Kinetics of plasma cytokine levels in children hyposensitized with wasp venom

Specific immunotherapy shifts immune responses towards a Th0/Th1 response. Production of chemokines is also decreased early after the initiation of ru sh venom immunotherapy. We aimed to investigate in vivo whether cytokine pl asma levels reflect the shift towards a Th0-Th1 pattern of immune response as seen in vitro in lymphocytes from patients undergoing venom immunotherap y. Therefore, we studied plasma levels of various cytokines before (day 1), during (day 2), and after (day 4) rush immunotherapy in nine wasp-allergic children. The levels of interleukin-5 and IFN-gamma were below the detecti on threshold. No variations were observed in levels of interleukin-4, inter leukin-10, and TNF-alpha. In contrast, mean levels of RANTES transiently in creased at day 2, and decreased below the pretreatment levels at day 4. Tho se alterations were significant in five children with high levels of RANTES at day 1, and reporting severe anaphylaxis. In the four other children, th e levels of RANTES were not significantly increased at day 4. These results suggest that RANTES plasma levels are positively correlated with the sever ity of the reaction to hymenoptera venom, and that a significant decrease i n the levels of RANTES occurs only in children with high pretreatment level s. However, the kinetics of RANTES plasma levels correlated neither with th e results of allergological tests, nor with the outcome of venom immunother apy. (C) 2001 Academic Press.