IN VITRO APPROACH TO PROBLEMS OF CLINICAL ALLERGY

描述(改编自调查者摘要)：过去两年 几十年来，这笔赠款支持了一项研究，表明当时的 对昆虫过敏的治疗，全身提取物，是无效的，但 蛇毒免疫治疗是有效的。毒液免疫疗法在#年被接受 美国(美国)和全世界。在美国，所有患有AFP的成年患者 昆虫叮咬过敏史和毒液皮肤试验阳性 治疗过了。最近，荷兰的调查人员发现，如果它们叮咬 挑战病史阳性，皮试阳性患者，超过70人 他们认为，百分之百的人没有反应，也不需要治疗。美国留学 重新启动时发现的非反应堆较少。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 会不会对叮咬有反应。当前应用程序基于 假设荷兰的研究部分是正确的，它是正确的 没有必要治疗像我们现在这样多的病人。调查人员将 重复他们的工作并解决该研究中的一个缺陷-无论是单一的刺痛 预测对后续叮咬的反应。众所周知，在早期， 多年的免疫治疗，抗蛇毒抗体与临床相关 保护。假设这是一种关联，但不是一种 原因之一，临床保护是由其他方面造成的 免疫接种。用FEL-1多肽免疫猫过敏性个体 导致暴露在猫身上的不那么直接的过敏反应。这个 研究人员将用来自抗原5的多肽对患者进行免疫。 标准的蛇毒免疫疗法会导致严重的副作用： 在接受治疗的患者中，大约50%的人出现了从 对全身过敏反应的局部大反应。多肽免疫疗法起作用 不会立即引起反应，但在大约50%的患者中，有 晚期“过敏样”反应，严重程度明显轻于 对过敏原的反应。调查人员推测，这些 反应是由于HRF样细胞因子或直接致敏原引起的。 属性。他们已经制定了一项协议来确定这一事件的性质 回应。最后，这些研究的主要目标是利用 200多名患者开发参数来预测哪些人 会对叮咬有反应。虽然这还没有完成 以前，这是由于刺痛了少数未受保护的个人和 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，还有炎症细胞激活、细胞因子 生产，血液和尿组胺水平，以及血浆类胰蛋白酶和 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.