Peng Zhikang, Simons F Estelle R
Department of Pediatrics and Child Health and Department of Immunology, University of Manitoba, Winnipeg, Manitoba, Canada.
Curr Opin Allergy Clin Immunol. 2007 Aug;7(4):350-4. doi: 10.1097/ACI.0b013e328259c313.
Allergic reactions, including severe local and systemic reactions to mosquito bites, are immunological in nature, and involve immunoglobulin E, immunoglobulin G, and T-lymphocyte-mediated hypersensitivities in response to allergens in mosquito saliva. Naturally acquired desensitization to mosquito saliva may occur during childhood or during long-term exposure to mosquitoes. Due to the lack of availability of mosquito salivary preparations for use in skin tests and in-vitro tests, allergic reactions to mosquito bites are under diagnosed and under treated.
Recombinant saliva allergens with biological activity are being developed. Recombinant Aedes aegypti salivary allergen rAed a 2 has been expressed, purified, characterized and used in in-vitro diagnosis of mosquito allergy. Mosquito saliva-induced non-immunoglobulin E-mediated skin mast cell degranulation was found to induce macrophage-inflammatory protein 2 in the skin and interleukin-10 in draining lymph nodes.
In this review, we discuss the allergic reactions to mosquito salivary allergens, the immune mechanisms involved, natural desensitization and immunotherapy with mosquito extracts, characteristics of salivary allergens and their recombinant forms, and prevention and treatment of allergic reactions to mosquito bites. Eventually, recombinant salivary allergens will significantly improve the diagnosis of mosquito allergy, and will also improve specific immunotherapy for patients with systemic reactions to mosquito bites.
过敏反应，包括对蚊虫叮咬的严重局部和全身反应，本质上是免疫反应，涉及免疫球蛋白E、免疫球蛋白G以及T淋巴细胞介导的针对蚊虫唾液中过敏原的超敏反应。对蚊虫唾液的自然获得性脱敏可能发生在儿童期或长期接触蚊虫的过程中。由于缺乏用于皮肤试验和体外试验的蚊虫唾液制剂，对蚊虫叮咬的过敏反应诊断不足且治疗不足。
具有生物活性的重组唾液过敏原正在研发中。重组埃及伊蚊唾液过敏原rAed a 2已被表达、纯化、鉴定，并用于蚊虫过敏的体外诊断。发现蚊虫唾液诱导的非免疫球蛋白E介导的皮肤肥大细胞脱颗粒可诱导皮肤中的巨噬细胞炎性蛋白2和引流淋巴结中的白细胞介素10。
在本综述中，我们讨论了对蚊虫唾液过敏原的过敏反应、涉及的免疫机制、自然脱敏和蚊虫提取物免疫疗法、唾液过敏原及其重组形式的特性，以及对蚊虫叮咬过敏反应的预防和治疗。最终，重组唾液过敏原将显著改善蚊虫过敏的诊断，也将改善对蚊虫叮咬有全身反应患者的特异性免疫疗法。
