[The key role of IgG4 subclass antibodies in the development of protection against XXXX to insect stings].

@entity1 @entity56 @entity5157
Allergen immunotherapy results in protection against allergen challenge and in the production of allergen specific antibodies. We investigated the reaction to @entity5157 sting exposure and its relationship to the subclass of IgG-antibodies produced. 23 @entity1 who had a history of @entity56 to @entity5157 stings were given 2-5 years courses of venom immunotherapy. 19 individuals tolerated a sting challenge 1, 2, and 3 years after the start of treatment, and after immunotherapy was discontinued. Four @entity1 with persisting systemic reactions and 6 @entity5157 keepers served as controls. All detectable IgG-antibodies were restricted to subclass 1 and 4. In successfully treated @entity1 the mean rise of IgG-subclass was 273%, and of IgG4 703%, compared to pretreatment levels. IgG4-antibodies were maintained at high levels in protected individuals when immunotherapy was discontinued. On the contrary, in non-protected individuals low IgG4-levels were observed. Specific IgG4-antibodies most closely reflect clinical protection from stings provided by immunotherapy or a repeated antigenic stimulation.
