IN VITRO APPROACH TO PROBLEMS OF CLINICAL ALLERGY

描述（改编自研究者摘要）：在过去两年中 几十年来，这项赠款支持的研究表明，当时的电流 治疗昆虫过敏，全身提取物，是无效的，但 蛇毒免疫治疗有效。 毒液免疫疗法被接受， 美国（US）和全世界。 在美国，所有患有 昆虫叮咬过敏史和毒液皮肤试验阳性 治疗。 最近，荷兰的调查人员发现， 攻毒史阳性、皮试阳性患者70余例 %的人没有反应，他们认为不需要治疗。 美国研究 发现静止状态下的无反应者更少 无论是美国还是荷兰 研究人员已经开发出诊断参数来预测哪些患者 会不会对蜇伤有反应 当前应用程序基于 假设荷兰的研究部分是正确的， 不需要像现在这样治疗这么多病人。 调查人员将 重复他们的工作，并解决该研究中的一个缺陷-无论是一个单一的刺痛 预测了被蜇后的反应 据了解，在早期 多年的免疫治疗，IgG抗蛇毒抗体与临床 保护 假设这是一种关联，但不是一种 因果关系之一，临床保护的结果从一些其他方面， 次免疫 用Fel d 1肽免疫猫过敏个体 导致接触猫时的立即过敏反应较少。 的 研究人员将用来自抗原5的肽免疫患者。 使用毒液的标准免疫疗法会导致显著的副作用： 大约50%的治疗者有反应， 对全身过敏反应的大的局部反应。 肽免疫疗法 不会立即引起反应，但在大约50%的患者中， 迟发性“过敏样”反应，严重程度明显轻于 对过敏原的反应 研究人员推测，这些 反应是由于HRF样细胞因子或一个直接过敏原 特性. 他们已经制定了一个协议来确定这一性质 反应 最后，这些研究的主要目标是利用 200多名患者开发参数，预测哪些人 会对蜇伤有反应 虽然这一目标尚未实现， 在此之前，这是由于刺痛少数未受保护的个体， 测量有限数量的参数。 现在计划研究 不仅是免疫球蛋白水平， 生产，血液和尿液组胺水平，血浆类胰蛋白酶和 纤维蛋白原水平。

DESCRIPTION (Adapted from Investigator's abstract): Over the last two decades this grant has supported studies showing that the then current therapy for insect allergy, whole body extracts, was not effective but that venom immunotherapy was effective. Venom immunotherapy became accepted in the United States (US) and worldwide. In the US, all adult patients with a history of anaphylaxis on insect sting and a positive venom skin test are treated. Recently, investigators in Holland found that if they sting challenge history positive, skin test positive patients, more than 70 percent have no reaction and, they contend, need no therapy. US studies found fewer non-reactors on re-sting. Neither the US nor the Dutch investigators have developed diagnostic parameters to predict which patients will or will not react on stings. The current application is based on the hypothesis that the Dutch study is, in part, correct and that it is unnecessary to treat as many patients as we do now. The investigators will repeat their work and address a flaw in that study - whether a single sting predicts the reaction to subsequent stings. It is known that in the early years of immunotherapy, IgG anti-venom antibodies correlate with clinical protection. It is hypothesized that this is an association, but not a causal one, and that clinical protection results from some other aspect of immunization. Using Fel d 1 peptides to immunize cat allergic individuals leads to a lesser immediate allergic response on exposure to cats. The investigators will immunize patients with peptides from antigen 5. Standard immunotherapy with venom leads to significant side-effects: approximately 50 percent of those treated have reactions ranging from a large local response to systemic anaphylaxis. Peptide immunotherapy does not cause immediate reactions, but in about 50 percent of patients, there is a late "anaphylactic-like" response, significantly milder in severity than the reactions to the allergen. The investigators hypothesize that these reactions are due to a HRF-like cytokine or one with direct anaphylactogenic properties. They have developed a protocol to ascertain the nature of this response. Finally, the major goal of these studies is to use the stings of more than 200 patients to develop parameters that predict which individuals will have a reaction to a sting. While this has not been accomplished before, this was due to stinging few unprotected individuals and the measurement of a limited number of parameters. It is now planned to study not only immunoglobulin levels but inflammatory cell activation, cytokine production, blood and urine histamine levels, and plasma tryptase and fibrinogen levels.