SummaryBackgroundrapid administration of bee venom in cumulative doses exceeding the quantity contained in one bee sting is well tolerated by most of the patients during 3.5 h of ultra‐rush bee venom immunotherapy (VIT). The mechanism of this tolerance is unknown.ObjectiveThe aim of the study was to verify the hypothesis that either slow mediator depletion of mast cells or blockade of their surface receptor mechanisms by increasing doses of allergen might be the major mechanisms of tolerance induced by ultra‐rush VIT.MethodsNine bee venom allergic patients with a history of severe systemic reactions after a bee sting, positive skin tests and bee venom specific serum IgE antibodies were treated as follows: on the first day a cumulative dose of 111 μg was administered over 3.5 h under intensive care conditions. Further injections were given on day 7, day 21 and thereafter at 4 week intervals, Intradermal tests with codeine phosphate (nonspecific mast cell degranulation) and bee venom were performed before the initiation of VIT and 30 min after the last injection on the same day as well as before the subsequent bee venom injections.ResultsNo significant changes of skin reactivity to both codeine phosphate and bee venom were observed on day I (before initiation of VIT and after the last injection on the same day).ConclusionsUltra‐rush VIT does not induce mediator depletion or surface receptor blockade in skin mast
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机译:摘要背景在超急蜂毒免疫疗法 (VIT) 的 3.5 小时内,大多数患者以超过一次蜂蜇所含量的累积剂量快速施用蜂毒,耐受性良好。这种耐受性的机制尚不清楚。目的本研究旨在验证以下假设:通过增加过敏原剂量来减缓肥大细胞介质耗竭或阻断其表面受体机制可能是超急 VIT 诱导的主要耐受机制。方法选取9例蜂毒过敏患者,蜂蜇伤后有严重全身反应史,皮肤试验阳性,血清IgE抗体检测结果为:第一天,在重症监护条件下给予111μg累积剂量3.5 h。在第 7 天、第 21 天及之后每隔 4 周进行一次进一步注射,在 VIT 开始前和当天最后一次注射后 30 分钟以及随后的蜂毒注射之前进行磷酸可待因(非特异性肥大细胞脱颗粒)和蜂毒皮内试验。结果在第 I 天(VIT 开始前和同一天最后一次注射后)未观察到皮肤对磷酸可待因和蜂毒的反应性发生显着变化。结论Ultra‐rush VIT不诱导皮肤肥大介质耗竭或表面受体阻断
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