Is the BAT Inhibition Able to Replace Sting Challenges? (BATIRS)
Is the BAT Inhibition Able to Replace Sting Challenges? (BATIRS)
Insect venom allergy is the major cause for severe allergic reactions in Europe. Wasps and
 honeybees are responsible for the majority of these allergic reactions. Symptoms range from
 generalized skin symptoms (wheals, swellings) to respiratory or cardiovascular problems such
 as asthma, dizziness, loss of consciousness, or cardiac arrest. The regular administration of
 insect venom ('venom immunotherapy') over up to 5 years is a well-established therapy,
 providing long-term protection from further systemic sting reactions in the majority of
 patients. However, there is no laboratory test which is able to identify patients who will
 still react to an insect sting. The only reliable method available is stinging patients with
 living insects ('sting challenges'). The key issue is that only few centers in Europe perform
 sting challenges and many patients have no access to these tests. Therefore, it is of utmost
 importance to find a method which is able to identify patients who are still at risk for
 future allergic sting reactions.

 The inhibition of the basophil activation test (BAT) could be a potential method to monitor
 the effectiveness of immunotherapy. Basophils are cells which are activated in acute allergic
 reactions. The basophil activation of blood donors with vespid venom allergy can be measured
 after adding sera from allergic patients undergoing immunotherapy. In a preliminary study we
 found that the activation of basophils could be inhibited in all patients treated with vespid
 venom, however, results must be confirmed in a larger study.

 In this study, a total of 219 patients with vespid venom allergy will be included. Those
 patients who are receiving or who have already finished venom immunotherapy will be sting
 challenged and blood samples will be taken to perform BAT inhibition experiments. At the same
 time, donors with confirmed vespid venom allergy, who have not undergone immunotherapy, will
 be recruited for a blood donation, which is necessary for the BAT inhibition tests.

 If results of the preliminary study could be confirmed, the BAT inhibition will facilitate
 monitoring the effectiveness of venom immunotherapy and patients would benefit from an early
 detection of lacking tolerance and consequently from the increased venom dose preventing
 future life threatening systemic sting reactions.
Inclusion Criteria:

 -  Legally competent male and female subjects who are currently treated or who have been
 treated with vespid venom immunotherapy

 -  Age ≥18 and ≤70 years

 -  Written consent of the participant after being informed

 Exclusion Criteria:

 -  Pregnancy

 -  Autoimmune disease

 -  Uncontrolled cardiovascular disease

 -  Uncontrolled asthma