Investigations on the monitoring of hyposensitization by means of the Cellular Antigen Stimulation Test (CAST)

In our study 30 patients(13 females and 17 males, age range 39 +/- 16) with bee and wasp venom allergy were investigated before and during the specifi c immunotherapy by determination of specific IgE antibodies against be and wasp venoms. Moreover, the Cellular Antigen Stimulation Test was performed using EDTA-blood. The 30 patients comprised all severity grades (I - IV (re f. H.L. Mueller)) of allergic reactions (9 patients with severity grade I, 11 patients with severity grade II, 4 patients with severity grade III, 6 p atients with severity grade IV). The allergological workup included the ana mnesis, skin tests (threshold determination up to 1 mug/ml), the measuremen t of specific IgE antibodies by CAP-FEIA system and the Celluar Antigen Sti mulation Test. The CAST was carried out with a concentration of 0.2 mug/ml bee and wasp venom (Apis mellifera Vespula spec.). respectively, in some ca ses also with concentrations of 0.002 mug/ml bee and wasp venom. Only in 2 patients a decrease of the sulfidoleukotriene values was observed during th e immunotherapy. Also in patients which tolerate a sting provocation testin g no decrease of sulfidoleukotriene values could be found. These results su ggest that the CAST cannot be recommended as good diagnostic tool for monit oring effectiveness of the hyposensitization.