1. Natural history of the hymenoptera venom sensitivity reactions in adults : study designSimona Perčič, Lidija Bojanić, Mitja Košnik, Andreja Kukec, 2022, izvirni znanstveni članek Povzetek: Background: Allergic reactions to Hymenoptera stings can have varying levels of severity,
according to the Müller grading system. Methods: By an epidemiological concept, this is a retrospective
cohort study. The observed cohort was represented by patients referred to the University Clinic
Golnik due to Hymenoptera allergic reaction in the period from 1997 to 2015. From the immunological
database of the University Clinic Golnik, we obtained laboratory data (sIgE, skin tests and basophil
activation test). The clinical characteristics of patients were obtained from BIRPIS. With the help of a
questionnaire, which was sent to each patient in the period from May 2019 to April 2021, we obtained
epidemiological data. For the assessment of the association between the severity of allergic reaction
for the observed outcome, the severity of the first allergic reaction after Hymenoptera sting was used.
Other variables were grouped according to risk factors. Discussion: We will identify the risk factors
that could play an important role in a severe systemic reaction: the aetiology of the Hymenoptera
sting, sex, age, history and severity of previous systemic reactions, being re-stung in an interval of
two months, the frequency of re-stings, atopy, genetic predisposition, preventive medication use,
other medication use, beekeeping or living next to beehives and why immunotherapy was not taken.
Laboratory data will also be analysed to determine if there is any association with laboratory tests and
the severity of the allergic reactions after Hymenoptera stings. Conclusions: Several new approaches
are introduced in the study design. The most important is that the protocol covers epidemiological
data gained from the questionnaire, as well as clinical data gained from the Immunological database
and BIRPIS database. We expect to obtain significant results that will explain the risk factors for the
natural history of Hymenoptera sting allergic reactions and will help allergologists, as well as general
doctors, when facing those patients allergic to Hymenoptera venom without immunotherapy. Ključne besede: hymenoptera venom allergy, risk factors, epidemiological association Objavljeno v DiRROS: 06.04.2022; Ogledov: 1003; Prenosov: 430
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2. Hymenoptera venom immunotherapy : immune mechanisms of induced protection and toleranceAjda Demšar Luzar, Peter Korošec, Mitja Košnik, Mihaela Zidarn, Matija Rijavec, 2021, pregledni znanstveni članek Povzetek: Hymenoptera venom allergy is one of the most severe allergic diseases, with a considerable prevalence of anaphylactic reaction, making it potentially lethal. In this review, we provide an overview of the current knowledge and recent findings in understanding induced immune mechanisms during different phases of venom immunotherapy. We focus on protection mechanisms that occur early, during the build-up phase, and on the immune tolerance, which occurs later, during and after Hymenoptera venom immunotherapy. The short-term protection seems to be established by the early desensitization of mast cells and basophils, which plays a crucial role in preventing anaphylaxis during the build-up phase of treatment. The early generation of blocking IgG antibodies seems to be one of the main reasons for the lower activation of effector cells. Long-term tolerance is reached after at least three years of venom immunotherapy. A decrease in basophil responsiveness correlates with tolerated sting challenge. Furthermore, the persistent decline in IgE levels and, by monitoring the cytokine profiles, a shift from a Th2 to Th1 immune response, can be observed. In addition, the generation of regulatory T and B cells has proven to be essential for inducing allergen tolerance. Most studies on the mechanisms and effectiveness data have been obtained during venom immunotherapy (VIT). Despite the high success rate of VIT, allergen tolerance may not persist for a prolonged time. There is not much known about immune mechanisms that assure longterm tolerance post-therapy. Ključne besede: allergy and immunology, hypersensitivity, immunotherapy, immune tolerance, venoms, Hymenoptera, Hymenoptera venom, short-term protection, long-term tolerance Objavljeno v DiRROS: 16.08.2021; Ogledov: 1177; Prenosov: 379
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3. The culprit insect but not severity of allergic reactions to bee and wasp venom can be determined by molecular diagnosisPia Gattinger, Christian Lupinek, Lampros Kalogiros, Mira Šilar, Mihaela Zidarn, Peter Korošec, Christine Koessler, Natalija Novak, Rudolf Valenta, Irene Mittermann, 2018, izvirni znanstveni članek Povzetek: Background. Allergy to bee and wasp venom can lead to life-threatening systemic reactions. The identification of the culprit species is important for allergen-specific immunotherapy. Objectives. To determine a panel of recombinant bee and wasp allergens which is suitable for the identification of bee or wasp as culprit allergen sources and to search for molecular surrogates of clinical severity of sting reactions. Methods. Sera from eighty-seven patients with a detailed documentation of their severity of sting reaction (Mueller grade) and who had been subjected to titrated skin testing with bee and wasp venom were analyzed for bee and wasp-specific IgE levels by ImmunoCAPTM. IgE-reactivity testing was performed using a comprehensive panel of recombinant bee and wasp venom allergens (rApi m 1, 2, 3, 4, 5 and 10; rVes v 1 and 5) by ISAC chip technology, ImmunoCAP and ELISA. IgG4 antibodies to rApi m 1 and rVes v 5 were determined by ELISA and IgE/ IgG4 ratios were calculated. Results from skin testing, IgE serology and IgE/IgG4 ratios were compared with severity of sting reactions. Results. The panel of rApi m 1, rApi m 10, rVes v 1 and rVes v 5 allowed identification of the culprit venom in all but two of the 87 patients with good agreement to skin testing. Severities of sting reactions were not associated with results obtained by skin testing, venom-specific IgE levels or molecular diagnosis. Severe sting reactions were observed in patients showing < 1 ISU and < 2kUA/L of IgE to Api m 1 and/or Ves v 5. Conclusion. We identified a minimal panel of recombinant bee and wasp allergens for molecular diagnosis which may permit identification of bee and/or wasp as culprit insect in venom-sensitized subjects. The severity of sting reactions was not associated with parameters obtained by molecular diagnosis. Ključne besede: allergy and immunology -- diagnosis, allergens -- diagnosis, hymenoptera, immunotherapy, bee, wasp, venom, sting reactions, molecular diagnosis, systemic reactions Objavljeno v DiRROS: 23.11.2020; Ogledov: 12712; Prenosov: 1661
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4. Worldwide perspectives on venom allergyPeter Korošec, Thilo Jakob, Harfi Harb, Robert Heddle, Sarah Karabus, Ricardo de Lima Zollner, Julij Šelb, Bernard Yu-Hor Thong, Fares Zaitoun, David B. K. Golden, Michael Levin, 2019, pregledni znanstveni članek Povzetek: Venom immunotherapy is the standard of care for people with severe reactions and has been proven to reduce risk of future anaphylactic events. There is a moral imperative to ensure production, supply and worldwide availability of locally relevant, registered, standardized commercial venom extracts for diagnosis and treatment. Insects causing severe immediate allergic reactions vary by region worldwide. The most common culprits include honeybees (Apis mellifera), social wasps including yellow jackets (Vespula and Dolichovespula), paper wasps (Polistes) and hornets (Vespa), stinging ants (Solenopsis, Myrmecia, Pachycondyla, and Pogonomyrmex), and bumblebees (Bombus). Insects with importance in specific areas of the world include the Australian tick (Ixodes holocyclus), the kissing bug (Triatoma spp), horseflies (Tabanus spp), and mosquitoes (Aedes, Culex, Anopheles). Reliable access to high quality venom immunotherapy to locally relevant allergens is not available throughout the world. Many current commercially available therapeutic vaccines have deficiencies, are not suitable for, or are unavailable in vast areas of the globe. New products are required to replace products that are unstandardized or inadequate, particularly whole-body extract products. New products are required for insects in which no current treatment options exist. Venom immunotherapy should be promoted throughout the world and the provision thereof be supported by health authorities, regulatory authorities and all sectors of the health care service. Ključne besede: allergy and immunology, venoms, Hymenoptera, bee venoms, wasp venoms, insecta, ants hornet, bumblebee, mosquitoes, venom immunotherapy, immunologic desensitization Objavljeno v DiRROS: 23.09.2020; Ogledov: 1992; Prenosov: 1152
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