The Polysaccharide Behaviour of Cancer Antigens
Authors: J. G. Makari
Journal: BMJ (1958)

MEDICAL JOURNL 3dosage is reached as a rule in 2-3 months.As in all " desensitization " procedures, it is inevitable that the state of hyposensitization attained will in due course be lowered if not lost.It is for this reason that maintenance doses as described should be continued for as long as thought necessary, especially in bee-keepers and others who cannot avoid contact with bees. Results of DesensitizationA description has been given (Ordman, 1951) of three persons sensitive to bee stings in whom effective desensitization had been achieved with the use of whole-bee extract administered intracutaneously.Since that time 19 further instances of successful desensitization by this method have come to notice, bringing the total to 22.These 19 cases have emerged from a study of 47 satisfactorily completed reports by physicians who had submitted their bee-stingsensitive patients to adequate desensitization.In 23 instances the patients had not been further stung by bees, and it is in the remaining 24, where stinging had followed desensitization, that these 19 persons were found to be fully protected (see Table ).It may seem surprising that only 22 authenticated in- stances of successful desensitization can be quoted when material for prophylactic desensitization had been supplied over the years for some hundreds of persons.The ex- planation is, firstly, that most people subjected to bee stings in South Africa live in the rural areas and information about them must be obtained by correspondence with their doctors, leading all too often to little or no details about their patients in spite of follow-up letters.Secondly, in the bulk of the replies that do become available the information is vouchsafed that, although the patients had been properly desensitized according to our instructions, they had not subsequently been stung by bees.Details are given in the Table of the 24 cases which had been submitted to desensitization and about which full reports were obtained.Effects of bee stings before and after such desensitization, results of skin-sensitivity tests, and the desensitization procedure itself are described for each case.It will be observed that in 19 of these cases (1-19) the results were highly satisfactory, as no reactions, or very mild reactions only, were now occurring in persons who were originally very severely affected by bee stings.In Case 20 " some improvement " only was claimed.In Cases 21, 22, 23,' and 24 it was reported that desensitization pro- cedures had produced no benefit at all-that is, reactions after bee stings were now as severe as they had been previously.Cases 21, 22, 23.-These patients were highly sensitive by skin test to whole-bee extract (10 units).Desensitization was carried out to only 100 units or less instead of to the required 3,000-4,000 units.Desensitization in each of these cases was obviously inadequate, and satisfactory results could not be expected.Case 24.-For some reason this patient does not appear to have been highly skin-sensitive to whole-bee extract (1,000 units) by test, and desensitization should have gone on with strengths up to 4,000 units or even higher.