidative stress occurs in many allergic and immunologic disorders as a result of the imbalance between the endogenous production of free reactive oxygen species (ROS) and/or the reduction of antioxidant defense mechanisms. Advanced glycation end products (AGEs), advanced oxidation protein products (AOPPs), and nitrosylated proteins (NPs) can be used as markers of oxidative stress and inflammation. Our objective was to examine the serum levels of AGEs, AOPPs, and NPs in patients with allergic reactions to hymenoptera venom before and after ultrarush venom immunotherapy (VIT). The study included two groups of patients: 30 patients allergic to yellow jacket or honey bee venom and treated by aqueous preparation of Vespula spp (26 patients) or Apis mellifera (four patients) VIT, and 30 healthy donors as controls. Blood samples were collected to measure serum levels of AGEs, AOPPs, and NPs at baseline (T1), at the end of the incremental phase of the VIT protocol (T2), and after 15 days (T3). Serum AOPP levels at T1 were significantly higher in comparison with controls (p = 0.001), whereas serum levels of NPs at T1 were significantly lower than those in controls (p < 0.0001). No significant difference in circulating levels of AOPPs, AGEs, and NPs was found during immunotherapy. These findings suggest that, although hymenoptera venom allergy (HVA) is characterized by isolated episodes of reactions to stinging insect venom and is not included among chronic inflammatory diseases, an oxidative stress status occurs in patients suffering from this kind of allergy. Furthermore, VIT does not modify serum levels of these oxidative stress biomarkers.

BackgroundGeneral opinion on pathogenesis and prevalence of bronchial asthma indicates that age and sex are the major risk factors. Detailed physiological mechanisms of the changing sex ratio are not fully known.Aims and objectivesInvestigate the influence the asthmatic patients treated with anti-IgE with different gender.MethodsHere, we pooled data from ten published studies from 1999 with more of our unpublished data of patients with severe persistent asthma treated with omalizumab, an anti-immunoglobulin E (IgE) monoclonal antibody. Static analysis was used to find gender risk factors as the ratio of treatment effect (omalizumab: control) on the standardized exacerbation rate per year.ResultsThe studies included 3270 patients (treated with omalizumab), whose had severe persistent asthma according to the Global Initiative for Asthma (GINA) classification. Analysis of 2 groups male versus female showed that the efficacy of omalizumab on asthma exacerbations was unaffected by patient age, gender, baseline serum IgE (split by median) or by 2- or 4-weekly dosing schedule, although a more large number of women were treated (1921/1349; 59 % women vs 41% men; P < 0.001) and benefit in absolute terms appeared to be greatest in women patients which had a more severe asthma, defined by a lower value of percentage predicted forced expiratory volume in 1 second (FEV1) at baseline, this subgroup showed odds of being a responder (composite definition) 1.25 times higher (95% CI, 1.18-3.01) than men.ConclusionsThese results suggest that in population of asthmatics treated with anti-IgE the number of women is shown higher than men, it confirms that asthma should be considered with different approach by the gender for being adequately controlled on current therapy.