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昆虫毒液过敏反应的流行病学

Epidemiology of insect-venom anaphylaxis.

作者信息

Bilò Beatrice M, Bonifazi Floriano

机构信息

Department of Internal Medicine, Immunology, Allergy and Respiratory Diseases, Azienda Ospedaliero-Universitaria, Ospedali Riuniti, Ancona, Italy.

出版信息

Curr Opin Allergy Clin Immunol. 2008 Aug;8(4):330-7. doi: 10.1097/ACI.0b013e32830638c5.

Abstract

PURPOSE OF REVIEW

Knowledge of the epidemiology, natural history and risk factors of insect-venom allergy is crucial for improving the clinical management of allergic patients. This review focuses on the recent research on these aspects of Hymenoptera-sting anaphylactic reactions.

RECENT FINDINGS

The latest data from population-based studies of anaphylactic reactions due to Hymenoptera stings, as well as those extrapolated from studies of epidemiology of anaphylaxis due to any cause are reviewed. The topic of biphasic anaphylactic reactions due to insect stings is also examined. Although no parameter has been identified that can predict which sensitized individuals will have a future anaphylactic reaction, several factors associated with the severity of a systemic resting reaction are known and emphasized here.

SUMMARY

As half of individuals with fatal sting reactions had no documented history of previous systemic reaction, we need to further improve the knowledge of the natural history and risk factors, especially in asymptomatic-sensitized individuals. Moreover, and no less important, the epidemiological studies on sting anaphylaxis conducted in the 2000s continue to reveal the poor management of allergic patients and the startling lack of awareness of the efficacy of venom immunotherapy. These findings indicate the urgent need to educate the general population and doctors on the management of venom-allergic patients.

摘要

综述目的

了解昆虫毒液过敏的流行病学、自然史和危险因素对于改善过敏患者的临床管理至关重要。本综述重点关注膜翅目昆虫叮咬过敏反应在这些方面的最新研究。

最新发现

回顾了基于人群的膜翅目昆虫叮咬过敏反应研究的最新数据,以及从任何原因引起的过敏反应流行病学研究中推断出的数据。还探讨了昆虫叮咬引起的双相过敏反应这一主题。尽管尚未确定能够预测哪些致敏个体将来会发生过敏反应的参数,但已知并在此强调了几个与全身性叮咬反应严重程度相关的因素。

总结

由于半数致命叮咬反应患者既往无全身性反应的记录,我们需要进一步了解自然史和危险因素,尤其是在无症状致敏个体中。此外,同样重要的是,21世纪开展的关于叮咬过敏反应的流行病学研究继续揭示过敏患者管理不善以及对毒液免疫疗法疗效惊人的缺乏认识。这些发现表明迫切需要对普通人群和医生进行毒液过敏患者管理方面的教育。

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