PMID- 23176884
OWN - NLM
STAT- MEDLINE
DCOM- 20130424
LR  - 20121126
IS  - 1534-4436 (Electronic)
IS  - 1081-1206 (Linking)
VI  - 109
IP  - 6
DP  - 2012 Dec
TI  - Evaluation and validation of a bee venom sting challenge performed by a 
      micro-syringe.
PG  - 438-41
LID - S1081-1206(12)00669-2 [pii]
LID - 10.1016/j.anai.2012.09.003 [doi]
AB  - BACKGROUND: The honeybee sting challenge is considered a reliable procedure to 
      evaluate the efficacy of specific immunotherapy, but it is difficult and 
      unpractical to perform in clinical practice, because live insects are required. 
      OBJECTIVE: To assess the feasibility and reliability of a challenge test using a 
      micro-syringe, and compared the procedure with sting challenge. METHODS: Patients 
      on bee venom immunotherapy and without systemic reactions at field sting were 
      enrolled. They underwent a sting challenge with live bee, and large local 
      reactions were assessed up to 48 hours. Those patients displaying systemic 
      reactions at the sting challenge were excluded from the syringe challenge for 
      ethical reasons. The syringe challenge was done by injecting 0.5 muL fresh 
      unfiltered bee venom at 2 mm depth (the length of the sting left by a bee). The 
      same follow-up as at the first challenge was performed. Bee-specific 
      immunoglobulin E (IgE) and tryptase were measured after each challenge. RESULTS: 
      Nineteen patients underwent the sting challenge with live bees. Four had 
      immediate systemic reactions (urticaria or asthma) and were excluded from the 
      second challenge. The remaining 15 patients with large local reaction underwent 
      the syringe challenge. No significant difference was seen in the maximum area of 
      the large local reactions between the challenge with live bees and the syringe 
      challenge. Also, no change was seen in tryptase and specific antibodies. 
      CONCLUSION: This preliminary study suggests that the micro-syringe challenge with 
      honeybee venom is feasible and produces results indistinguishable from those of 
      the traditional sting challenge.
CI  - Copyright (c) 2012 American College of Allergy, Asthma & Immunology. Published by 
      Elsevier Inc. All rights reserved.
FAU - Cortellini, Gabriele
AU  - Cortellini G
AD  - Internal Medicine and Rheumatology, Rimini Hospital, Italy.
FAU - Severino, Maurizio
AU  - Severino M
FAU - Francescato, Elisabetta
AU  - Francescato E
FAU - Turillazzi, Stefano
AU  - Turillazzi S
FAU - Spadolini, Igino
AU  - Spadolini I
FAU - Rogkakou, Anthi
AU  - Rogkakou A
FAU - Passalacqua, Giovanni
AU  - Passalacqua G
LA  - eng
PT  - Journal Article
DEP - 20121010
PL  - United States
TA  - Ann Allergy Asthma Immunol
JT  - Annals of allergy, asthma & immunology : official publication of the American 
      College of Allergy, Asthma, & Immunology
JID - 9503580
RN  - 0 (Bee Venoms)
RN  - 37341-29-0 (Immunoglobulin E)
RN  - EC 3.4.21.59 (Tryptases)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Animals
MH  - Bee Venoms/*administration & dosage/adverse effects/*immunology
MH  - Bees
MH  - Female
MH  - Humans
MH  - Immunoglobulin E/immunology
MH  - Immunotherapy/methods
MH  - Insect Bites and Stings/*immunology
MH  - Male
MH  - Middle Aged
MH  - *Syringes
MH  - Tryptases/immunology
EDAT- 2012/11/28 06:00
MHDA- 2013/04/25 06:00
CRDT- 2012/11/27 06:00
PHST- 2012/07/13 00:00 [received]
PHST- 2012/09/05 00:00 [revised]
PHST- 2012/09/05 00:00 [accepted]
PHST- 2012/11/27 06:00 [entrez]
PHST- 2012/11/28 06:00 [pubmed]
PHST- 2013/04/25 06:00 [medline]
AID - S1081-1206(12)00669-2 [pii]
AID - 10.1016/j.anai.2012.09.003 [doi]
PST - ppublish
SO  - Ann Allergy Asthma Immunol. 2012 Dec;109(6):438-41. doi: 
      10.1016/j.anai.2012.09.003. Epub 2012 Oct 10.