title: Advances in mosquito allergy.
abstract: OBJECTIVE
  Allergic reactions, including severe local and systemic reactions to mosquito bites, are immunological in nature, and involve immunoglobulin E, immunoglobulin G, and T-lymphocyte-mediated hypersensitivities in response to allergens in mosquito saliva. Naturally acquired desensitization to mosquito saliva may occur during childhood or during long-term exposure to mosquitoes. Due to the lack of availability of mosquito salivary preparations for use in skin tests and in-vitro tests, allergic reactions to mosquito bites are under diagnosed and under treated.
  
  
  RESULTS
  Recombinant saliva allergens with biological activity are being developed. Recombinant Aedes aegypti salivary allergen rAed a 2 has been expressed, purified, characterized and used in in-vitro diagnosis of mosquito allergy. Mosquito saliva-induced non-immunoglobulin E-mediated skin mast cell degranulation was found to induce macrophage-inflammatory protein 2 in the skin and interleukin-10 in draining lymph nodes.
  
  
  CONCLUSIONS
  In this review, we discuss the allergic reactions to mosquito salivary allergens, the immune mechanisms involved, natural desensitization and immunotherapy with mosquito extracts, characteristics of salivary allergens and their recombinant forms, and prevention and treatment of allergic reactions to mosquito bites. Eventually, recombinant salivary allergens will significantly improve the diagnosis of mosquito allergy, and will also improve specific immunotherapy for patients with systemic reactions to mosquito bites.
authors.affiliation: Department of Pediatrics and Child Health and Department of Immunology, University of Manitoba, Winnipeg, Manitoba, Canada. zpeng@ms.umanitoba.ca
authors.forename: Zhikang
authors.initials: Z
authors.lastname: Peng
authors.forename: F Estelle R
authors.initials: FE
authors.lastname: Simons
mesh_terms: D000330:Aedes / Q000276:immunology*; D000818:Animals; D003465:Culex / Q000276:immunology*; D003888:Desensitization, Immunologic / Q000379:methods; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D007159:Immunologic Tests / Q000379:methods; D007299:Insect Bites and Stings / Q000188:drug therapy / Q000276:immunology*; D019476:Insect Proteins / Q000009:adverse effects / Q000276:immunology*; D011994:Recombinant Proteins / Q000276:immunology; D012471:Salivary Proteins and Peptides / Q000009:adverse effects / Q000276:immunology*; D012882:Skin Tests / Q000379:methods
chemical_list: D019476:Insect Proteins; D011994:Recombinant Proteins; D012471:Salivary Proteins and Peptides