Abstract
In this review, we outline and reflect on the important differences between allergen-specific immunotherapy for inhalant allergies (i.e., aeroallergens) and venom-specific immunotherapy (VIT), with a special focus on Venomil® Bee and Wasp. Venomil® is provided as a freeze-dried extract and a diluent to prepare a solution for injection for the treatment of patients with IgE-mediated allergies to bee and/or wasp venom and for evaluating the degree of sensitivity in a skin test. While the materials that make up the product have not changed, the suppliers of raw materials have changed over the years. Here, we consolidate relevant historical safety and efficacy studies that used products from shared manufacture supply profiles, i.e., products from Bayer or Hollister–Stier. We also consider the characterization and standardization of venom marker allergens, providing insights into manufacturing controls that have produced stable and consistent quality profiles over many years. Quality differences between products and their impacts on treatment outcomes have been a current topic of discussion and further research. Finally, we review the considerations surrounding the choice of depot adjuvant most suitable to augmenting VIT.
Highlights
Introduction distributed under the terms andThe immune responses to insect stings, such as those from wasps or bees in Hymenoptera venom allergies (HVA), can lead to severe and life-threatening reactions
Allergens found in low abundance in HBV (Api m 3, Api m 5 and Api m 10) have been been demonstrated to play an important role as sensitizing allergens, and must be classidemonstrated to play an important role as sensitizing allergens, and must be classified fied as major allergens, as more than 50% of honeybee venom-allergic patients display as major allergens, as more than 50% of honeybee venom-allergic patients display IgEIgE-reactivity to them [16]
A wealth of quality and clinical data using venom products derived from shared material sources have been consolidated here
Summary
The immune responses to insect stings, such as those from wasps or bees in Hymenoptera venom allergies (HVA), can lead to severe and life-threatening reactions. Processing may result in differences in allergen composition, as shown in recent studies studying the component resolutions of therapeutic grade honeybee venom (HBV) extracts to examine cases of treatment failures [12,13,14,15,16,17,18] In these instances, underrepresentation of relevant allergens has been highlighted, emphasizing the importance of a well-characterized allergen product [19]. Contraindications against VIT differ from those of AIT against inhalant allergens; consider the life-threatening nature of HVA [20]. This review is the first to consolidate relevant historical safety and efficacy studies that included products with shared manufacturer supply profiles, i.e., venom products from Bayer or Hollister–Stier, and consider quality differences between products and the impacts on treatment outcomes
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