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ABSTRACT
Stings of hymenoptera can induce IgE-mediated hypersensitivity reactions in venom-allergic patients, ranging from local up to severe systemic reactions and even fatal anaphylaxis. Allergic patients' quality of life can be mainly improved by altering their immune response to tolerate the venoms by injecting increasing venom doses over years. This venom-specific immunotherapy is highly effective and well tolerated. However, component-resolved information about the venoms has increased in the last years. This knowledge is not only able to improve diagnostics as basis for an accurate therapy, but was additionally used to create tools which enable the analysis of therapeutic venom extracts on a molecular level. Therefore, during the last decade the detailed knowledge of the allergen composition of hymenoptera venoms has substantially improved diagnosis and therapy of venom allergy. This review focuses on state of the art diagnostic and therapeutic options as well as on novel directions trying to improve therapy.
Abbreviations
| AAAAI | = |
American Academy of Allergy, Asthma and Immunology |
| ACE | = |
angiotensin-converting enzyme |
| Api m | = |
Apis mellifera |
| BAT | = |
basophil activation test |
| Breg | = |
regulatory B cell |
| CCD | = |
cross-reactive carbohydrate determinant |
| CD | = |
cluster of differentiation |
| CRD | = |
component-resolved diagnosis |
| DPP | = |
dipeptidyl peptidase |
| EAACI | = |
European Academy of Allergy and Clinical Immunology |
| E. coli | = |
Escherichia coli |
| Foxp3 | = |
Forkhead Box P3 |
| GATA-3 | = |
GATA binding protein 3 |
| ICOS | = |
inducible T cell costimulator |
| Ig | = |
Immunoglobulin |
| IL | = |
interleukin |
| LLR | = |
large local reaction |
| LPS | = |
lipopolysaccharide |
| MHC | = |
major histocompatibility complex |
| MPL | = |
monophosphoryl lipid A |
| MRJP | = |
major royal jelly protein |
| PLGA | = |
poly lactic-co-glacolic acid |
| Pol d | = |
Polistes dominula |
| r | = |
recombinant |
| Sf9 | = |
Spodoptera frugiperda |
| sIgE | = |
specific Immunoglobulin E |
| SR | = |
systemic (generalized) reaction |
| T-bet | = |
T-Box 21 |
| TGF- β | = |
transforming growth factor β |
| Th | = |
T helper |
| Treg | = |
regulatory T cell |
| Ves v | = |
Vespula vulgaris |
| VIT | = |
venom-specific immunotherapy |
Disclosure of potential conflicts of interest
MS has received travel support from ALK-Abelló and Bencard. MO has received consultancy fees from Siemens Healthcare, Hitachi Chemical Diagnostics and Bencard; has received lecture fees from Thermo Fisher Scientific, Bencard and Siemens Healthcare; is co-founder of PLS-Design GmbH. CBS-W has received grants from Allergopharma, Leti, PLS-Design and Regeneron; is member of the scientific advisory board of Leti and Bencard; has received consultancy fees from Leti, GLG Consultancy, Allergopharma and Bencard. SB has received speaker's honorarium and/or travel support from ALK-Abelló, Bencard and Thermo Fisher Scientific; has received consultancy fees as an advisory board member and research support from Bencard. AG declares to have no conflict of interest.
