Allergologia et immunopathologia
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Allergol Immunopathol (Madr) · Sep 2005
Case ReportsImmunologic and clinical responses to parenteral immunotherapy in peanut anaphylaxis--a study using IgE and IgG4 immunoblot monitoring.
Specific desensitisation to food allergens, which produce anaphylaxis after ingestion, has not been considered as a treatment for food allergy until recently. The purpose of this study was to assess if a parenteral immunotherapy program, using a partially characterised crude peanut extract, could induce a state of immunological tolerance in a patient who exhibited anaphylaxis, asthma and urticaria on exposure to peanut and other legumes. A further aim was to measure the serum antibody responses to the immunotherapy. ⋯ Parenteral immunotherapy may offer an alternative treatment to lifelong dietary restriction and epinephrine injections in patients who exhibit life-threatening IgE-mediated anaphylaxis to peanut. Cross desensitisation to other legumes appears to have occurred in this study. The quality and potency of the extract used is an important factor in achieving the desired acquisition of clinical tolerance. In our patient this tolerance correlated with his ability to maintain high levels of specific IgG4, which acted as a marker of protection against anaphylaxis. The use of IgG4 immunoblotting may provide an improved level of discrimination in the assessment of correlation of clinical efficacy with the immunologic response.