Mosquito allergy: Clinical features and natural course

Abstract

Mosquito bite allergic reactions are due to sensitization to mosquito salivary proteins. The purpose of our study was to assess the clinical features of Thai patients with mosquito allergy, and to define the natural desensitization course. Seventy patients with mosquito allergy were enrolled. Most patients were female. Half of the patients had a personal history of atopy. The average age of onset of mosquito reaction was 5.7 years old (range 2-58). Four patients were in the desensitization phase in which clinical symptoms disappeared within 9.5 years (median). The common cutaneous lesions were erythematous papules (68.6%) and immediate wheals (67.1%). The most common area of involvement was the leg. Forty of 50 patients (80%) had positive skin prick testing to mosquito allergen (Culex quinquefasciatus) and 31 of 42 patients (73.8%) had positive immunoglobulin E antibodies against allergens in C. quinquefasciatus saliva proteins.

Allergens involved in the cross-reactivity of Aedes aegypti with other arthropods

“…1 Sensitization to mosquito bites is common in the United States, Canada, Japan, Switzerland, and Finland, 2e4 sometimes causing severe systemic reactions, such as generalized urticaria, angioedema, wheezing, and even anaphylaxis. 1,5,6 Several allergens from the genera Aedes, Culex, and…”

Identification and Characterization of IgE-Binding Tropomyosins in <b><i>Aedes aegypti</i></b>

“…Manifestations of mosquito allergy are variable and depend on the route of exposure. When the contact with the allergens occurs via skin bites (saliva allergens), the symptoms consist of mild or severe local or systemic reactions [1,2,3,4]. However, evidence suggests that the inhalation of mosquito emanations and detritus deposited in house dust may induce allergic respiratory symptoms such as allergic asthma and rhinitis [5].…”

Immunological Aspects of the Immune Response Induced by Mosquito Allergens

“…The natural history of mosquito allergy suggests that after prolonged exposure to mosquito bites, desensitization may occur. This is accompanied by a decrease in the serum levels of specific IgE and an increase in specific IgG antibodies [21,48]. The abundance of A. communis in Finland in the summer is accompanied by increasing levels of IgE, IgG1 and IgG4 in the population.…”

“…In a population of children from Winnipeg, Man., Canada, high levels of specific IgE and IgG occurred in the first 6 months, but had decreased by adolescence, suggesting that these children were desensitized naturally by exposure [57]. Kulthanan et al [21] showed the required interval between sensitization and desensitization in a population in Thailand to be approximately 4 years.…”

“…Individuals may experience a variable degree of symptoms after a mosquito bite consisting of unusual large local ecchymotic and vesiculated reactions and, in some cases, systemic reactions, such as generalized urticaria, angioedema or wheezing and even anaphylaxis [20,21,22,23]. However, it has also been shown that mosquito debris remains suspended in the air and produces an allergic respiratory response similar to that caused by other airborne allergens, such as those from the dust mite and cockroach [18,24,25].…”