title: Multicolored Asian lady beetle hypersensitivity: a case series and allergist survey.
abstract: BACKGROUND
  Multicolored Asian lady beetles (Harmonia axyridis) have been used as a biological control agent against crop-destroying aphids in the United States. Outside their natural habitat, H. axyridis seeks refuge in homes during fall and winter, leading to patient complaints and symptoms of rhinitis, wheezing, and urticaria on exposure to the beetles.
  
  
  OBJECTIVE
  To gain a better understanding of the character and spectrum of allergic disease provoked by exposure to home-infesting lady beetles.
  
  
  METHODS
  Eight patients with allergic symptoms suspected of being caused by H. axyridis and consistent with an IgE-mediated process were identified and interviewed. A whole-body extract from H. axyridis was prepared. Western blots using the patients' serum identified specific IgE antibodies in the extract. Through a novel technique, immunohistochemical analysis using beetle sections overlayed with patient serum was performed. A random survey of allergists from across the United States was also performed to evaluate experience with cases of lady beetle allergy.
  
  
  RESULTS
  Western blots revealed IgE binding to 5 proteins with molecular weights of approximately 8.6, 21, 28, 31, and 75 kDa. Specific IgE bound to proteins localized in the beetle's mouth and leg areas. The allergist survey revealed positive responses in North Central, Mid-Atlantic and New England states.
  
  
  CONCLUSIONS
  In 8 patients with allergic symptoms on exposure to high levels of lady beetles, specific IgE bound to proteins from H. axyridis. There was also an increased frequency of suspected cases of lady beetle allergy in endemic areas.
authors.affiliation: Department of Allergy and Immunology, Wilford Hall Medical Center, Lackland Air Force Base, Texas 78236, USA. deborah.albright@wpafb.af.mil
authors.forename: Deborah D
authors.initials: DD
authors.lastname: Albright
authors.forename: Diane
authors.initials: D
authors.lastname: Jordan-Wagner
authors.forename: Diane C
authors.initials: DC
authors.lastname: Napoli
authors.forename: Amy L
authors.initials: AL
authors.lastname: Parker
authors.forename: Fonzie
authors.initials: F
authors.lastname: Quance-Fitch
authors.forename: Bonnie
authors.initials: B
authors.lastname: Whisman
authors.forename: Jacob W
authors.initials: JW
authors.lastname: Collins
authors.forename: Larry L
authors.initials: LL
authors.lastname: Hagan
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology* / Q000302:isolation & purification; D000818:Animals; D002648:Child; D001517:Coleoptera / Q000033:anatomy & histology / Q000737:chemistry; D004781:Environmental Exposure; D005260:Female; D006306:Health Surveys; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology*; D007150:Immunohistochemistry; D019476:Insect Proteins / Q000276:immunology* / Q000302:isolation & purification; D007407:Interviews as Topic; D008875:Middle Aged; D014481:United States / Q000453:epidemiology
chemical_list: D000485:Allergens; D019476:Insect Proteins