Allergic reaction to snake venom after repeated bites of <i>Vipera aspis</i>

Kopp, Peter; Dahinden, C. A.; Müllner, G.

doi:10.1111/j.1365-2222.1993.tb00887.x

Cited by 11 publications

(8 citation statements)

References 6 publications

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“…Ever since it was discovered that IgE antibodies can mediate anaphylactic reactions 52-55 , the development of IgE antibodies specific for certain antigens, including components of venoms 25, 26, 29, 31, 33, 56, 57 , has primarily been regarded as a risk factor for the development of deleterious IgE-mediated hyperreactivity upon subsequent antigen exposure. Yet a recent survey of more than 7,000 German adults 58, 59 showed a prevalence of 22.6 % for sensitization (i.e., having specific serum IgE antibodies) against hymenoptera (wasp and bee) venom in the general public 58 , while the lifetime prevalence of diagnosed insect venom allergy in that group is only 2.8 % 59 .…”

Section: Discussionmentioning

confidence: 99%

IgE antibodies, FcεRIα, and IgE-mediated local anaphylaxis can limit snake venom toxicity

Starkl

Marichal

Gaudenzio

et al. 2016

Journal of Allergy and Clinical Immunology

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Background Type 2 cytokine-related (i.e., type 2) immune responses associated with development of antigen-specific Immunoglobulin E antibodies (IgE) can contribute to pathology in allergic diseases and to fatal anaphylaxis. However, recent findings in mice indicate that IgE also can enhance defense against honeybee venom. Objective We tested whether IgE antibodies, IgE-dependent effector mechanisms, and a local anaphylactic reaction to an unrelated antigen can enhance defense against Russell's viper venom (RVV) and determined whether such responses can be influenced by immunization protocol or mouse strain. Methods We compared the resistance of RVV-immunized wild-type, IgE-deficient, and Fcer1a-deficient mice following injection of a potentially lethal dose of RVV. Results A single prior exposure to RVV enhanced the ability of wild-type mice, but not mice lacking IgE or functional FcεRI, to survive challenge with a potentially lethal amount of RVV. Moreover, IgE-dependent local passive cutaneous anaphylaxis in response to challenge with an antigen not naturally present in RVV significantly enhanced resistance to the venom. Finally, we observed different effects on resistance to RVV or honeybee venoms in BALB/c versus C57BL/6 mice which had received a second exposure to that venom prior to challenge with a high dose of that venom. Conclusion These observations illustrate the potential benefit of IgE-dependent effector mechanisms in acquired host defense against venoms. The extent to which type 2 immune responses against venoms can decrease pathology associated with envenomation seems to be influenced by the type of venom, the frequency of venom exposure, and the genetic background of the host.

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Section: Discussionmentioning

confidence: 99%

IgE antibodies, FcεRIα, and IgE-mediated local anaphylaxis can limit snake venom toxicity

Starkl

Marichal

Gaudenzio

et al. 2016

Journal of Allergy and Clinical Immunology

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“…Snake venom can induce allergic or anaphylactic reactions due to various substances like toxic peptides, phospholipase A2, and various other proteins present in their venom [4]. Furthermore, there are several case reports of viper bites leading to KS [5, 6].…”

Section: Discussionmentioning

confidence: 99%

Cardiogenic Shock due to Kounis Syndrome following Cobra Bite

Priyankara

Manoj

Gunapala

et al. 2019

Case Reports in Critical Care

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Kounis syndrome is associated with mast cell activation resulting in acute coronary syndrome secondary to an allergic insult. Various drugs such as antibiotics, analgesics, and environmental exposures such as bee, wasp sting, and poison ivy are known to induce Kounis syndrome. A 68-year-old man admitted with a cobra bite on both hands to emergency care unit and sustained cardiorespiratory arrest. Electrocardiogram, taken 6 hours after the cardiac arrest, showed ST elevations in leads V2 to V5 suggestive of anterior ST elevation myocardial Infarction (STEMI). Serum Troponin was 10 ng/ml (control= <0.5). Serum IgE levels were significantly high (19155IU/ml, baseline 100). 2-Dimensional echocardiogram showed anterior and apical-septal hypokinesia with left ventricular ejection fraction of 30-35%. Coronary angiogram was normal. He remained hypotensive requiring inotropic and vasopressor support during ICU stay. This was a case of Kounis syndrome leading to cardiogenic shock secondary to Cobra (naja naja) bite. This is the only reported case of cobra bite causing Kounis syndrome and cardiogenic shock. Identification of the cause of myocardial infarction in snake envenomation is useful in the management as some of the drugs like adrenaline, morphine, and beta blockers may worsen the clinical syndrome if it is due to Kounis syndrome.

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“…In the literature there are occasional reports suggesting IgE‐mediated allergy in patients with repeated snake bites [ 7, 8, 14, 15]. Parish [ 15] found a positive scratch test in four of 13 patients with repeated snake bites and was able to passively transfer this sensitivity in Prausnitz‐Küstner test.…”

Section: Discussionmentioning

confidence: 99%

“…Kopp et al . [ 7] report on a snake biologist who developed a severe local haemorrhagic oedema, dyspnoea and abdominal pain after his first, angioedema of the face and wheezing after the second bite by Va. The patient had a positive skin prick test with Va venom and Va venom‐specific IgE was demonstrated in his serum.…”

Section: Discussionmentioning

confidence: 99%

“…Anaphylactic symptoms like urticaria, localized angioedema and asthma are sometimes observed, which are thought by some to be due to the release of endogenous vasoactive agents such as bradykinin and histamine [ 1]. Considering the high frequency of immunoglobulin (Ig) E‐mediated allergic reactions to other animal venoms, especially those of bees and wasps, and occasional reports suggesting allergic sensitization to snake venoms after repeated bites [ 7–9], we looked for IgE antibodies to Vipera venoms in 10 Swiss patients with a history of one or several bites by Va or Vb.…”

Section: Introductionmentioning

confidence: 99%

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