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1.
Allergy Asthma Proc ; 45(3): 195-200, 2024 May 01.
Article in English | MEDLINE | ID: mdl-38755779

ABSTRACT

Introduction: Hymenoptera venom immunotherapy (VIT) is the only therapy that protects patients with Hymenoptera venom allergy by preventing systemic reactions after a new sting. Various extracts for VIT are available and used. VIT administration consists of an induction phase and a maintenance phase. Depot preparations of Hymenoptera VIT extracts are typically used for cluster and conventional protocols, and the maintenance phase. Many patients with Hymenoptera allergy need to achieve tolerance quickly because of the high risk of re-sting and possible anaphylaxis. Objective: Our study aimed to show the safety and efficacy of an accelerated regimen with depot preparations on aluminum hydroxide by using relatively high starting doses in a heterogeneous group of patients. Methods: The research focused on a group of patients with a history of severe systemic reactions to Hymenoptera stings, with the necessity of swift immunization due to high occupational risks. Aluminum hydroxide depot extracts either of Vepula species or Apis mellifera extracts were used. Results: The induction protocol was started with the highest concentration of depot venom extract of 100,000 standard quality unit and was well tolerated by 19 of 20 patients. Onne patient presented with a mild systemic reaction during the accelerated induction schedule, which was promptly treated with intravenous steroids and intramuscular H1 antihistamine; when switched to a conventional induction protocol, he had a similar reaction but finally reached maintenance with an H1-antagonist premedication. Conclusion: If validated, the accelerated induction protocol by using depot aluminum adsorbed extracts with the highest concentration of venom from the beginning could offer a streamlined and accessible treatment modality for patients diagnosed with anaphylaxis from bee and wasp venoms in need of rapid desensitization.


Subject(s)
Desensitization, Immunologic , Hymenoptera , Humans , Desensitization, Immunologic/methods , Desensitization, Immunologic/adverse effects , Animals , Adult , Male , Female , Middle Aged , Hymenoptera/immunology , Aluminum Hydroxide , Insect Bites and Stings/immunology , Insect Bites and Stings/therapy , Treatment Outcome , Young Adult , Allergens/immunology , Allergens/administration & dosage , Adolescent , Hypersensitivity/therapy , Hypersensitivity/immunology , Arthropod Venoms/immunology , Aged , Bee Venoms/immunology , Bee Venoms/administration & dosage , Bee Venoms/adverse effects
2.
Med Clin North Am ; 108(4): 757-776, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38816116

ABSTRACT

Stinging insects are a frequent cause of local and systemic hypersensitivity reactions, including anaphylaxis. For those with a history of life-threatening anaphylaxis, venom immunotherapy is effective, safe, and can be life-saving. Arachnids are a much less common source of envenomation through bites or stings and are less likely to cause a hypersensitivity reaction. However, recognizing the clinical manifestations when they do present is important for accurate diagnosis and treatment, and, when indicated, consideration of other diagnoses.


Subject(s)
Anaphylaxis , Insect Bites and Stings , Humans , Insect Bites and Stings/complications , Anaphylaxis/therapy , Anaphylaxis/diagnosis , Anaphylaxis/etiology , Animals , Hypersensitivity/therapy , Hypersensitivity/diagnosis , Arthropod Venoms/immunology , Arthropod Venoms/adverse effects , Desensitization, Immunologic/methods , Venom Hypersensitivity
3.
BMC Immunol ; 25(1): 23, 2024 Apr 27.
Article in English | MEDLINE | ID: mdl-38678193

ABSTRACT

BACKGROUND: Flow cytometry-based basophil activation tests (BAT) have been performed with various modifications, differing in the use of distinct identification and activation markers. Established tests use liquid reagents while a new development involves the use of tubes with dried antibody reagents. The aim of this pilot study was to compare these two techniques in patients with insect venom allergy. METHODS: Seventeen patients with an insect venom allergy were included in the study. The established "BAT 1" utilizes conventional antibody solutions of anti-CCR3 for basophil identification and anti-CD63 to assess basophil activation, whereas "BAT 2" uses dried anti-CD45, anti-CD3, anti-CRTH2, anti-203c and anti-CD63 for identification and activation measurement of basophils. Negative and positive controls as well as incubations with honey bee venom and yellow jacket venom at three concentrations were performed. RESULTS: Seven patients had to be excluded due to low basophil counts, high values in negative controls or negative positive controls. For the remaining 10 patients the overall mean (± SD) difference in activated basophils between the two tests was 0.2 (± 12.2) %P. In a Bland-Altman plot, the limit of agreement (LoA) ranged from 24.0 to -23.7. In the qualitative evaluation (value below/above cut-off) Cohen's kappa was 0.77 indicating substantial agreement. BAT 2 took longer to perform than BAT 1 and was more expensive. CONCLUSION: The BAT 2 technique represents an interesting innovation, however, it was found to be less suitable compared to an established BAT for the routine diagnosis of insect venom allergies.


Subject(s)
Basophils , Flow Cytometry , Humans , Basophils/immunology , Female , Male , Adult , Middle Aged , Flow Cytometry/methods , Arthropod Venoms/immunology , Pilot Projects , Animals , Hypersensitivity/immunology , Hypersensitivity/diagnosis , Insect Bites and Stings/immunology , Insect Bites and Stings/diagnosis , Bee Venoms/immunology , Young Adult , Aged , Antibodies/immunology , Adolescent , Basophil Degranulation Test/methods , Venom Hypersensitivity
4.
Toxicon ; 241: 107685, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38503352

ABSTRACT

Determination of protein concentration in Hymenoptera venoms requires an accurate and reproducible assay as the results will be used to support subsequent proteomic techniques employed in their analyses. However, all protein assay techniques have inherent strengths and weaknesses, demanding their assessment before selecting the most suitable platform for sample analysis. In this study, protein profiles of ant, honeybee, and wasp venoms, and bovine serum albumin (BSA) and hyaluronidase standards were qualitatively assessed using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Their amino acid and protein concentration were quantitatively determined via Amino Acid Analysis (AAA). Amino acid concentration was determined via hydrolysis, derivatization, and chromatographic quantification. Protein concentration was estimated using four different protein concentration assays. The ratios of protein concentration in venom samples to protein standards were calculated, and the accuracy of the protein concentration assays was analysed relative to the concentration determined from AAA. SDS-PAGE analysis showed that BSA contained several protein bands, while hyaluronidase contained a mixture of peptide and protein bands. Ant and honeybee venoms contained a higher proportion of peptide bands, while wasp venom contained more protein bands. As determined by AAA, the ratio of protein concentration in Hymenoptera venoms varied between 1.01 and 1.11 to BSA, and between 0.96 and 1.06 to hyaluronidase. Overall, the Bradford assay was found to be the least accurate and the BCA assay was the most accurate in estimating protein concentration in Hymenoptera venoms. There was no significant advantage in using hyaluronidase as a standard or increasing incubation temperature of BCA assay when analysing Hymenoptera venoms. Diluent solutions containing phenol and human serum albumin interfered with Lowry-based assays.


Subject(s)
Arthropod Venoms , Bee Venoms , Hymenoptera , Bees , Humans , Animals , Proteome , Hyaluronoglucosaminidase/analysis , Proteomics , Wasp Venoms , Venoms , Amino Acids , Serum Albumin, Bovine , Peptides , Allergens
5.
Int J Mol Sci ; 25(6)2024 Mar 20.
Article in English | MEDLINE | ID: mdl-38542470

ABSTRACT

Allergen-specific venom immunotherapy (VIT) is a well-established therapy for Hymenoptera venom allergy (HVA). However, the precise mechanism underlying its clinical effect remains uncertain. Our study aimed to identify the molecular mechanisms associated with VIT efficiency. We prospectively included 19 patients with HVA undergoing VIT (sampled before the beginning of VIT, after reaching the maintenance dose, one year after finishing VIT, and after a sting challenge) and 9 healthy controls. RNA sequencing of whole blood was performed on an Illumina sequencing platform. Longitudinal transcriptomic profiling revealed the importance of the inhibition of the NFκB pathway and the downregulation of DUX4 transcripts for the early protection and induction of tolerance after finishing VIT. Furthermore, successful treatment was associated with inhibiting Th2, Th17, and macrophage alternative signalling pathways in synergy with the inhibition of the PPAR pathway and further silencing of the Th2 response. The immune system became activated when reaching the maintenance dose and was suppressed after finishing VIT. Finally, successful VIT restores the immune system's balance to a state similar to that of healthy individuals. Our results underline the important role of the inhibition of four pathways in the clinical effect of VIT: Th2, Th17, NFκB, and macrophage signalling. Two biomarkers specific for successful VIT, regardless of the time of sampling, were C4BPA and RPS10-NUDT3 and should be further tested as potential biomarkers.


Subject(s)
Arthropod Venoms , Hymenoptera , Hypersensitivity , Animals , Humans , Hymenoptera/genetics , Desensitization, Immunologic/methods , Hypersensitivity/therapy , Treatment Outcome , Immunotherapy , Biomarkers , Gene Expression Profiling , Gene Expression
6.
Iran J Allergy Asthma Immunol ; 23(1): 59-68, 2024 Feb 11.
Article in English | MEDLINE | ID: mdl-38485910

ABSTRACT

Little is known about the quality of life of patients with anaphylaxis to Hymenoptera venom. The Vespid Allergy Quality of Life Questionnaire (VQLQ) is commonly used to assess the psychological burden of this condition. This study aimed to evaluate the validity and reliability of the Persian version of VQLQ. In this cross-sectional study, VQLQ was translated into Persian according to expert recommendations.  The final translated version of VQLQ was then administered to 115 patients with Hymenoptera venom allergy at an asthma and allergy clinic in Iran. More than half of the participants were between 20 and 40 years of age, and 60% were male. Fear, anxiety, and outdoor activities had the most significant impact on the quality of life of patients with Hymenoptera venom allergy. Additionally, quality of life was more affected in women than in men, while no correlation was found with age. Furthermore, the quality of life was affected by a history of acute anaphylactic shock due to Hymenoptera venom. The Persian version of VQLQ enables the measurement of quality of life in patients with Hymenoptera venom allergy in the Iranian population. The inclusion of VQLQ in the initial evaluation of these patients may potentially guide allergist in providing support for venom-specific immunotherapy.


Subject(s)
Anaphylaxis , Arthropod Venoms , Hymenoptera , Insect Bites and Stings , Animals , Humans , Male , Female , Iran/epidemiology , Quality of Life , Cross-Sectional Studies , Reproducibility of Results , Desensitization, Immunologic
7.
Toxicon ; 240: 107630, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38342412

ABSTRACT

The pathophysiology of recurrent pregnancy loss (RPL) involves deficiencies in the proliferation and migration capacities of endometrial stromal cells (hESCs), which impair embryo implantation and development. Since animal venoms are rich source of bioactive molecules, we aimed to characterize the cytoprotective effects of Lonomia obliqua venom on hESCs. hESCs were isolated from endometrial biopsies and the mechanisms of L. obliqua venomous secretions on cell viability, proliferation and migration were characterized. Venom components were identified by chromatography and proteomic analyses. L. obliqua venom induced hESC proliferation, viability and migration in a dose-dependent manner, both in the presence and absence of serum. By ion-exchange chromatography, one fraction enriched in cytoprotective components and devoid of hemotoxins was obtained. Venom proteome identified at least six protein classes with potential cytoprotective properties (hemolins, lipocalins, hemocyannins, antiviral proteins, antimicrobial peptides, and protease inhibitors). L. obliqua venom protected hESCs from oxidative insult. Cytoprotection was also related to nitric oxide and PKC-ERK-activation and down-regulation of cAMP-PKA-dependent pathways that control cell proliferation. L. obliqua venom-induced hESC viability, proliferation and migration occurs mainly by protecting against oxidative damage and activating ERK. Thus, L. obliqua venom components are promising pharmacological tools to understand the underlying mechanisms of hESC deficiency in RPL.


Subject(s)
Arthropod Venoms , Animals , Humans , Arthropod Venoms/chemistry , Proteomics , Epithelial Cells
8.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 53(2): 194-200, 2024 Apr 25.
Article in English, Chinese | MEDLINE | ID: mdl-38268403

ABSTRACT

OBJECTIVES: To isolate a potassium ion channel Kv4.1 inhibitor from centipede venom, and to determine its sequence and structure. METHODS: Ion-exchange chromatography and reversed-phase high-performance liquid chromatography were performed to separate and purify peptide components of centipede venom, and their inhibiting effect on Kv4.1 channel was determined by whole-cell patch clamp recording. The molecular weight of isolated peptide Kv4.1 channel inhibitor was identified with matrix assisted laser desorption ionization-time-of-flight mass spectrometry; its primary sequence was determined by Edman degradation sequencing and two-dimensional mass spectrometry; its structure was established based on iterative thread assembly refinement online analysis. RESULTS: A peptide SsTx-P2 was separated from centipede venom with the molecular weight of 6122.8, and its primary sequence consists of 53 amino acid residues NH2-ELTWDFVRTCCKLFPDKSECTKACATEFTGGDESRLKDVWPRKLRSGDSRLKD-OH. Peptide SsTx-P2 potently inhibited the current of Kv4.1 channel transiently transfected in HEK293 cell, with 1.0 µmol/L SsTx-P2 suppressing 95% current of Kv4.1 channel. Its structure showed that SsTx-P2 shared a conserved helical structure. CONCLUSIONS: The study has isolated a novel peptide SsTx-P2 from centipede venom, which can potently inhibit the potassium ion channel Kv4.1 and displays structural conservation.


Subject(s)
Amino Acid Sequence , Arthropod Venoms , Shal Potassium Channels , Animals , Humans , Arthropod Venoms/chemistry , Arthropod Venoms/pharmacology , Molecular Sequence Data , Peptides/pharmacology , Peptides/isolation & purification , Peptides/chemistry , Potassium Channel Blockers/pharmacology , Potassium Channel Blockers/isolation & purification , Potassium Channel Blockers/chemistry , Shal Potassium Channels/antagonists & inhibitors , Chilopoda/chemistry
9.
Dermatologie (Heidelb) ; 75(2): 126-133, 2024 Feb.
Article in German | MEDLINE | ID: mdl-38214725

ABSTRACT

BACKGROUND: In Germany, honeybees (Apis mellifera) and various Vespula species (wasps) are primarily relevant for hypersensitivity reactions to stings. Hornets (Vespa crabro), bumblebees, paper wasps (Polistes) and yellowjackets (Dolichovespula) less frequently cause sting reactions. OBJECTIVE: What effects do intensive agricultural utilization and climate change have on the living conditions and occurrence of Hymenoptera and what consequences do they have for the diagnostics and treatment of hypersensitivity reactions to Hymenoptera stings. MATERIAL AND METHODS: A literature search was carried out. RESULTS: Honeybees and wild bees are endangered due to introduced diseases, invasive species and pesticides. The aim of widespread beekeeping activity is to protect honeybees, which is why no reduction in stings is to be expected despite increased bee mortality. In Germany, there is evidence of the spread of thermophilic Polistes species (paper wasps) from south to north and the immigration of Vespa velutina nigrithorax (Asian hornet). It is unlikely that these species will lead to a significant increase in sting reactions. Nests of the red fire ant (Solenopsis invicta), which was originally common in South America, were first detected in Sicily in 2022. Red fire ants are aggressive insects with a high potential for adverse sting reactions. CONCLUSION: Invasive insects must be considered as a trigger in the anamnesis and diagnostics. Diagnostics are only available for the detection of Polistes sensitization. Therapeutic allergens can be obtained from other European countries for venom immunotherapy of a Polistes allergy. Due to cross-reactivity, diagnostic and therapeutic allergens from Vespula spp. are used for the diagnosis and treatment of suspected allergies to the Asian hornet.


Subject(s)
Ants , Arthropod Venoms , Hypersensitivity , Insect Bites and Stings , Venom Hypersensitivity , Wasps , Bees , Animals , Insect Bites and Stings/diagnosis , Wasp Venoms , Hypersensitivity/diagnosis , Allergens , Fire Ants
10.
Allergy ; 79(3): 702-710, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38093663

ABSTRACT

BACKGROUND: Epidemiologic data on occupational anaphylaxis is scarce, and there is a need of more knowledge about work-related anaphylactic episodes. METHODS: Based on the data of the Anaphylaxis Registry, we identified cases related to occupational exposure and analyzed the elicitors, demographics, severity of clinical reaction and management. RESULTS: Since 2017, 5851 cases with an information about the occupational relation of the anaphylactic episode were registered whereby 225 (3.8%) were assigned to be caused by an occupational allergen. The vast majority of these occupational anaphylaxis cases were caused by insects (n = 186, 82.7%) followed by food (n = 27, 12.0%) and drugs (n = 8, 3.6%). Latex elicited occupational anaphylaxis in only two cases. Beekeepers, gardeners, farmers, and individuals working in professions associated with food handling, for example, employees in restaurants, bakery, pastry, and cooks were most frequently affected. The comparison of the occupational insect venom-induced anaphylaxis to a group of non-occupational insect anaphylaxis in adults (n = 1842) revealed a significant younger age in occupational anaphylaxis (46 vs. 53 years), a predominance of bee-induced cases (38% vs. 17%), and a higher rate of venom immunotherapy in a primary care setting (3.3% vs. 1.3%, p = .044). In the occupational- versus non-occupational adults with food-induced anaphylaxis atopic dermatitis as concomitant atopic disease was observed more frequently (n = 486; 20% vs. 10%), although this was not significant. CONCLUSION: Our data demonstrate the impact of venom allergy in work-related anaphylaxis. Foods and drugs are less frequently elicitors, and latex-induced occupational anaphylaxis was rare. More data are needed to determine risk factors associated with occupational anaphylaxis.


Subject(s)
Anaphylaxis , Arthropod Venoms , Adult , Humans , Bees , Animals , Anaphylaxis/etiology , Anaphylaxis/chemically induced , Latex , Risk Factors , Arthropod Venoms/adverse effects , Allergens , Insecta , Registries
12.
Toxicon ; 238: 107568, 2024 Feb 01.
Article in English | MEDLINE | ID: mdl-38110040

ABSTRACT

Most anti-inflammatory drugs currently adopted to treat chronic inflammatory joint diseases can alleviate symptoms but they do not lead to remission. Therefore, new and more efficient drugs are needed to block the course of joint inflammatory diseases. Animal venoms, rich in bioactive compounds, can contribute as valuable tools in this field of research. In this study, we first demonstrate the direct action of venoms on cells that constitute the articular joints. We established a platform consisting of cell-based assays to evaluate the release of cytokines (IL-6, IL-8, TNFα, IL-1ß, and IL-10) by human chondrocytes, synoviocytes and THP1 macrophages, as well as the release of neuropeptides (substance-P and ß-endorphin) by differentiated sensory neuron-like cells, 24 h after stimulation of cells with 21 animal venoms from snake and arthropod species, sourced from different taxonomic families and geographic origins. Results demonstrated that at non-cytotoxic concentrations, the venoms activate at varying degrees the secretion of inflammatory mediators involved in the pathology of articular diseases, such as IL-6, IL-8, and TNF-α by chondrocytes, synoviocytes, and macrophages and of substance P by neuron-like cells. Venoms of the Viperidae snake family were more inflammatory than those of the Elapidae family, while venoms of Arthropods were less inflammatory than snake venoms. Notably, some venoms also induced the release of the anti-inflammatory IL-10 by macrophages. However, the scorpion Buthus occitanus venom induced the release of IL-10 without increasing the release of inflammatory cytokines by macrophages. Since the cell types used in the experiments are crucial elements in joint inflammatory processes, the results of this work may guide future research on the activation of receptors and inflammatory signaling pathways by selected venoms in these particular cells, aiming at discovering new targets for therapeutic intervention.


Subject(s)
Animals, Poisonous , Arthropod Venoms , Arthropods , Joint Diseases , Scorpion Venoms , Scorpions , Viperidae , Animals , Humans , Interleukin-10 , Interleukin-6 , Interleukin-8 , Snake Venoms/chemistry , Cytokines , Tumor Necrosis Factor-alpha , Anti-Inflammatory Agents
13.
Toxicon ; 238: 107588, 2024 Feb 01.
Article in English | MEDLINE | ID: mdl-38147939

ABSTRACT

Pest insects pose a heavy burden on global agricultural industries with small molecule insecticides being predominantly used for their control. Unwanted side effects and resistance development plagues most small molecule insecticides such as the neonicotinoids, which have been reported to be harmful to honeybees. Bioinsecticides like Bacillus thuringiensis (Bt) toxins can be used as environmentally-friendly alternatives. Arachnid venoms comprise another promising source of bioinsecticides, containing a multitude of selective and potent insecticidal toxins. Unfortunately, no standardised insect models are currently available to assess the suitability of insecticidal agents under laboratory conditions. Thus, we aimed to develop a laboratory model that closely mimics field conditions by employing a leaf disk assay (LDA) for oral application of insecticidal agents in a bioassay tray format. Neonate larvae of the cotton bollworm (Helicoverpa armigera) were fed with soybean (Glycine max) leaves that were treated with different insecticidal agents. We observed dose-dependent insecticidal effects for Bt toxin and the neonicotinoid insecticide imidacloprid, with imidacloprid exhibiting a faster response. Furthermore, we identified several insecticidal arachnid venoms that were active when co-applied with sub-lethal doses of Bt toxin. We propose the H. armigera LDA as a suitable tool for assessing the insecticidal effects of insecticidal agents against lepidopterans.


Subject(s)
Arthropod Venoms , Bacillus thuringiensis , Insecticides , Moths , Neonicotinoids , Nitro Compounds , Toxins, Biological , Humans , Infant, Newborn , Animals , Insecticides/toxicity , Glycine max , Helicoverpa armigera , Bacillus thuringiensis Toxins/pharmacology , Larva , Insecta , Toxins, Biological/pharmacology , Arthropod Venoms/pharmacology , Biological Assay , Plant Leaves , Bacterial Proteins/pharmacology , Hemolysin Proteins/toxicity , Endotoxins , Pest Control, Biological , Insecticide Resistance
14.
Allergy Asthma Proc ; 45(1): 50-52, 2024 Jan 01.
Article in English | MEDLINE | ID: mdl-38151734

ABSTRACT

Background: Hymenoptera venom anaphylaxis (HVA) is reported in up to 3% of stings and accounts for approximately 40 US deaths annually. HVA patients require immediate availability of epinephrine and Allergist referrals for consideration of venom immunotherapy. Data regarding epinephrine autoinjector prescriptions, Allergist referral rates, and potential racial disparities are limited. Objective: The primary objective was to determine if there were statistically significant differences in epinephrine autoinjector prescriptions and Allergist referrals between white and African American patients. The secondary objectives were to determine if there were statistically significant differences between adult and pediatric patients and to determine if there were significant differences between epinephrine prescriptions between patients with and without Allergist referrals. Method: This study is a retrospective, descriptive chart review analyzing patients seen between January 01, 2019 and December 31, 2021. Data were obtained utilizing the Epic Systems (Verona, WI) application Slicer Dicer. Individual chart review was performed for age, race, epinephrine autoinjector prescription, and Allergist referral. Results: 342 patients were identified as having HVA. White patients (60 out of 219; 27.4%) were more likely to get epinephrine autoinjector prescriptions than African American patients (17 out of 109; 15.6%) (p = 0.018). Adult patients (25 out of 314; 8.0%) were less likely than pediatric patients (8 out of 28; 28.6%) to have Allergist referrals (p = 0.004). Patients with Allergist referrals (25 out of 32; 78.1%) were more likely to be prescribed an epinephrine autoinjector than patient without Allergist referrals (54 out of 310; 17.4%) (p < 0.00001). Conclusion: Epinephrine autoinjector prescriptions and Allergist referrals are low overall in HVA. Racial disparities were identified with African American patients being significantly less likely to receive epinephrine autoinjector prescriptions. Additionally, adult patients, who may be at increased risk, were less likely to receive Allergist referrals.


Subject(s)
Anaphylaxis , Arthropod Venoms , Adult , Humans , Child , Retrospective Studies , Emergency Service, Hospital , Anaphylaxis/drug therapy , Anaphylaxis/epidemiology , Anaphylaxis/etiology , Epinephrine/therapeutic use , Health Inequities
15.
Int J Mol Sci ; 24(22)2023 Nov 15.
Article in English | MEDLINE | ID: mdl-38003556

ABSTRACT

Hymenoptera venom-triggered anaphylaxis (HVA) affects up to 8.9% of the general population and is the most frequent cause of anaphylaxis in adults, accounting for approximately 20% of all fatal anaphylaxis cases. Quite often, a fatal reaction is a victim's first manifestation of HVA. Mastocytosis represents one of the most important risk factors for severe HVA. We analyzed patients with documented fatal HVA for the presence of underlying clonal mast cell disorder (cMCD). Here, we report three cases of fatal HVA, with undiagnosed underlying cMCD identified by the presence of the peripheral blood and/or bone marrow KIT p.D816V missense variant postmortem. In the first case, anaphylaxis was the initial episode and was fatal. In the other two cases, both patients were treated with specific venom immunotherapy (VIT), nevertheless, one died of HVA after VIT discontinuation, and the other during VIT; both patients had cardiovascular comorbidities and were taking beta-blockers and/or ACE inhibitors. Our results point to the importance of screening all high-risk individuals for underlying cMCD using highly sensitive molecular methods for peripheral blood KIT p.D816V variant detection, including severe HVA and possibly beekeepers, for proper management and the need for lifelong VIT to prevent unnecessary deaths. Patients at the highest risk of fatal HVA, with concomitant cardiovascular and cMCD comorbidities, might not be protected from field stings even during regular VIT. Therefore, two adrenaline autoinjectors and lifelong VIT, and possibly cotreatment with omalizumab, should be considered for high-risk patients to prevent fatal HVA episodes.


Subject(s)
Anaphylaxis , Arthropod Venoms , Hymenoptera , Mastocytosis , Adult , Animals , Humans , Anaphylaxis/diagnosis , Mast Cells , Mastocytosis/complications , Mastocytosis/diagnosis , Mastocytosis/therapy
17.
Immunol Allergy Clin North Am ; 43(4): 699-710, 2023 11.
Article in English | MEDLINE | ID: mdl-37758407

ABSTRACT

Patients with mastocytosis have an increased risk for mast cell activation events including anaphylaxis when exposed to certain drugs and Hymenoptera venom. Hypotension and cardiovascular collapse without skin or other systemic manifestations can occur after Hymenoptera stings, during the perioperative period, and after exposure to nonsteroidal ntiinflammatory drugs, opioids, and other mast cell activating medications, including vancomycin and quinolones. This chapter reviews the epidemiology, mechanisms, diagnosis, management, and treatment options for Hymenoptera venom and drug-induced reactions in patients with mastocytosis.


Subject(s)
Anaphylaxis , Arthropod Venoms , Hymenoptera , Insect Bites and Stings , Mastocytosis , Venom Hypersensitivity , Animals , Humans , Insect Bites and Stings/complications , Insect Bites and Stings/chemically induced , Mastocytosis/diagnosis , Mastocytosis/drug therapy , Mastocytosis/epidemiology , Anaphylaxis/diagnosis , Anaphylaxis/epidemiology , Anaphylaxis/etiology , Arthropod Venoms/adverse effects
18.
J Allergy Clin Immunol ; 152(4): 933-939, 2023 10.
Article in English | MEDLINE | ID: mdl-37558059

ABSTRACT

BACKGROUND: Increased TPSAB1 copy numbers encoding ⍺-tryptase are associated with severe reactions in adults with Hymenoptera venom allergy, systemic mastocytosis, and idiopathic anaphylaxis. OBJECTIVE: The primary objective was to assess the association between ⍺-tryptase and severity of food allergy. METHODS: A total of 119 subjects underwent tryptase genotyping; 82 of them were from an observational food allergy cohort at the National Institute of Allergy and Infectious Disease (NIAID), and 37 were from a cohort of children who reacted to peanut oral food challenge (OFC) at Lurie Children's Hospital of Chicago. The primary predictor was presence or absence of ⍺-tryptase. The primary outcomes for both cohorts were measures of severity of food allergy reaction. Secondary outcomes included OFC symptom scores (Bock/Practical Allergy [PRACTALL] and Severity Grading Score for Acute Reactions [SGSAR]). Correlation between total α-tryptase isoforms and OFC scores was also assessed to account for gene dosage effects. RESULTS: Among the subjects in the NIAID cohort, the presence of ⍺-tryptase was associated with a higher prevalence of food-triggered anaphylaxis than in those with only ß-tryptase (P = .026). Similarly, only 1 of 6 subjects in the OFC cohort with only ß-tryptase (17%) had a severe reaction, whereas 20 of 31 of subjects with α-tryptase (65%) had a severe reaction (P = .066). Subjects with ⍺-tryptase also had higher total SGSAR scores than did the subjects with no ⍺-tryptase (P = .003). In addition, there were also significant positive correlations between ⍺-tryptase isoform copy numbers and both higher total SGSAR and Bock/PRACTALL OFC scores (P = .008 and P = .003, respectively). CONCLUSION: The presence of α-tryptase in subjects is correlated with a higher prevalence of anaphylaxis or severe reaction to food than in subjects without any α-tryptase.


Subject(s)
Anaphylaxis , Arthropod Venoms , Food Hypersensitivity , Adult , Child , Humans , Anaphylaxis/epidemiology , Anaphylaxis/etiology , Anaphylaxis/diagnosis , Tryptases , Food Hypersensitivity/epidemiology , Allergens
19.
Toxicon ; 233: 107231, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37517595

ABSTRACT

Research on centipede venoms has led to the discovery of a diverse array of novel proteins and peptides, including those with homology to previously discovered toxin families (e.g., phospholipase A2s and pM12a metalloproteases) and novel toxin families not previously detected in venoms (e.g., ß-pore forming toxins and scoloptoxins). Most of this research has focused on centipedes in the order Scolopendromorpha, particularly those in the families Scolopendridae, Cryptopidae, and Scolopocryptopidae. To generate the first high-throughput venom characterization for a centipede in the scolopendromorph family Plutoniumidae, we performed venom-gland transcriptomics and venom proteomics on two Theatops posticus. We identified a total of 64 venom toxins, 60 of which were detected in both the venom-gland transcriptome and venom proteome and four of which were only detected transcriptomically. We detected a single highly abundant arylsulfatase B (ARSB) toxin, the first ARSB toxin identified from centipede venoms. As ARSBs have been detected in other venomous species (e.g., scorpions), ARSBs in T. posticus highlights a new case of convergent evolution across venoms. Theatops posticus venom also contained a much higher abundance and diversity of phospholipase A2 toxins compared to other characterized centipede venoms. Conversely, we detected other common centipedes toxins, such as CAPs and scoloptoxins, at relatively low abundances and diversities. Our observation of a diverse set of toxins from T. posticus venom, including those from novel toxin families, emphasizes the importance of studying unexplored centipede taxonomic groups and the continued potential of centipede venoms for novel toxin discovery and unraveling the molecular mechanisms underlying trait evolution.


Subject(s)
Arthropod Venoms , Arthropods , Animals , Chilopoda/metabolism , Arthropods/chemistry , Arylsulfatases/metabolism , Phospholipases/metabolism , Arthropod Venoms/chemistry , Transcriptome
20.
Toxins (Basel) ; 15(7)2023 07 03.
Article in English | MEDLINE | ID: mdl-37505709

ABSTRACT

Venoms produced by arthropods act as chemical weapons to paralyze prey or deter competitors. The utilization of venom is an essential feature in the biology and ecology of venomous arthropods. Solenopsis fire ants (Hymenoptera: Formicidae) are medically important venomous ants. They have acquired different patterns of venom use to maximize their competitive advantages rendered by the venom when facing different challenges. The major components of fire ant venom are piperidine alkaloids, which have strong insecticidal and antibiotic activities. The alkaloids protect fire ants from pathogens over the course of their lives and can be used to defend them from predators and competitors. They are also utilized by some of the fire ants' natural enemies, such as phorid flies to locate host ants. Collectively, these ants' diverse alkaloid compositions and functions have ecological significance for their survival, successful invasion, and rapid range expansion. The venom alkaloids with powerful biological activities may have played an important role in shaping the assembly of communities in both native and introduced ranges.


Subject(s)
Alkaloids , Ant Venoms , Ants , Arthropod Venoms , Diptera , Animals , Ant Venoms/pharmacology , Ant Venoms/chemistry , Ants/chemistry , Alkaloids/pharmacology , Alkaloids/chemistry
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