Reactions to Honeybee Stings
Purpose of review The purpose of this article is to provide a brief overview of the events involved in honeybee allergy and to concisely update the reader on progress toward knowledge of honeybee venom (HBV), strides in solving diagnostic difficulties, and advancements in improving safety and efficacy of HBV immunotherapy.
Recent findings It is well known that honeybee allergy is unique in venom allergen and protein composition, diagnostic challenges, and immunotherapy safety and efficacy. Many new honeybee allergens have been recognized. Advances in testing, evaluation, and extract manipulation methods, many using recombinant technology, have allowed a greater ability to help with honeybee allergy diagnosis and resultant improvement in immunotherapy safety and evaluation of immunotherapy efficacy.
Summary In an effort to address many honeybee allergy concerns, specific advances have been recently made. Some recently characterized honeybee allergens appear to be major contributors to honeybee allergy. In the setting of double-positivity, cross-reacting carbohydrate determinants and other cross-reacting components in HBV have made diagnosis of honeybee allergy challenging. Recombinant technology, including component-resolved diagnostics, and other evolving testing methods should help clarify double-positivity, if not now, in the very near future. Purified HBV and possibly depot formulations for immunotherapy appear to make it more well tolerated. Recombinant methods may help with evaluation of immunotherapy's safety and efficacy.
To the practicing allergist, venom allergy is important because of the life-protecting implications of recognition and proper therapy. More than other flying Hymenoptera, honeybee allergy presents unique challenges. Diagnosis of true honeybee sensitization, especially in the face of double-positivity, and the efficacy and safety of honeybee venom immunotherapy (VIT) are often problematic and remain the focus of ongoing research. After reviewing honeybee sting reactions, this review summarizes recent findings in allergenic honeybee venom (HBV) components, progress to solve challenges in diagnosing honeybee sensitization and hence true allergy, and strides in making honeybee VIT more well tolerated and efficacious.
Abstract and Introduction
Abstract
Purpose of review The purpose of this article is to provide a brief overview of the events involved in honeybee allergy and to concisely update the reader on progress toward knowledge of honeybee venom (HBV), strides in solving diagnostic difficulties, and advancements in improving safety and efficacy of HBV immunotherapy.
Recent findings It is well known that honeybee allergy is unique in venom allergen and protein composition, diagnostic challenges, and immunotherapy safety and efficacy. Many new honeybee allergens have been recognized. Advances in testing, evaluation, and extract manipulation methods, many using recombinant technology, have allowed a greater ability to help with honeybee allergy diagnosis and resultant improvement in immunotherapy safety and evaluation of immunotherapy efficacy.
Summary In an effort to address many honeybee allergy concerns, specific advances have been recently made. Some recently characterized honeybee allergens appear to be major contributors to honeybee allergy. In the setting of double-positivity, cross-reacting carbohydrate determinants and other cross-reacting components in HBV have made diagnosis of honeybee allergy challenging. Recombinant technology, including component-resolved diagnostics, and other evolving testing methods should help clarify double-positivity, if not now, in the very near future. Purified HBV and possibly depot formulations for immunotherapy appear to make it more well tolerated. Recombinant methods may help with evaluation of immunotherapy's safety and efficacy.
Introduction
To the practicing allergist, venom allergy is important because of the life-protecting implications of recognition and proper therapy. More than other flying Hymenoptera, honeybee allergy presents unique challenges. Diagnosis of true honeybee sensitization, especially in the face of double-positivity, and the efficacy and safety of honeybee venom immunotherapy (VIT) are often problematic and remain the focus of ongoing research. After reviewing honeybee sting reactions, this review summarizes recent findings in allergenic honeybee venom (HBV) components, progress to solve challenges in diagnosing honeybee sensitization and hence true allergy, and strides in making honeybee VIT more well tolerated and efficacious.