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Review
. 2020 Jan 7:13:1-10.
doi: 10.2147/JAA.S200917. eCollection 2020.

Clinical Utility of Rush Venom Immunotherapy: Current Status

Vianney Gruzelle  1 , Claire Mailhol  2   3 , David W Waters  4 , Laurent Guilleminault  2   4
Affiliations
Review

Clinical Utility of Rush Venom Immunotherapy: Current Status

Vianney Gruzelle et al. J Asthma Allergy. .

Abstract

Hymenoptera venom allergy (HVA) is the leading cause of anaphylactic reactions in adults and the second most common cause in children. Venom immunotherapy (VIT) is used to elicit an immune tolerance against hymenoptera venom in allergic patients and is based on the administration of purified venom extracts regularly for defined periods. The protocols of administration include 2 phases: an up-dosing phase that incrementally reaches the final dose resulting in a protective effect, and a maintenance phase in order to obtain the sustained effect. The goal of this review is to detail the efficacy and the safety of the up-dosing phase also named rush. Pathophysiological mechanisms, indications of VIT and technical aspects of up-dosing protocol are also covered.

Keywords: allergy; hymenoptera; immunotherapy.

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Conflict of interest statement

LG declares financial and non-financial support from ALK, during the conduct of this work. CM declares non-financial support from ALK. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Mechanisms of immunotherapy. The switch from allergen-specific Th2 cells to Tregs is a key event during venom immunotherapy. Tregs secrete IL-10 and TGFβ; these mediators suppress the degranulation of mast cells and basophils and reduce FcεRI expression and function. IL-10 and TGFβ also inhibit IgE production by B cells and drive the switch to the non-inflammatory isotypes IgA and IgG.
See this image and copyright information in PMC

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