Eich-Wanger C, Müller U R
Division of Internal Medicine, Zieglerspital, Bern, Switzerland.
Clin Exp Allergy. 1998 Oct;28(10):1292-8. doi: 10.1046/j.1365-2222.1998.00411.x.
Beekeepers are strongly exposed to honey bee stings and therefore at an increased risk to develop IgE-mediated allergy to bee venom.
We wondered whether bee venom-allergic beekeepers were different from normally exposed bee venom-allergic patients with regard to clinical and immunological parameters as well as their response to venom immunotherapy.
Among the 459 bee venom-allergic patients seen over the 5 year period 1987-91, 62 (14%) were beekeepers and 44 (10%) family members of beekeepers. These two groups were compared with 101 normally exposed bee venom-allergic patients matched with the allergic beekeepers for age and sex, regarding clinical parameters, skin sensitivity, specific IgE and IgG antibodies to bee venom as well as safety and efficacy of venom immunotherapy.
As expected, allergic beekeepers had been stung most frequently before the first allergic reaction. The three groups showed a similar severity of allergic symptoms following bee stings and had an equal incidence of atopic diseases. Allergic beekeepers showed higher levels of bee venom-specific serum IgG, lower skin sensitivity and lower levels of bee venom specific serum IgE than bee venom-allergic control patients. A negative correlation between number of stings and skin sensitivity as well as specific IgE was found in allergic beekeepers and their family members, while the number of stings was positively correlated with specific IgG in these two groups. Venom immunotherapy was equally effective in the three groups, but better tolerated by allergic beekeepers than the two other groups. The majority of allergic beekeepers continued bee-keeping successfully under the protection of venom immunotherapy.
The lower level of sensitivity in diagnostic tests and the better tolerance of immunotherapy in allergic beekeepers is most likely related to the high level of specific IgG in this group.
养蜂人频繁接触蜜蜂蜇刺，因此发生IgE介导的蜂毒过敏风险增加。
我们想知道，在临床和免疫学参数以及对蜂毒免疫疗法的反应方面，对蜂毒过敏的养蜂人与正常接触蜂毒的过敏患者是否存在差异。
在1987年至1991年这5年期间就诊的459例蜂毒过敏患者中，62例（14%）为养蜂人，44例（10%）为养蜂人的家庭成员。将这两组与101例年龄和性别与过敏养蜂人相匹配的正常接触蜂毒的过敏患者进行比较，比较内容包括临床参数、皮肤敏感性、针对蜂毒的特异性IgE和IgG抗体，以及蜂毒免疫疗法的安全性和有效性。
正如预期的那样，过敏养蜂人在首次过敏反应之前被蜇刺的频率最高。三组在蜜蜂蜇刺后出现的过敏症状严重程度相似，特应性疾病的发病率相同。与蜂毒过敏对照患者相比，过敏养蜂人显示出更高水平的蜂毒特异性血清IgG、更低的皮肤敏感性和更低水平的蜂毒特异性血清IgE。在过敏养蜂人及其家庭成员中，蜇刺次数与皮肤敏感性以及特异性IgE之间呈负相关，而在这两组中，蜇刺次数与特异性IgG呈正相关。蜂毒免疫疗法在三组中同样有效，但过敏养蜂人比其他两组耐受性更好。大多数过敏养蜂人在蜂毒免疫疗法的保护下继续成功从事养蜂工作。
过敏养蜂人诊断试验中的敏感性较低以及免疫疗法耐受性较好，很可能与该组中高水平的特异性IgG有关。
