Korošec Peter, Jakob Thilo, Harb Harfi, Heddle Robert, Karabus Sarah, de Lima Zollner Ricardo, Selb Julij, Thong Bernard Yu-Hor, Zaitoun Fares, Golden David B K, Levin Michael
University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.
Department of Dermatoloy and Allergy, University Medical Center Giessen UKGM, Justus-Liebig-University, Giessen, Germany.
World Allergy Organ J. 2019 Oct 24;12(10):100067. doi: 10.1016/j.waojou.2019.100067. eCollection 2019 Oct.
Venom immunotherapy is the standard of care for people with severe reactions and has been proven to reduce risk of future anaphylactic events. There is a moral imperative to ensure production, supply and worldwide availability of locally relevant, registered, standardized commercial venom extracts for diagnosis and treatment. Insects causing severe immediate allergic reactions vary by region worldwide. The most common culprits include honeybees (), social wasps including yellow jackets ( and ), paper wasps () and hornets (), stinging ants (, , , and ), and bumblebees (). Insects with importance in specific areas of the world include the Australian tick (), the kissing bug ( spp), horseflies ( spp), and mosquitoes (, , ). Reliable access to high quality venom immunotherapy to locally relevant allergens is not available throughout the world. Many current commercially available therapeutic vaccines have deficiencies, are not suitable for, or are unavailable in vast areas of the globe. New products are required to replace products that are unstandardized or inadequate, particularly whole-body extract products. New products are required for insects in which no current treatment options exist. Venom immunotherapy should be promoted throughout the world and the provision thereof be supported by health authorities, regulatory authorities and all sectors of the health care service.
毒液免疫疗法是重度过敏反应患者的标准治疗方法,并且已被证明可降低未来发生过敏反应事件的风险。从道德层面上讲,必须确保生产、供应并在全球范围内提供适用于当地、已注册、标准化的商业毒液提取物,用于诊断和治疗。在全球范围内,引起严重速发型过敏反应的昆虫因地区而异。最常见的罪魁祸首包括蜜蜂()、社会性黄蜂,如小黄蜂(和)、胡蜂()和大黄蜂()、叮人的蚂蚁(、、、和)以及熊蜂()。在世界特定地区具有重要影响的昆虫包括澳大利亚蜱()、锥蝽(锥蝽属)、马蝇(马蝇属)和蚊子(、、)。在全球范围内,并非处处都能可靠地获得针对当地相关过敏原的高质量毒液免疫疗法。目前许多商业可用的治疗性疫苗存在缺陷,在全球广大地区不适用或无法获得。需要新产品来替代未标准化或不合格的产品,特别是全身体外提取物产品。对于目前尚无治疗选择的昆虫,需要新产品。应在全球范围内推广毒液免疫疗法,卫生当局、监管当局和医疗服务的所有部门都应支持其供应。