Insect Allergy Research Articles

Rank correlation between atopic comorbidity and laboratory parameters in allergic rhinitis

One of the current cutting-edge problems in allergy and ENT is the study of comorbidity in allergic rhinitis, which is the most common atopic disease among all other atopies. Two decades ago, a new endotype of the disease, local allergic rhinitis, was discovered. In the past, some patients with typical complaints of chronic nasal congestion, persistent runny nose, and other similar symptoms, did not display such characteristic diagnostic criteria as positive allergy skin tests and an increased value of serum total IgE and specific IgE antibodies. They were qualified by allergists and ENT specialists as individualists with non-allergic rhinitis and, accordingly, did not receive adequate treatment. However, their symptoms remained, prompting them to abuse decongestants and resulting in an increased burden on the cardiovascular system. This, along with the burden of concomitant pathology, including other atopies, can be considered a significant medical and social problem. With the purpose to study rank correlation between comorbidity and three laboratory biomarkers, 46 patients with allergic rhinitis were examined. The list of parameters included two routine items such as serum total IgE and eosinophilic cationic protein, and rarely studied IL-4 in skin exudate. Clinical analysis showed that significantly more often allergic rhinitis in patients was combined with bronchial asthma (in 39.1%, p 0.05), less often with food allergy (in 19.6%), atopic dermatitis (in 10.9%), insect allergy (in 8.7%), and allergic urticaria (in 4.5%). In one case, local perennial rhinitis was identified, accompanied by conventional seasonal rhinitis with a high content of serum total IgE and positive allergic skin tests with pollen allergens. Skin tests with household allergens, including house dust mite products, showed a negative result. This case was regarded as a manifestation of the so-called “double” allergic rhinitis. The Spearman correlation demonstrated a negative mean strength relationship between comorbidity and serum IgE and eosinophilic cationic protein (p 0.05). The seemingly paradoxical result can be interpreted quite logically, taking into account immunopathogenetic mechanisms of allergic inflammation. In particular, with an increase in the frequency of atopic comorbidity, the migration of eosinophils from the blood to sites of eosinophilic inflammation increases.

Allergy to stings and bites from rare or locally important arthropods: Worldwide distribution, available diagnostics and treatment.

Insect venom allergy is the most frequent cause of anaphylaxis in Europe and possibly worldwide. The majority of systemic allergic reactions after insect stings are caused by Hymenoptera, and among these, vespid genera induce most of the systemic sting reactions (SSR). Honey bees are the second leading cause of SSR. Depending on the global region, other Hymenoptera such as different ant genera are responsible for SSR. Widely distributed hornets and bumblebees or local vespid or bee genera rarely induce SSR. Hematophagous insects such as mosquitoes and horse flies usually cause (large) local reactions while SSR occasionally occur. This position paper aimed to identify either rare or locally important insects causing SSR as well as rarely occurring SSR after stings or bites of widely distributed insects. We summarized relevant venom or saliva allergens and intended to identify possible cross-reactivities between the insect allergens. Moreover, we aimed to locate diagnostic tests for research and routine diagnosis, which are sometimes only regionally available. Finally, we gathered information on available immunotherapies. Major allergens of most insects were identified, and cross-reactivity between insects was frequently observed. While some diagnostics and immunotherapies are locally available, standardized skin tests and immunotherapies are generally lacking in rare insect allergy.

Relevance of allergen specific immunoglobulin e testing in Indian population: A retrospective study

Prevalence of allergies has increased dramatically in recent decade and is now considered major chronic disease at the global level. Measurement of total and allergen specific IgE (Immunoglobulin E) is often requested to assess possible allergy. The main objective of our study was to understand the relevance of allergen specific IgE testing in Indian population. This retrospective study was conducted at a Global Reference Laboratory in Mumbai from May 2020 to May 2022. Total available data of 65431 patients was included in the study. The data was sub grouped as per age group, gender, and positivity for specific allergens. Of the total 65431 patients, 34601 (52.88%) were Females and 30830 (47.12%) were Males. Among those tested for specific IgE allergen, positivity was found to be 30%. The dust allergy was the most prevalent (62.18%) followed by Insect allergy (52.69%) and food allergy (51.78%). Out of the 18377 patients tested for Specific allergens, 7340 (39.94%) had at least one allergen positive. The availability of multiple and allergen specific panels has proved to be a major tool for the detection and diagnosis of multiple allergies. Detection of allergy is necessary to avoid wrong diagnosis and mismanagement of disease. Combination of total IgE with specific IgE can be used as evidence of allergy along with clinical findings. It is recommended to proceed with clinically appropriate allergen specific IgE tests, regardless of total IgE concentration in patients with a history of an acute allergic reaction.

Reported Cases and Diagnostics of Occupational Insect Allergy: A Systematic Review.

A significant part of adult-onset asthma is caused by occupational exposure to both high- and low-molecular-mass agents. Insects are occasionally described to cause occupational allergy in professions including anglers and fishers, laboratory workers, employees of aquaculture companies, farmers, bakers, sericulture workers and pet shop workers. Occupational insect allergies are often respiratory, causing asthma or rhinoconjunctivitis, but can be cutaneous as well. The European Union recently approved three insect species for human consumption, enabling an industry to develop where more employees could be exposed to insect products. This review overviews knowledge on occupational insect allergy risks and the tools used to diagnose employees. Despite the limited availability of commercial occupational insect allergy diagnostics, 60.9% of 164 included reports used skin prick tests and 63.4% of reports used specific IgE tests. In 21.9% of reports, a more elaborate diagnosis of occupational asthma was made by specific inhalation challenges or peak expiratory flow measurements at the workplace. In some work environments, 57% of employees were sensitized, and no less than 60% of employees reported work-related symptoms. Further development and optimization of specific diagnostics, together with strong primary prevention, may be vital to the health conditions of workers in the developing insect industry.

Diagnosis and Management of Insect Allergy: Barriers and Facilitators in the United States.

While guidelines recommend testing and treatment for patients with venom-induced anaphylaxis to prevent morbidity and mortality, significant barriers prevent most patients from receiving the evaluation and treatments that they need. This review examines these barriers in the United States along with the facilitators that can be used to overcome them.

Diagnosis of Apis dorsata venom allergy: use of recombinant allergens of Apis mellifera and a passive basophil activation test

BackgroundAllergy to Apis dorsata (Giant Asian Honeybee) venom is the commonest insect allergy in Sri Lanka and South East Asia. However, laboratory diagnosis is difficult as the pure venom and diagnostic reagents are not commercially available.ObjectiveThis study assessed the use of four recombinant allergens of A. mellifera venom and the passive basophil activation test in the diagnosis of A. dorsata venom anaphylaxis.MethodsSerum IgE levels to four recombinant allergens of A. mellifera, rApi m 1, 2, 5 and 10 were assessed and compared with serum IgE to the crude venom of A. mellifera or V. vulgaris by Phadia ImmunoCAP, in patients who developed anaphylaxis to A. dorsata stings. Basophil activation in response to venom of A. dorsata or V. affinis was assessed using a passive basophil activation test. Association of the severity of the reaction with basophil activation was compared.ResultsrApi m 1 and 10 combinedly had significant correlation (r = 0.722; p < 0.001) with the crude venom of A. mellifera (Western honeybee) and a higher positivity rate of 90% (27/30). Whereas, IgE reactivity to rApi m 2 or 5 had significant correlation (p = 0.02 and p = 0.005 respectively) with V. vulgaris crude venom. All 30 (100%) were positive to A. dorsata venom in passive BAT; 70% (21/30) had over 80% activation, 96.7% (29/30) had over 60% activation and 100% had over 50% activation. Percentage activation of basophils in patients who had mild or moderate reactions (n = 20) was significantly low (p = 0.02) from that of patients who had severe reactions (n = 10).ConclusionsrApi m 1 and 10 when combined was sensitive for the diagnosis of A. dorsata allergy. This combination had the lowest cross-reactivity rate with Vespula vulgaris. The passive BAT is highly sensitive in A. dorsata allergy. The basophil reactivity was significantly higher in severe anaphylaxis compared to mild/moderate anaphylaxis. This finding should be further explored in further studies.

Safety of subcutaneous allergen immunotherapy.

Subcutaneous allergen immunotherapy (SCIT) is a unique treatment option for managing patients with allergic rhinitis, asthma, atopic dermatitis, and stinging insect allergy. Although systemic reactions to allergen injections are rare, near-fatal, and fatal anaphylactic reactions can occur. Patients with asthma are at greatest risk for more severe reactions as are those with previous systemic reactions. Treating allergists should institute best clinical practices to prevent and manage severe systemic reactions to SCIT, including the following: (1) prescreening patients with asthma for recent increases in asthma symptoms, (2) not prescribing SCIT to patients with severe and uncontrolled asthma, (3) instituting clinic protocols to prevent dosing errors, (4) considering modifying allergen doses during peak allergy seasons in patients at high risk, (5) instituting measures that require all patients on SCIT to be observed for at least 30 minutes after injections, and (6) regular training of all clinical staff in the recognition and expeditious treatment of anaphylaxis.

The analysis of the pharmaceutical supply with medicines used in insect allergy therapy and approaches to the development of new medicines in the form of a gel for the local treatment

According to the World Allergy Organization, allergies occur in 10 % to 40 % of the world’s population. Currently, the number of such patients in Europe is about 150 million people. It is projected that in the next decade there will be more than 250 million people, 5 % of whom have a predisposition to insect allergies (IA).Aim. To analyze the range of drugs used in the local treatment of IA and approaches to the development of new domestic drugs in the form of a gel.Materials and methods. The scientific publications of domestic and foreign authors, data from official sites on the subject, ICD-10, materials of the State Register of Medicines of Ukraine, directory Compendium, Protocol for medical care for insect allergies, as well as methods of the system analysis, comparison, graphical, analytical and the content analysis were used.Results. The regimen of IA treatment has been studied depending on the severity (mild, moderate, severe, anaphylactic shock), which is given in the Protocol of medical care for insect allergies in accordance with the Order of the Ministry of Health of Ukraine from 03.07.2006 No.432. It is considered that IA is treated with the subgroup “D04A A – Antihistamines for topical application”, which has only 5 drugs (including release forms); among them 80 % of medicines are foreign, 60 % are produced in the form of a gel. It is very insufficient because of the fact that there are consequences of insect bites during the local therapy of children since constant scratching of the bite sites is a threat of infection of wounds and delay their healing.Conclusions. On the example of the pharmaceutical composition in the form of a gel, the expediency for developing new domestic drugs that are available compared to foreign ones for the local therapy in IA, and manifestations of allergic reactions to insect bites has been proven.

Клініко-епідеміологічна характеристика найпоширеніших алергічних захворювань у дітей

Актуальність. Алергічні захворювання (АЗ) (бронхіальна астма (БА), алергічний риніт (АР), атопічний дерматит (АД), харчова алергія (ХА), гостра кропив’янка (ГК), інсектна алергія (ІА)) є життєво небезпечними інвалідизуючими станами та причиною занепокоєння у всьому світі. Мета — визначення поширеності й особливостей сучасного перебігу найбільш поширених АЗ у дітей Київського регіону. Матеріали та методи. Проанкетовано 1011 дітей таких вікових груп: І (1 міс. — 4 роки) — 305, ІІ (6–7 років) — 254, ІІІ (13–14 років) — 254, ІV (15–17 років) — 198. Результати. Отримані досить високі показники поширеності симптомів БА, АР, АД, ХА, ГК та ІА. При цьому виявлені суттєво низькі рівні діагностики даних захворювань, зокрема БА. Незважаючи на значну частоту випадків приступів візингу (більше трьох за минулий рік життя), у дітей всіх вікових категорій вірогідно низька діагностика БА (р = 0), особливо в дітей до 4 років. За отриманими результатами відмічається суттєве зростання частоти проявів ХА у вигляді гострої кропив’янки й ангіонабряку в більш ранньому віці. Відсоток даних проявів у дітей до 4 років вірогідно перевищує рівень показників інших вікових категорій (р &lt; 0,015). Висновки. Рівень діагностики АЗ, зокрема БА, в Україні залишається низьким, особливо в дітей до 4 років.

Use of electronic medical records to describe the prevalence of allergic diseases in Canada

BackgroundLeveraging the data management resources of the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) is a viable approach for describing the prevalence of allergic disease documented in primary care settings.MethodsThe dataset used for this study was inclusive of data from EMR initiation up to Dec 31st 2018. The sample included 1235 primary care providers representing 1,556,472 patients across Canada.ResultsIn total, there were 536,005 patients with a documented allergy that fit into one of the 10 suggested categories. The allergy table includes 718,032 distinct entries representing 564,242 unique patients, which is 36.3% of the patients within the CPCSSN repository. The most common allergies recorded were drug allergy (39.0%), beta-lactam allergy (14.4%), environmental allergy (11.0%), and food allergy (8.0%). Anticipated upcoming studies include physician-documented drug allergy with a focus on beta-lactam allergy, as well as stinging insect allergy, among others. To our knowledge, these will also be the first such prevalence studies of primary care physician-documented allergic disease done in Canada.InterpretationThe CPCSSN dataset represents electronic medical records from 1.5 million patients across Canada including documentation of allergic diseases. This dataset provides a national representative population to describe and characterize Canadian patients with common allergic conditions. This robust dataset provides the opportunity for health surveillance, and in particular data to explore the impact of allergic disease on primary care practice.Trial registrationNot applicable.

Allergic diseases at an early age

In recent years, there has been a sharp increase in the incidence of allergic diseases (ADs), mainly in countries with a high level of development. Particularly noted is the increase in the prevalence of AZs in young children, among which cutaneous and gastrointestinal manifestations of allergy are the most common. These include atopic dermatitis (ATD), urticaria, gastrointestinal manifestations associated in most cases with food allergy, as well as contact allergic dermatitis, and insect allergy. The leading mechanism of development is immunoglobulin E (IgE)-mediated reactions. There are three main factors that predispose to AZ: genetic, direct contact with an allergen, and external environmental factors. The article deals with the causes, manifestations, therapy and diagnosis of a number of allergic diseases: urticaria, allergic contact dermatitis, insect allergy and some methods of therapy.

Investigation of excipients influence on rheological behaviour of hydrogels with dimethindene maleate and dexpanthenol: conditions of controlled shear rate

Abstract Every year, the number of cases of hypersensitivity to insect bites increases. Thus, particular attention needs to be paid to the treatment of insect allergy in children, as scratching the bites can complicate the healing process and lead to infection. Therefore, a topical issue for modern medicine and pharmacy is the development of a gel of combined anti-allergic, reparative and anti-inflammatory action for the treatment of local manifestations of allergic skin reactions. Rheological studies are one of the stages of pharmaceutical development of soft dosage forms. In this study, we perform rheological studies of hydrogels containing 0.1% dimethindene maleate and 3.0% dexpanthenol made on different carriers of dispersed structures: Carbopol™ Polymers carbomer Ultrez 10 NF, Hydroxypropyl methylcellulose (HPMC) of brand Metolose SR-90SH-100000SR, Ziboxan F200 xanthan gum. The rheological studies were undertaken using a rheometer in controlled shear rate mode CSR. Basic structural and mechanical indices of the dispersed systems were determined. These included: yield stress, structural viscosity, viscosity at infinite shear rate, the hysteresis loop area. Moreover, dynamic liquefaction coefficients have been calculated. Based on the rheological studies of hydrogels containing 0.1% dimethindene maleate and 3.0% dexpanthenol prepared with various carriers, the use of 1.8% and 2.0% HPMC hydrogels, 2.0% and 2.5% xanthan gum hydrogels, 0.5% and 0.75% carbomer gels is recommended for further biopharmaceutical studies. The application of one of these formulations as the final composition, provides adhesion and will not complicate the scaling-up of the process.

Status of fungal and insects allergy in patients of rhinitis with or without asthma reporting from the desert area

Background: The most effective diagnostic test to detect IgE mediated type I allergic reactions like allergic rhinitis, atopic asthma, acute urticaria, food allergy, etc. is skin prick test (SPTs). SPTs are performed to check allergic sensitivity and functional for devising immunotherapy as the therapeutic modality. Methodology: Present study was performed in the Department of TB and Respiratory Diseases, S.P. Medical College, Bikaner (Rajasthan). A total of 118 patients suffering from allergic rhinitis with and without bronchial asthma were included in this study. SPT was performed to check reactivity against fungal and insect allergens in the desert areas. Results: Suggested that maximum cases (3/4th) were having both rhinitis and asthma. Around (3/4th) were belonging to rural area. Maximum cases (95%) were belonging to 15-45 years of age group. In fungal group max positivity was seen with Alternaria, Curvularia and Aspergillus fumigatus. In insects group cockroach reactivity was most common. Conclusions: Comparative analysis showed that maximum reactivity was seen with insect allergens than fungal allergens. Among which maximum reactivity was seen against cockroach male. There was significant relief in the severity of symptoms, medication intake with the help of allergen immunotherapy. Keywords: Allergic rhinitis; Asthma; Fungal allergy; Insect allergy; Immunotherapy.

17646 Hydroa vacciniforme-like lymphoproliferative disorder initially presenting as severe insect allergy in a 46-year-old woman

Background: Hydroa vacciniforme–like lymphoproliferative disorder (HV-LPD) is a chronic EBV-associated lymphoproliferative disorder most commonly seen in Asian and South American children. Initially thought to be a benign photodermatosis, HV-LPD is a disorder of monoclonal or rarely polyclonal T cells or NK cells.

Tabanidae insect (horsefly and deerfly) allergy in humans: A review of the literature.

Allergy to insects of the family Tabanidae (order Diptera), commonly called horseflies or deerflies, is anecdotally common, although the published literature is limited to case reports and small case series. This review summarizes the available literature, in which there is enormous variability in clinical detail, identification of species or even genus, and means and thoroughness of assessment of sensitization. The clinical utility of in vivo and in vitro assays remains unclear. Investigation and management of patients reporting anaphylaxis to suspected bites must therefore be pragmatic, by considering other insects (eg Hymenoptera), provision of a written action plan and self-injectable adrenaline if appropriate, and advice on avoidance.

Therapeutic DNA vaccine attenuates itching and allergic inflammation in mice with established biting midge allergy.

Forcipomyia taiwana is a tiny hematophagous midge that attacks en masse. It is responsible for the most prevalent biting insect allergy in Taiwan. For t 2 is its major allergen. The intense itchy reactions can prevent allergic individuals from performing their regular daily outdoor activities. This study aimed to investigate whether the For t 2 DNA vaccine was effective in treating mice with established biting midge allergy. Mice were sensitized with recombinant For t 2 proteins or whole midge extracts. Two to four consecutive shots of various concentrations of For t 2 DNA vaccine, with or without CpG adjuvants, were then administered to midge-sensitized mice. Mice that received two shots of 50-100 μg For t 2 DNA vaccine showed a significant reduction in allergen-induced bouts of scratching, For t 2-specific IgE, specific IgG1/IgG2a ratio in sera, skin eosinophil infiltration, and IL-31 production, as well as IL-4 and IL-13 production by splenocytes. Two doses of For t 2 DNA vaccine one week apart was sufficient to treat mice with established biting midge allergy. The treatment resulted in clinical, immunological, and histopathological improvements. We recommend that this low-cost, convenient treatment strategy be developed for use in humans who are allergic to biting midges.

Epidemiological Pilot Study of the Sensitization to Caterpillars of the Genus &lt;i&gt;Thaumetopoea&lt;/i&gt; in Forestry Workers in Bulgaria

Insect bites and Lepidopterism are a major sensitization hazard for forestry workers. In recent years, different species of the genus Thaumetopoea are expanding their habitat in Bulgaria and represent a serious health threat for people working in the forests. The present epidemiological pilot study aims to investigate the specific sensitization of the forestry workers to the caterpillars of the most spread Thaumetopoea species in Bulgaria, as well as to evaluate their hypersensitivity to a range of inhalant, insect and food allergens.Thirty four forestry workers (28 men and 6 women) were surveyed. The sensitization to pine processionary (Thaumetopoea pityocampa); oak processionary (Thaumetopoea processionea) and Thaumetopoea solitaria was assessed by skin prick tests. Blood samples were taken for determination of total and allergen-specific IgE against a range of inhalant, insect and food allergens. Fourteen (41%) of the forestry workers reported skin rash, itching, runny nose and sneezing during their daily professional activities in the forest. Sixteen (47%) were sensitized to one or more representatives of the Thaumetopoeidae family. The most common is poly-sensitization to all three Thaumetopoea species - in 6 (38%), as well as mono-sensitization to pine processionary - in other 5 (31%). In 13 (39%) increased levels of total IgE, were found. A prevalence of insect allergy was also found. In conclusion, this pilot study provided important information on the impact of the different Thaumetopoea species on the health of the forestry workers. It also outlined the key role of different environmental allergens for the development of symptoms of IgE-mediated allergy and the need for more detailed epidemiologic and allergologic study on the medico-social importance of the sensitization to Thaumetopoea species.

Insect allergy: local and systemic manifestations

<h3></h3> Аллергические реакции на укусы и ужаления насекомых являются распространенной проблемой, и степень тяжести реакций варьирует от выраженных местных проявлений до анафилаксии. В настоящем обзоре обобщены данные российской и зарубежной литературы о важных, с медицинской точки зрения, насекомых, их месте в классификации, факторах риска и эпидемиологии инсектной аллергии в России и мире, дана краткая характеристика механизмов гиперчувствительности к аллергенам насекомых. Описаны большие (выраженные) местные реакции, системные аллергические, системные токсические реакции и необычные реакции на укусы жалящих насекомых. Поскольку практикующие врачи чаще всего сталкиваются с развитием местных аллергических реакций на нежалящих насекомых, подробно охарактеризованы клинические проявления, связанные с укусами кровососущих и кусающих насекомых, а также некоторые контактные реакции. Описаны нечастые проявления инсектной аллергии на кровососущих насекомых, такие как папулезная крапивница, синдром Скитера, и тяжелые местные реакции, связанные с возможной ассоциацией с вирусом Эпштейна—Барр. Диагностика пациентов с инсектной аллергией складывается из сбора анамнеза, который имеет свои особенности, показанием к дальнейшему специфическому обследованию для выявления причинно-значимых аллергенов являются системные реакции на укусы жалящих насекомых. Приведены основные подходы к лечению и профилактике местных и системных проявлений инсектной аллергии врача-дерматолога. Перенесенные системные реакции на укусы перепончатокрылых насекомых являются показанием для направления к аллергологу-иммунологу для консультации по оказанию самостоятельной неотложной помощи при последующих ужалениях и определения возможности аллергенспецифической иммунотерапии.

Diagnostics of insect allergy in clinical practice

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Insect sting allergy: new guidelines from the European and USA consensus groups: algorithms and recommendations.

Guidelines on insect sting allergy and venom immunotherapy (VIT) have been updated. This review describes the evolution of these guidelines and their similarities and differences. The US and European guidelines show the evolution of guideline development in the grading of recommendations and the transparency of the evaluation of evidence. The US and European guidelines on VIT are similar in most areas and complimentary in others. The European guidelines are limited to VIT and are based on a published systematic review; the US practice parameters cover all areas of the diagnosis and management of insect sting allergy and do not use the Grading of Recommendation Assessment, Development and Evaluation (GRADE) approach.There is general agreement that both children and adults with cutaneous systemic reactions do not require VIT, and that there is minimal risk associated with β-blockers and angiotensin-converting enzyme inhibitors during VIT. There are minor differences in the details of VIT dose, regimen, and choice of venom, but agreement on the duration and risk factors for relapse after VIT. The US and European guidelines are complementary in their discussion of the relation of mastocystosis and insect sting anaphylaxis and the value of measuring basal serum tryptase. The updated guidelines on insect sting allergy from the US and European groups differ in scope, with a somewhat different focus in specific areas but are complementary overall. Where they overlap, there are relatively few differences in recommendations, and these are subtle. The US practice parameter offers an annotated algorithm for the evaluation and treatment of patients with reactions to insect stings.