Honeybee venom specific IgG subclass antibodies in Brazilian beekeepers and in patients allergic to bee stings.

Fifty-nine beekeepers who had been practicing apiculture for more than 2 years were selected in order to determine the distribution of bee venom specific IgG subclasses using ELISA. The assays were standardized into arbitrary units. For comparison, IgG subclasses were determined in eight individuals allergic to bee stings who did not receive specific treatment. No correlation was detected between beekeeping time and specific IgG1, IgG2 or IgG4 levels. There was a correlation between IgG2 levels and mean number of stings per month received by the beekeepers. Twenty-five percent of the beekeepers presented bee venom specific IgE class II or more in an ELISA assay. The IgG1 levels detected in beekeepers were similar to those detected in allergic individuals. IgG2 and IgG4 levels were significantly higher in beekeepers than in allergic individuals. IgG3 was not detected in any group studied. In conclusion, the maintenance of high levels of bee venom specific IgG2 and IgG4 represents a characteristic of beekeepers. These subclasses may be related to a modulatory effect of IgG on allergic reactions.

Metabolic responses to cholecystectomy: open vs. laparoscopic approach.

Laparoscopic cholecystectomy is considered a minor surgical procedure. In a prospective, randomized study, we compared the metabolic responses to surgery in two groups of patients submitted to open or laparoscopic cholecystectomy. The aim of the study was to verify if the latter caused less metabolic changes. Blood samples were drawn before the operation (basal), 1 h and 2 h after skin incision, and on the first and second postoperative days. The following parameters were studied: cortisol, renin, and leukocytes, including subpopulations. The mean values for age, weight, height, basal neutrophil and lymphocyte counts, basal values of cortisol and renin of patients, and sex distribution of group 1 patients (open, n = 20) matched with those for group 2 (laparoscopic, n = 20), with the exception of age (p < 0.05). No differences were detected between the two groups in terms of cortisol and renin values. However, the neutrophil count 1 h after skin incision was statistically significantly higher with the laparoscopic approach (p < 0.05). The lymphocyte count on the second postoperative day was also statistically significantly higher in group 2 (p < 0.05). We conclude that when a cholecystectomy is performed, the laparoscopic approach has no advantage over the open approach from the standpoint of the metabolic responses we studied. It appears that leukocytes have a more rapid return to normal values after laparoscopic cholecystectomy. Although pneumoperitoneum is known to be responsible for important cardiorespiratory changes, no worse response was found in the laparoscopic group than in the open group.