Zink Alexander, Schuster Barbara, Winkler Julia, Eyerich Kilian, Darsow Ulf, Brockow Knut, Eberlein Bernadette, Biedermann Tilo
Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.
World Allergy Organ J. 2019 Jun 28;12(7):100039. doi: 10.1016/j.waojou.2019.100039. eCollection 2019.
Hymenoptera venom sensitization in highly exposed individuals frequently requires risk assessment for future severe sting reactions. In this study, we determined the prevalence of Hymenoptera venom sensitization in individuals who hunt and fish and analyzed possible correlations between the severity of sting reactions and the IgE sensitization profile.
In this cross-sectional study, paper-based, self-filled questionnaires about previous insect stings and sting reactions were obtained from individuals who hunt and fish in Bavaria, Germany. Blood samples were taken and analyzed for the levels of tryptase, total IgE and IgE to honey bee (i1) and wasp (13) venom, the recombinant allergens rApi m 1, rApi m 2, rApi m 3, rApi m 5, rApi m 10, rVes v 1, rVes v 5, and the CCD marker molecule MUXF3. Odd ratios (ORs) for sensitization and anaphylaxis and Pearson's correlations for the different allergens were calculated.
Of 257 participants, 50.2% showed a sensitization to honey bee venom (i1), and 58.4% showed sensitization to wasp venom (i3). A total of 98.4% of participants claimed to have been stung at least once. Anaphylaxis was reported in 18.7%, and a local sting reaction was reported in 18.3%. The highest sensitization rates were found for whole venom extracts, sensitization to any of the available recombinant allergens exceeded sIgE levels to honeybee venom (i1) in 28.5% and to wasp venom (i3) in 52.9% of participants. Participants with a history of more than 5 stings showed a higher risk for anaphylaxis.
Sensitization to Hymenoptera venom and their recombinant allergens are present in the majority of individuals who hunt and fish. Sensitization to distinct recombinant allergens does not necessarily affect the severity of sting reactions including anaphylaxis. A meticulous medical history of the number of previous stings as well as systemic reactions remains essential.
在高度暴露的个体中，膜翅目毒液致敏情况常常需要对未来严重蜇伤反应进行风险评估。在本研究中，我们测定了狩猎和捕鱼个体中膜翅目毒液致敏的患病率，并分析了蜇伤反应严重程度与IgE致敏谱之间的可能相关性。
在这项横断面研究中，我们从德国巴伐利亚州的狩猎和捕鱼个体中获取了基于纸质的、自行填写的关于既往昆虫蜇伤和蜇伤反应的问卷。采集血样并分析其中类胰蛋白酶、总IgE以及针对蜜蜂（i1）和黄蜂（i3）毒液、重组变应原rApi m 1、rApi m 2、rApi m 3、rApi m 5、rApi m 10、rVes v 1、rVes v 5以及慢性荨麻疹标记分子MUXF3的IgE水平。计算致敏和过敏反应的比值比（OR）以及不同变应原之间的Pearson相关性。
257名参与者中，50.2%对蜜蜂毒液（i1）致敏，58.4%对黄蜂毒液（i3）致敏。共有98.4%的参与者声称至少被蜇过一次。报告有过敏反应的占18.7%，报告有局部蜇伤反应的占18.3%。全毒液提取物的致敏率最高，28.5%的参与者对任何一种可用重组变应原的致敏超过了对蜜蜂毒液（i1）的特异性IgE水平，52.9%的参与者超过了对黄蜂毒液（i3）的特异性IgE水平。有超过5次蜇伤史的参与者发生过敏反应的风险更高。
大多数狩猎和捕鱼个体存在对膜翅目毒液及其重组变应原的致敏情况。对不同重组变应原的致敏不一定会影响包括过敏反应在内的蜇伤反应的严重程度。既往蜇伤次数以及全身反应的详细病史仍然至关重要。
