Fig. 4
From: A 13-year real-life study on efficacy, safety and biological effects of Vespula venom immunotherapy
Suggested model of long-lasting immunological changes induced by VIT. Before VIT, Vespula-specific IgE and IgG4 antibodies are already present in the patients. VIT induces a progressive and steady decline in both bound and circulating pools of IgE. In contrast, IgG4 levels increase. The IgE levels remain low long after VIT discontinuation, while the IgG4 decline to pre-VIT values