[New variants of diagnostic procedures and therapeutic methods in insect venom allergy].
Hymenoptera venom allergy (HVA) is a typical IgE-dependent allergy. Its diagnosis includes confirmation of the presence of specific IgE antibodies to venom allergens (vsIgE), and its treatment is based on developing of immunotolerance (venom immunotherapy, VIT). In most cases of sting anaphylaxis, vsIgE can be found, in some, however, the antibodies are undetectable, in spite of systemic reaction to venom, which may be due to low specificity of diagnostic methods. Diagnostic methods might be improved by the use of recombinant allergens which, being "uncontaminated" by other venom constituents, allow for a precise setup of "individual allergogram." A diagnostic novelty is the tryptase serum level assay that is capable of confirming ex-post anaphylaxis and coincidence of mastocytosis. The diagnostic procedures applied in venom allergy make possible only to prove the existence of allergy while it is impossible to estimate, on their basis, the risk of development and intensification of future reactions. New diagnostic concept that could supplement the imperfect diagnostic armamentarium is still lacking. Clinical practice has proven that VIT is a very effective method of protection of patients with IgE-dependent wasp-sting anaphylaxis, but both the effectiveness and safety of VIT in patients allergic to bee venom are not optimal. The future of VIT is the use of modified, recombinant allergens or their peptide fragments, but clinical data on their effectiveness are unavailable as yet. The safety of VIT can be increased by means of introducing premedication with antihistamines.
Nittner-Marszalska
Marita
M
Katedra i Klinika Chorób Wewnetrznych i Alergologii Akademii Medycznej we Wrocławiu.
D000818:Animals; D006634:Histamine H1 Antagonists / Q000627:therapeutic use*; D006801:Humans; D006927:Hymenoptera / Q000276:immunology*; D006967:Hypersensitivity / Q000188:drug therapy* / Q000276:immunology*; D007073:Immunoglobulin E / Q000276:immunology; D007299:Insect Bites and Stings / Q000276:immunology*; D013997:Time Factors; D014688:Venoms / Q000276:immunology
D006634:Histamine H1 Antagonists; D014688:Venoms; D007073:Immunoglobulin E