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Possible dual role of anti-idiotypic antibodies in combined passive and active immunotherapy in honeybee sting allergy

1994; Elsevier BV; Volume: 93; Issue: 6 Linguagem: Inglês

10.1016/s0091-6749(94)70053-2

1097-6825

Yvan Boutin, Marie Jobin, Pierre-Michel Bédard, Michel Hébert, Jacques Hébert,

Allergic Rhinitis and Sensitization

Passive infusion of beekeepers' plasma was shown to protect patients against systemic reactions occurring during active immunotherapy by mechanisms still to be clarified. It is tempting to speculate that anti-idiotypic antibodies could play a role because they are found in beekeepers' plasma and are involved in the regulation of IgE synthesis.In this report we studied the effects of passive infusion of a beekeeper's plasma rich in anti-idiotypic antibodies to a patient who experienced systemic reactions to honeybee venom.We reported, during the days after the infusion, a decrease of clinical sensitivity to the honeybee venom. Indeed, the patient tolerated a cumulative dose of 280 micrograms of venom without adverse reactions. We also observed decreases in skin mast cell and in basophil sensitivity. After the plasma infusion, a modified rush immunotherapy with honeybee venom was initiated in our patient. In the following 76 weeks, increased levels of anti-idiotypic antibodies in the serum of the patient were associated with a diminution of specific antibodies (IgG and IgE) to honeybee venom.These results suggest a dual role of anti-id in our combined protocol of passive and active immunotherapy: an immediate action on clinical sensitivity along with a decrease of skin mast cell and basophil sensitivity and an immunoregulatory role on specific antibody production.