Bee venom allergy T78.8

Humoral allergic reaction of the immediate type (type I) to bee venom. The allergens are the species-specific enzymes phospholipase A2 (Api m1), the acid phosphatase Api m3, mellitin Api m4 and the wasp cross-reacting dipeptidyl peptidases Api m5 (allergen C/DPPIV) and the hyaluronidase Api m2, which show a high homology to the corresponding wasp allergens Ves v2 and Ves v3 (see also wasp venom allergy).a. Wasp venom allergy). It can be assumed that due to newer analytical methods the number of allergens known so far will continue to increase. Since > 100 different components interact, the complexity of the venome and its plasticity cannot be fully assessed.

Hymenopteran venoms contain low molecular weight substances (biogenic amines, leukotrienes), peptides, proteins. Cytotoxic and neurotoxic effects are mainly due to peptides and phospholipases. Hyaluronidases act together with biogenic amines as "spreading factor".

Versch. Studies show that a low number of annual bee stings (<10/year) is a risk factor for the development of bee venom allergy. The combination of allergic diathesis and casual exposure to bee venom could favour the development of bee venom allergy (Dinkel G et al. 2017).

Identified single allergens of the different Bee species according to IUIS Allergen Nomenclature Sub-Committee.

• Apis cerana (Eastern honey bee/Eastern hive bee)
  • Api c 1 Phospholipase A2
• Apis dorsata (Giant honeybee)
  • Api d 1 Phospholipase A2
• Apis mellifera (honey bee)
  • Api m 1 phospholipase A2: Major allergen, marker for bee venom sensitization
  • Api m 2 Hyaluronidase: minor allergen; cross-reaction with wasp venom hyaluronidase (Ves v 2) possible
  • Api m 3 acid phosphatase: major allergen, marker for bee venom sensitization
  • Api m 4 Melittin: Miorallergen
  • Api m 5 vitellogenin (dipeptidyl peptidase IV): Major allergen, cross-reactive with Ves v 3, the vitellogenin of the wasp venom
  • Api m 6 Icarapine (putative protease inhibitor): Major allergen
  • Api m 7 CUB Serine protease
  • Api m 8 Carboxylesterase
  • Api m 9 Serine carboxypeptidase (relevance not yet clearly defined)
  • Api m 10 Icarapine variant 2, carbohydrate-rich protein
  • Api m 11.0101: Major Royal Jelly Protein (MRJP 8)
  • Api m 11.0201: Major Royal Jelly Protein (MRJP 9)
  • Api m 12: Vitellogenin

S.u. Insect venom allergy.

The incidence of bee venom allergies among beekeepers in German-speaking countries and Europe is estimated at 4.4% to 43%! More recent data show an incidence of 29.7% with a tendency to increase, compared to 39.8% among non beekeepers (Dinkel G et al. 2017).

A bee sting releases 50-150ug of venom. With a bee sting it is about 1.7-17ug of venom.

1. Denkel G et al (2017) Biengift allergy - a trend among hobby beekeepers. Allergo J 26: 20-21
2. Jakob T et al (2012) Comparable IgE reactivity to natural and recombinant Api m 1 in cross-reactive carbohydrate determinant-negative patients with bee venom allergy. J Allergy Clin Immunol 130:276-278.
3. Kleine-Tebbe J et al (2016) Molecular allergy diagnostics with IgE single determinations (singleplex): Methodological and practical aspects. In: Kleine-Tebbe JK et al (Hrsg) Molecular allergy diagnostics. Springer Publishing House GmbH S 91-138
4. Köhler J et al (2013) Component resolution reveals additional major allergens in patients with honeybee venom allergy. J Allergy Clin Immunol 133:1383-1389.
5. Müller U et al (2012) IgE to recombinant allergens Api m 1, Ves v 1, and Ves v 5 distinguish double sensitization from crossreaction in venom allergy. Allergy 67:1069-1073.
6. Van Vaerenbergh M et al (2015) IgE recognition of chimeric isoforms of the honeybee (Apis mellifera) venom allergen Api m 10 evaluated by protein array technology. Mol Immunol 63:449-455.
7. WHO/IUS Allergen Nomenclature Sub-Committee