The Ige and IgG subclass antibody response in patients allergic to yellow jacket venom undergoing different regiments of venom immunotherapy

Abstract

We developed a three-layer immunoradiometric assay for quantitation of IgG antibodies of all four subclasses to YJV. We studied the IgE and IgG subclass antibody response to YJV in 31 patients allergic to YJV who were undergoing three different kinds of venom immunotherapy. Group A received weekly single injections with alum-adsorbed venon, group B received weekly clustered injections with aqueous venom, and group C received fortnightly clustered injections with aqueous venom during the increasing dose phase of our study. All patients received alum-adsorbed venom during maintenance therapy. Results from the first 6 months of observation are reported. After 6 months of therapy the IgE antibody level rose significantly in group A, was unchanged in group B, and tended to fall in group C. The fall in IgE antibody level in group C correlated significantly to the pretreatment IgE antibody level. The IgG subclass antibody assays measured IgG antibodies of different subclasses in comparable units. No IgG 2 or IgG 3 antibodies to YJV were found. Before the start of immunotherapy, 23 patients had significant concentrations of IgG 1 antibodies to YJV, and 14 had significant concentrations of IgG 4 antibodies. In group A the IgG 1 antibody level rose significantly after 6 months, and the IgG 4 antibody level rose significantly after 3 months. In group B the IgG 1 antibody level rose after 2 weeks and the IgG 4 antibody level rose after 3 weeks. In group C the IgG 1 antibody level rose after 2 weeks and the IgG 4 antibody concentration rose after 8 weeks. When the maintenance dose was reached, the IgG 1 antibody level in group C was significantly higher than that in group A. The possiblity that IgG 1 antibodies formed during venom immunotherapy take part in a feedback inhibition of the IgE antibody production is discussed.