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Minutes of the The EAACI Insect Venom Hypersensitivity Interest Group: Göteborg 2007

Held on Monday 11th June, 2007
Göteborg, Sweden

Chairman: Marek Jutel
Secretary: M.Beatrice Bilòl
21  IG Members attended the Insect Venom Hypersensitivity Business Meeting

Agenda
Opening by the Chairman
Registration of Members present by name and address
Chairman's report
Secretary's report
Project reports
New Chairman-Secretary elections
Closing of the Business Meeting
The Chairman welcomed all Members of the IG to the meeting which was declared open at 17.15

Chairman’s report
1. Intensive activities in the field were organised in addition to B.M. by the Interest Group including A) Post Graduate Course on Insect Venom Hypersensitivity (Saturday, 9 June 2007); B) Oral abstract Session on Advances in Diagnostics and Management of Venom Hypersensitivity (Sunday, 10 June 2007); C) Workshop on Venom Hypersensitivity (Monday, 11 June 2007); D) Poster Discussion Session on Venom Hypersensitivity (Monday, 11 June 2007); E) Meet the Professor breakfast seminar on Management of Insect Venom Hypersensitivity (Tuesday, 12 June 2007).
2. The Chairmen and Secretary both went to the Board of directors meeting the 9th of June. It seems that the relationship between the ExCom and the IG is going to change in a more collaborative way. Pr C Akdis will be the EAACI vice-president for this activity.
They want people of the IG to be in charge of organizing the postgraduate courses of the meetings and that the speakers to be also those participating to other sessions of the same meeting. The money earned will be for the IG.
In order to attract people, the IG business meeting will last two hours and they will have one or two speakers plus the general information.
They will introduce representation of the IG in the ExCom and C. Akdis will be the coordinator of the IG.
They also think that it is really important to organize evidence based position papers through Task Forces.

Report of the Secretary

1. There are 505 Interest Group members from 26 countries registered on the EAACI files.

 

2. The budget balance during the EAACI Meeting in Vienna was Euro 1.000.

Since the EAACI Congress in Vienna no other expenses have been incurred.

The Chairman proposed to transfer the Secretary budget to the Website activity.

 

3. Only 32 abstracts were submitted, although of good quality. Attempt must be taken to increase the numbers of abstracts. We hope to receive more abstracts for the EAACI 2008 in Barcelona.

 

Projects reports

2. Dr. Rueff reported on the study on mastocytosis and venom hypersensitivity (see the attachment).

 

2. Dr Sanches (who arrived after the end of BM) presented to the Prof. Jutel, Dr. Rueff and Bilò the current status of the Website of Insect Venom Hypersensitivity Interest Group. He suggested to hold all the content of our web page: "www.insectallergy.org" into the www.EAACI.net.

He said that until now this page was only a link from our Interest Group and the facilities to get there were limited. Our IG web page contents in 5 different languages the current knowledge on hymenoptera allergy, not only for patients but as well for physicians and specialists, with taxonomy, symptoms, treatment, immunotherapy and recommendations for patients, with updates positions papers and references from the last five years on this topic. There are also links to national web pages and interesting links, and obviously to EAACI Interest Group on Insect Venom Hypersensitivity. He estimated over 500 to 600€ of expenses.

 

Future plans

1. The Secretary proposed two study on the allergic follow-up of the patients after discontinuation of immunotherapy in which the primary objective is to define the criteria for suspending immunotherapy in Europe with less risk for the patient and to identify risk factors for a relapse.

The first is a prospective study: all patients who stopped VIT during 2007 and those who will stop VIT in the next two years may be enrolled in the study and asked to return annually for repeat skin test and in vitro tests. Whenever possible, they annually perform sting challenge and record the outcome of in-field re-stings. The inclusion period will be about 3 years and the follow-up period may last 3 years or more. Therefore the study will start in December 2007 with an inclusion phase of two years and is planned to terminate three years after the end of the inclusion phase. The expected study end is in December 2012.

The second study is a retrospective one: We can evaluate all patients who had stopped VIT between 1997 and 2001 after a duration of at least 3 years, in a follow-up period up to 10 years after discontinuation. Therefore the retrospective study will start in September 2007, a first draft will be planned to be available in May 2008 and the final draft in December 2008.

Dr Bilò will send the first draft of the two studies to all the members for their comments as soon as possible.

 

2. Dr. Rueff proposed an European study on the follow-up of the allergic patients treated with venom immunotherapy who present some controindications for VIT. She will design a protocol in turn to sent to all the members for their comments.

 

3. Dr. Sanchez proposed n European epidemiological study on natural venom allergen in Europe. He suggested to study in different countries the distribution of hypersensitivity to Bee and Vespids, through the study  of in vitro sensitivity to the main allergens of  Hymenoptera venoms ( nApi m 1; nVes v 1, nVes v 2, nVes v 5; nPol d 1 and nPol d 5).

From 10 to 15 centres in Europe will contribute to send sera to study these allergens kindly provided by ALK-Abello Spain. Secondary, we try to make a sera-bank to future studies for example with recombinant venom allergens. Dr. Sanchez estimated from 300 to 500€ from sera transport charges fro every centre. The expenses related to in vitro study will be kindly provided by ALK-Abello, and the keep in store  the sera to -70ªC will be provided by University Department in Alicante.

 

4. Dr. Bonifazi suggest to organize a Summer School in Italy (Ancona). The Chairman and Secretary will try to organize a nice programme and Dr. Bilò will be in charge of the application. Luis Delgado, EAACI vice-president for these activities will be contacted.

 

New Chairman-Secretary elections

Marek Jutel underlined that the IG Chairman and Secretary may not hold office continuously for more than four years, therefore proceeded to the election.

Without any abstention or negative vote, M.Beatrice Bilò was proposed as the Chairman and Franziska Rueff as Secretary for the next 2 years.

According to the EAACI bylaws, the President should be confirmed by the EAACI ExCom.

 

As there being no other business to discuss, the Chairman thanked the Members for their participation and declared the meeting closed.

 

 

Preliminary results of the Study Protocol of EAACI Interest Group on Insect Venom Allergy

Franziska Rueff

Study title: Increased baseline serum mast cell tryptase levels in insect venom allergic patients: A risk factor for severe sting reactions, for side effects during venom immunotherapy, or for treatment failure?

Objective: This study of the EAACI Interest Group on Insect venom allergy is an open, multicentre, prospective observational study in patients with Hymenoptera venom allergy designed to evaluate the risk associated with an elevated mast cell tryptase (MCT) level in the serum regarding severity of sting reactions, occurrence of systemic side effects during dose increase of venom immunotherapy (VIT), and VIT failures.

Results: 15 study centres from 6 European countries participated in the study. 1126 patients were screened, 942 (54.6 male, mean age 40.9 + 16.5 years old) were included into the study. MTC was elevated (>11.4 µg/l, 95th percentile) in 7.8 % of patients with Hymenoptera venom allergy, in 20 patients (2.1 %) serum tryptase was > 20 µg/l (minor criterion of systemic mastocytosis). Elevated MTC (>11.4µg/l) was significantly associated with a higher severity grade of a previous systemic anaphylactic reaction (SAR).

686 patients received VIT of whom 106 patients received treatment with various venoms. During dose increase patients with elevated MTC (> 11.4 µg/l) more often developed SAR than patients with MTC concentration within the 95thth percentile. percentile (n.s., p = 0.088). During maintenance treatment patients with elevated MTC more often had SAR (p=0.016) than patients with levels within the 95

Treatment efficacy was not influenced by serum tryptase concentration. However, up to now only data of 174 patients are evaluated.

Working plan: After data inclusion stop (about October 2007) data will be evaluated and prepared for publication.