Abstract
Along with food and drug allergic reactions, a Hymenoptera insect Sting (Apoidea, Vespidae, Formicidae) is one of the most common causes of anaphylaxis worldwide. Diagnoses of Hymenoptera venom allergy (HVA) and specific immunotherapy (SIT) have been based on the use of crude venom extracts. However, the incidence of cross-reactivity and low levels of sensibility during diagnosis, as well as the occurrence of nonspecific sensitization and undesired side effects during SIT, encourage the search for novel allergenic materials. Recombinant allergens are an interesting approach to improve allergy diagnosis and SIT because they circumvent major problems associated with the use of crude venom. Production of recombinant allergens depends on the profound molecular characterization of the natural counterpart by combining some “omics” approaches with high-throughput screening techniques and the selection of an appropriate system for heterologous expression. To date, several clinically relevant allergens and novel venom toxins have been identified, cloned and characterized, enabling a better understanding of the whole allergenic and envenoming processes. Here, we review recent findings on identification, molecular characterization and recombinant expression of Hymenoptera venom allergens and on the evaluation of these heterologous proteins as valuable tools for tackling remaining pitfalls on HVA diagnosis and immunotherapy.
Highlights
20,000 species of Hymenoptera from Apoidea and Formicidae together with 15,000 species of Vespoidea have been identified as clinically relevant [1]
The estimated prevalence of systemic reactions associated with Hymenoptera venom allergy (HVA) is 0.3%–8.9%, while anaphylaxis occurs in 0.3%–42.8% of the cases [4]
Life-threatening cases occur in 0.1%−0.5% of inhabitants in Europe and the United States [5] and are mainly due to systemic hypersensitive reactions mediated by the specific allergen IgE, which binds to the Fc receptors on the surface of several cell types, including mastocytes and basophiles
Summary
20,000 species of Hymenoptera from Apoidea (bees) and Formicidae (ants) together with 15,000 species of Vespoidea (wasps, yellow jackets) have been identified as clinically relevant [1]. Hymenoptera venom can cause local and systemic allergic reactions including anaphylaxis. Several factors, such as the insect type, concomitant cardiovascular and respiratory disease, age, mastocytosis, high levels of serum tryptase, and previous use of angiotensin-converting enzyme (ACE) inhibitors, determine the severity of the clinical symptoms [2]. Life-threatening cases occur in 0.1%−0.5% of inhabitants in Europe and the United States [5] and are mainly due to systemic hypersensitive reactions mediated by the specific allergen IgE, which binds to the Fc receptors on the surface of several cell types, including mastocytes and basophiles. Most of the survey studies currently reported were conducted in developing countries where prevalence of HVA is assumed to be low, given the small percentage of people who live or develop their economic activities near populations of Hymenoptera insects
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