Immunotherapy - 2076. A controlled study of delta inulin-adjuvanted honey bee venom immunotherapy

Robert Heddle, Paul Russo, Nikolai Petrovsky, Rory Hanna, Anthony Smith

    Research output: Contribution to journalMeeting Abstractpeer-review


    Honey bee (HB) venom immunotherapy (HBVIT) reduces the frequency of immediate generalised reactions (IGR) to subsequent sting by only ~ 80% and in the process induces IGR in many subjects. In influenza vaccine studies delta inulin adjuvant enhanced immunogenicity and provided antigen-sparing without any adverse reactions. In an ongoing double-blinded clinical trial we are studying the benefits of inulin adjuvant for HBVIT.

    Following institutional ethics committee approval, 26 subjects with a history of IGR to HB sting were randomized 2:1 to receive Albey (Stallergenes) HBVIT (100 mcg maintenance) by clustered, semi-rush regime with (gp A) or without (gp B) Advax™ inulin adjuvant (Vaxine Pty Ltd). Specific IgE (sIgE) was measured by CAP, and specific IgG1 and IgG4 by ELISA.

    Clinicians remain blinded to patient randomization. Two subjects have withdrawn for personal reasons. One subject had two anaphylactic reactions at 3 and 100ug of venom, was withdrawn and on breaking code was in gp B (no adjuvant). Two other subjects had mild systemic reactions. A major difference between groups is apparent in sIgG4 responses. Both groups showed a peak sIgG4 response at 14 weeks (early maintenance HBVIT). In gp A however, the sIgG4 rise started earlier, the peak response was much higher and after 12 months of maintenance HBVIT, sIgG4 levels were ~3 fold higher by ELISA OD [results mean (SEM); baseline gp A 0.110 (0.032),gp B 0.076 (0.038), peak .gp A .0.822 (0.155), gp B 0.326 ((0.106), 52 weeks gp A 0.453 (0.223) gp B 0.170 (0.059)]. sIgE responses showed a wide scatter with a rise from baseline of similar magnitude but occurring earlier in group A, followed by a progressive fall, [ baseline gp A 0.960 ((0.171), gp B 0.624 (0.138), peak gp A. 1.242 (0.154), gp B 0.888 (0.163), 52 weeks gp A 0.862 (0.243), gp B 0.541 (0.117)]. sIgG1 responses showed a similar pattern.

    With the caveat that only surrogate markers have yet been analysed, delta inulin adjuvant appears to enhance the immunogenicity of HBVIT and to favour sIgG4 responses.
    Original languageEnglish
    Article numberP158
    Number of pages1
    JournalWorld Allergy Organisation Journal
    Issue numberSupplement 1
    Publication statusPublished - 2013
    Event2nd WAO International Scientific Conference -
    Duration: 6 Dec 2012 → …

    Bibliographical note

    © 2013 Heddle et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative CommonsAttribution License (, which permits unrestricted use, distribution, and reproduction inany medium, provided the original work is properly cited


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