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Venom immunotherapy provides clinical protection against hymenoptera stings in almost all treated allergic patients. Venom specific IgG antibodies often rise during immunotherapy and some studies found an association between their levels and clinical protection in subjects treated with Yellow Jacket venom. It is interesting to report that, among IgG subclasses, venom specific IgG4 show the most significant increase but IgG1 could represent a relevant immunological mechanism, exerting a regulatory function on venom specific IgE levels. We observed in patients submitted to Honey Bee venom immunotherapy a significant increase of venom specific IgG1 and IgG4 antibodies, while IgG2 showed an insignificant increase only in some patients. Persistent high levels of IgG4 with respect to decreasing levels of IgG1 were observed only after prolonged treatment.
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