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Background: Current literature is inconsistent regarding the risk of severe side effects using accelerated induction protocols in Hymenoptera venom immunotherapy (VIT). In addition, several data indicate the influence of purity grade of venom preparation on tolerability. We evaluated the safety and tolerability of ultra-rush and rush build-up protocols using purified and non-purified venom preparations. Methods: Retrospective single-center study of 581 VIT inductions (325 ultra-rush and 256 rush protocols) from 2005 to 2018 in 559 patients with bee and vespid venom allergy using aqueous purified (ALK SQ®) for ultra-rush protocol and aqueous non-purified (ALK Reless®) venom preparations for rush protocol. Results: Urticaria (8% vs. 3.1%, p = 0,013) and dose reductions (4.3% vs. 1.2%, p = 0,026) were significantly more frequent in the ultra-rush group. Overall rate of moderate-to-severe side effects (anaphylaxis ≥grade 2 according to Ring and Meβmer) was low and did not differ significantly between protocols (p = 0.105). Severe events (grade 4 anaphylaxis) were not reported. Discontinuation rate was very low in both cohorts (0.6% vs 1.2%). The higher purity grade of venom preparations in the ultra-rush cohort did not improve tolerability. The bee venom group showed a non-significant trend towards higher incidence of mild reactions (urticaria), resulting in more frequent dose reductions and antiallergic therapy. Conclusion: Rush and ultra-rush protocols show an excellent safety profile with only infrequent and mild anaphylactic reactions in bee and vespid venom allergy. Ultra-rush immunotherapy reduces the duration of the inpatient build-up phase setting and thus is viewed by the authors as preferred treatment in Hymenoptera venom allergic patients.
The results of spectroscopic and paramagnetic resonance investigations show that the previously prepared substance with the empirical composition [VIdip3] J · ½ py is most presumably a mixed crystal of two similar compounds of bivalent and zero-valent vanadium. The ion [VIdip3] + exists only in solution and gives no paramagnetic resonance signal, which is understood on account of a low-lying singlet ground state.
Mit Alkalimetallen reduzierte Lösungen von 2,2′-Dipyridyl liefern ein ESR-Signal, dessen Hyperfeinstruktur vom Reduktionsmittel abhängt. Bei Verwendung von Lithium beobachtet man das Spektrum des Ionenpaares (Li+, dip-), mit Kalium dagegen erhält man im wesentlichen das ESR-Spektrum des Anionradikals dip-. Seine Hyperfeinstruktur wird quantitativ interpretiert. Abweichungen zwischen den daraus entnommenen experimentellen Spindichten und theoretischen Spindichten, die mittels der HÜCKELschen Theorie erhalten wurden, deuten auf Grenzen in der Anwendbarkeit dieser Theorie.