Bee venom allergy in beekeepers and their family members

Müller, Ulrich

doi:10.1097/01.all.0000173783.42906.95

Cited by 114 publications

(83 citation statements)

References 30 publications

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“…These figures have to be interpreted cautiously, however, as we cannot be completely sure that patients recalled correctly when they had been re-stung. For a long time, beekeepers and their family members have been identified as a high-risk group of hymenopteravenom-allergic patients, and management options for this population have already been adapted, recommending VIT not only to beekeepers suffering from mild grade I and grade II systemic allergic reactions, but even to those suffering from repeated large local reactions [23] . However, the majority (63%) of bee-venom-allergic patients do not belong to this high-risk group and only face a small risk of being re-stung.…”

Section: Discussionmentioning

confidence: 99%

Risk Assessment of Hymenoptera Re-Sting Frequency: Implications for Decision-Making in Venom Immunotherapy

Moos

Graf²,

Johansen³

et al. 2012

Int Arch Allergy Immunol

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BACKGROUND: Venom immunotherapy is highly efficacious in preventing anaphylactic sting reactions. However, there is an ongoing discussion regarding patient selection and whether and how to apply a cost-benefit analysis of venom immunotherapy. In order to help decision-making, we investigated the re-sting frequency of hymenoptera-venom-allergic patients to single out those at high risk. METHODS: In this retrospective study, re-sting data of 96 bee-venom-allergic patients and 95 vespidvenom-allergic patients living mainly in a rural area of Switzerland were analyzed. Hymenoptera venom allergy status was rated according to the classification system of H.L. Mueller [J Asthma Res 1966;3:331-333]. Different risk-groups were defined according to sting exposure and their median sting-free interval was calculated. RESULTS: The risk factors for a wasp or bee re-sting were outdoor occupation, beekeeping and habitation close to a bee-house. Half of all vespid-venom-allergic outdoor workers were re-stung within 3.75 years compared to 7.5 years for indoor workers. Similarly, 50% of the bee-venom-allergic beekeepers or subjects with a bee-house in the vicinity suffered a bee re-sting within 5.25 years compared to 10.75 years for individuals who were not beekeepers. CONCLUSIONS: The high degree of exposure of vespid-venom-allergic outdoor workers and bee-venom-allergic beekeepers and subjects living close to bee-houses underlines the high benefit of venom immunotherapy for these patients even if they suffered a non-life-threatening grade II reaction. Yet, bee-venom-allergic individuals with no proximity to beehouses and with an indoor occupation face a very low exposure risk, which justifies epinephrine rescue treatment for these patients especially if they have suffered from grade II sting reactions. beekeepers or subjects with a bee-house in the vicinity suffered a bee re-sting within 5.25 years compared to 10.75 years for individuals who were not beekeepers. Conclusions: The high degree of exposure of vespid-venom-allergic outdoor workers and bee-venom-allergic beekeepers and subjects living close to bee-houses underlines the high benefit of venom immunotherapy for these patients even if they suffered a non-life-threatening grade II reaction. Yet, bee-venom-allergic individuals with no proximity to beehouses and with an indoor occupation face a very low exposure risk, which justifies epinephrine rescue treatment for these patients especially if they have suffered from grade II sting reactions.

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Section: Discussionmentioning

confidence: 99%

Risk Assessment of Hymenoptera Re-Sting Frequency: Implications for Decision-Making in Venom Immunotherapy

Moos

Graf²,

Johansen³

et al. 2012

Int Arch Allergy Immunol

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“…131 This may be a result of true double-sensitization, or cross-reactivity between bee and vespid venom protein allergens (hyaluronidase has about 50% sequence homology), or cross-reacting CCDs. Inhibition tests with both venoms and CCDs using RAST inhibition or immunoblot have been used to distinguish between doublesensitization and cross-reactivity, 125,126,131,132 which is important for the selection of venoms for immunotherapy.…”

Section: Risk Assessment In Individuals With Hymenoptera Venom Allergymentioning

confidence: 99%

Risk assessment in anaphylaxis: Current and future approaches

Simons

Frew

Ansotegui

et al. 2007

Journal of Allergy and Clinical Immunology

263

300

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“…Recent studies have shown that bee-keepers, despite being frequently stung and having a positive skin-prick test and IgE specific to bee venom, do not develop allergic symptoms when stung. Protection seems to be mediated through the induction of bee venom-specific IgG4 following bee stings, since long-term exposure to bee stings drives the IgG response from a mainly IgG1 response to an IgG4 response (Muller 2005), although an in vivo switch to IL-10-secreting T regulatory cells has also recently been implicated in this process (Meiler et al 2008). In addition to IgG, recent studies have also provided evidence for increases in the amount of TGF-b-driven allergen-specific IgA following SIT, indicating that other antibody classes might contribute to clinical efficacy (Pilette et al 2007).…”

Section: Roles Of Other Immunoglobulins In Allergymentioning

confidence: 99%

B Cells: From Early Development to Regulating Allergic Diseases

Samitas

Lötvall

Bossios

2010

Arch. Immunol. Ther. Exp.

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B lymphocytes are characterized by a unique and highly specialized developmental pathway that is responsible for their vast phenotypic and function diversity. B cell development is strictly regulated to ensure sufficient specific humoral immunity while at the same time avoiding any errors that would compromise B cell functionality. The generation and maintenance of mature B cells from the constant flux of bone marrow progenitors is a complex process that is generally poorly understood, although great progress has been made in recent years. B cells have for long been considered mainly as antibody-producing cells and therefore believed to play an important role in the pathophysiology of allergic diseases, primarily through their ability to produce IgE antibodies. However, recent findings have revealed new aspects of their role in immune responses that place them again under the spotlight as important immune regulators, independent of antibody production. This review focuses on the developmental processes responsible for the numerous phenotypes and functions of the B-lymphocyte pool and the different aspects of effector B cell functionality in the context of allergy.

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Bee venom allergy in beekeepers and their family members

Abstract: Beekeepers and their family members are at an increased risk of severe sting anaphylaxis and therefore need especially careful instruction with regard to avoidance of re-exposure, emergency treatment and specific immunotherapy with bee venom.

Cited by 114 publications

References 30 publications

Risk Assessment of Hymenoptera Re-Sting Frequency: Implications for Decision-Making in Venom Immunotherapy

Risk Assessment of Hymenoptera Re-Sting Frequency: Implications for Decision-Making in Venom Immunotherapy

Risk assessment in anaphylaxis: Current and future approaches

B Cells: From Early Development to Regulating Allergic Diseases

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