Advances in hymenoptera venom immunotherapy.
OBJECTIVE
Venom immunotherapy is highly effective treatment, capable of improving health-related quality of life. This overview examines advances in various aspects of this treatment.


RESULTS
New findings on the immunological mechanisms of the early and long-term efficacy of venom immunotherapy have been made. The decision to start and then to stop venom immunotherapy is best made on an individual case basis and should take into account medical and other factors, like the influence on patient quality of life. Venoms for use in immunotherapy should be selected according to the geographical distribution of each species and partial cross-reactivity between certain types of venom. Rapid protocols seem to be as safe as slower ones, though the major incidence of bee venom immunotherapy side-effects remains. Patients suffering from mast cell diseases seem to be at greater risk for an adverse reaction during treatment, without influencing its efficacy that much until the immunotherapy is actually ongoing. A number of new strategies for venom immunotherapy, mostly based on genetic engineering, have been described, and so far only a few have been used in humans.


CONCLUSIONS
Although there has been progress in the past few years, much remains to be accomplished.
Bilò
Beatrice M
BM
Department of Internal Medicine, Immunology, Allergy and Respiratory Diseases, University Hospital, Ancona, Italy. b.bilo@ao-umbertoprimo.marche.it
Bonifazi
Floriano
F
D000818:Animals; D001514:Bee Venoms / Q000276:immunology* / Q000627:therapeutic use*; D006801:Humans; D006927:Hymenoptera / Q000276:immunology*; D007167:Immunotherapy / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D007299:Insect Bites and Stings / Q000276:immunology / Q000628:therapy*
D001514:Bee Venoms