title: Honeybee venom immunotherapy: certainties and pitfalls.
abstract: The honeybee is an interesting insect because of the fundamental agricultural role it plays, together with the composition of its venom, which presents new diagnostic and immunotherapeutic challenges. This article examines various aspects of honeybee venom allergy from epidemiology to diagnosis and treatment, with special emphasis on venom immunotherapy (VIT). Honeybee venom allergy represents a risk factor for severe systemic reaction in challenged allergic patients, for the diminished effectiveness of VIT, for more frequent side effects during VIT and relapse after cessation of treatment. Some strategies are available for reducing the risk of honeybee VIT-induced side effects; however, there is considerable room for further improvement in these all-important areas. At the same time, sensitized and allergic beekeepers represent unique populations for epidemiological, venom allergy immunopathogenesis and VIT mechanism studies.
authors.affiliation: Allergy Unit, Department of Immunology, Allergy & Respiratory Diseases, University Hospital Ospedali Riuniti di Ancona, Ancona, Italy. b.bilo@ospedaliriuniti.marche.it
authors.forename: M Beatrice
authors.initials: MB
authors.lastname: Bilò
authors.forename: Leonardo
authors.initials: L
authors.lastname: Antonicelli
authors.forename: Floriano
authors.initials: F
authors.lastname: Bonifazi
mesh_terms: D000485:Allergens / Q000276:immunology / Q000627:therapeutic use*; D000707:Anaphylaxis / Q000209:etiology / Q000517:prevention & control; D000818:Animals; D001514:Bee Venoms / Q000276:immunology / Q000627:therapeutic use*; D056630:Beekeeping; D002985:Clinical Protocols; D003888:Desensitization, Immunologic / Q000009:adverse effects / Q000379:methods*; D005060:Europe; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology / Q000276:immunology / Q000628:therapy*; D009784:Occupational Diseases / Q000453:epidemiology / Q000276:immunology / Q000628:therapy*; D015995:Prevalence; D012306:Risk; D014481:United States
chemical_list: D000485:Allergens; D001514:Bee Venoms