Inmunotek, S.L. Alcalá de Henares, Madrid, Spain.
Faculty of Medicine, Universidad de los Andes, Allergy Section, Fundación Santa Fe de Bogotá, UNIMEQ ORL, Bogotá, Colombia.
Mol Immunol. 2023 Dec;164:153-158. doi: 10.1016/j.molimm.2023.11.009. Epub 2023 Nov 30.
Mosquito allergy has been conceived as the cutaneous reactions that appears during and after mosquito biting process; a perception that is supported by several scientific research. Additional data have led to conceive that other manifestations of allergic responses may occur as a cause of the exposure to somatic mosquito allergens. Two main phenotypes of mosquito allergy are identifiable: the cutaneous allergic reactions, induced by salivary allergens, and other manifestations of the allergic responses such as asthma and allergic rhino conjunctivitis that are caused by somatic allergens. The cutaneous reactions have kept the focus of attention of the scientific community. It appears as skin lesions that resembles the phenotype of papular urticaria with a defined natural history of the disease. Although these two phenotypes of mosquito allergy seem to be well differentiated in terms of the allergens that are involved and the routes of exposures, other factors such as geographical distribution, may participate. Mosquitoes have adapted to the host immune response against bites, producing immunomodulatory molecules that counteract such defensive response. The role that the immunomodulatory molecules have on the allergic immune response has not been studied yet and it is still not known if affects all mosquito allergy phenotypes. Only a few studies of allergen specific immunotherapy for cutaneous allergic reactions induced by mosquito bites have been done, and none for respiratory allergic responses. The clinical practice focuses on symptom management and avoiding mosquito bites as much as possible. Avoiding mosquitoes, using different well described methods, is still the best option to limit contact with these insects. The lack of knowledge of mosquito allergy have raised several questions that affects the clinical management of this allergic disease, from its diagnosis, prevention and immunotherapy.
蚊虫过敏被认为是在蚊虫叮咬过程中及之后出现的皮肤反应；这一观点得到了多项科学研究的支持。进一步的研究表明，由于接触到了虫体过敏原，可能会出现其他过敏反应的表现。蚊虫过敏有两种主要的表型：一种是由唾液过敏原引起的皮肤过敏反应，另一种是由体过敏原引起的过敏反应的其他表现，如哮喘和过敏性鼻结膜炎。皮肤反应一直是科学界关注的焦点。它表现为类似于丘疹性荨麻疹的皮肤损伤，具有明确的疾病自然史。尽管这两种蚊虫过敏表型在涉及的过敏原和暴露途径方面似乎有很好的区分，但其他因素，如地理分布，也可能参与其中。蚊子已经适应了宿主对叮咬的免疫反应，产生了免疫调节分子，以对抗这种防御反应。免疫调节分子在过敏免疫反应中的作用尚未得到研究，也不知道它是否会影响所有蚊虫过敏表型。只有少数关于蚊虫叮咬引起的皮肤过敏反应的过敏原特异性免疫治疗的研究，而没有关于呼吸道过敏反应的研究。临床实践的重点是症状管理和尽可能避免蚊虫叮咬。尽可能避免蚊虫，使用不同的、已明确描述的方法，仍然是限制与这些昆虫接触的最佳选择。对蚊虫过敏的了解不足，引发了一些问题，影响了这种过敏性疾病的临床管理，包括其诊断、预防和免疫治疗。
