In Vitro Approach To Problems of Clinical Allergy

描述（由申请人提供）：35年来，这项赠款一直支持 涉及过敏性疾病治疗的研究。在过去的25年里， 我们的重点是昆虫过敏。1976年，我们证明了当时的标准 治疗免疫疗法，与全身提取物，没有什么不同， 安慰剂，而用毒液治疗消除了刺痛反应。毒液 免疫疗法迅速成为标准。指导方针要求所有历史 阳性，皮试阳性患者接受毒液免疫治疗，但这 涉及全美3%的公民欧洲工人报告说， 大约8年前，75%的黄蜂过敏个体， 皮试对蜇伤没有反应。我们已经证实了这项工作。我们目前 目标建立在我们最近开发的实验室测试的基础上 预测98%的病人不会有反应 我们希望继续开展这项工作，以发展实验室测试， 会对斯汀做出反应我们受到低反应速率的限制， 与宾夕法尼亚州农村的一位同事联手， 患者我们还将尝试更接近现场刺痛， 通常发生在患者锻炼时。更好的是，我们将努力 看看我们能不能用高浓度的毒液来模拟螫刺 与毒液中的血管扩张剂，如组胺和激肽。我们 我最近发现，目前的诊断方法，那就是皮肤的毒液 测试和RAST，是不够的。病史阳性，皮试阳性， 阴性患者对蜇伤的反应率相同我们将尝试 通过透析和/或使用纯化的 黄夹克的主要过敏原，Ves v 5。我们希望将研究扩展到 大的局部反应，其发生率是全身反应的3-5倍 反应.在大约三分之一的此类患者中，反应充分 需要类固醇药物治疗的痛苦。我们打算证明， 免疫疗法可以消除这种反应。 最后，我们与Dynavax Technologies公司合作， 公司 *，该公司已表明，过敏原与细菌 含有CpG基序的寡核苷酸具有降低的变应原性， 将Th 2型转化为Th 1型反应。因为有50%的全身反应 率环毒免疫疗法，我们希望更少的伤害和更有效的 免疫治疗的材料。最后，我们最近的研究表明， 并非所有患者都可以在5年后停止毒液免疫治疗， 目前的建议，并不是所有的儿童都能摆脱昆虫过敏。 我们需要继续研究这些患者，以开发最有用的临床 指南

DESCRIPTION (provided by applicant): For 35 years, this grant has supported studies involving the treatment of allergic diseases. For the last 25 of these, our focus has been on insect allergy. In 1976, we showed that the then standard treatment immunotherapy, with whole body extract, was no different than placebo, whereas treatment with venoms eliminated the reaction to sting. Venom immunotherapy rapidly became standard. Guidelines call for all history positive, skin test positive patients to receive venom immunotherapy, but this involves fully 3% of all United States citizens. European workers reported, about 8 years ago, that fully 75% of vespid allergic individuals with positive skin tests would not react to sting. We have confirmed that work. Our present goals build on the fact that we have very recently, developed laboratory tests which predict 98% of those patients who will not react. We would like to continue that work to develop laboratory tests, which identify who will react on sting. We are limited by the low reaction rate and so have joined forces with a colleague in rural Pennsylvania to obtain additional patients. We will also try to more closely approximate the field sting which usually takes place when patients are exercising. Even better, we will try to see if we can mimic a sting using very high concentrations of venom together with the vasodialators which are in venoms, such as histamine and kinins. We have recently found that the current diagnostic methods, that is the venom skin test and RAST, are not adequate. History positive, skin test positive and negative patients have the same rate of reactions to sting. We will tempt to improve the skin test material by dialysis and/or working with the purified major allergen of yellow jackets, Ves v 5. We hope to extend our studies into large local reactions, which occur 3-5 times more commonly than systemic reactions. In about one-third of such patients, the reactions are sufficiently painful to require medication with steroids. We intend to demonstrate that immunotherapy will ablate this type of reaction. Finally, we are collaborating with a company, Dynavax Technologies Corporation*, which has shown that allergens linked to bacterial oligonucleotides containing the CpG mot have decreased allergenicity and changed a Th2- to a Th1-like response. Since there is a 50% systemic reaction rate ring venom immunotherapy, we would like less harmful and more effective materials for immunotherapy. Finally, our most recent studies have shown that not all patients can discontinue venom immunotherapy after 5 years, which is the current recommendation, and that not all children outgrow insect allergy. We need to continue to study these patients to develop the most useful clinical guidelines.