Hymenoptera venom immunotherapy and field stings

Area of Science:

• Allergy and Immunology
• Clinical Medicine
• Toxicology

Background:

• Hymenoptera venom allergy affects many patients, with anaphylactic sting reactions posing a significant risk.
• Venom immunotherapy (VIT) is the primary method for preventing these reactions in most individuals.

Purpose of the Study:

• To evaluate field re-sting reactions during and after venom immunotherapy (VIT).
• To identify patient risk factors for systemic allergic reactions (SARs).
• To explore correlations between SARs and basal serum tryptase levels.

Main Methods:

• Retrospective analysis of clinical data from 192 patients experiencing field stings during VIT.
• Patient interviews regarding re-stings post-VIT cessation.
• Analysis of baseline mast-cell tryptase and specific IgE in patients with SARs.

Main Results:

• 14.1% of patients (27/192) experienced SARs following field stings.
• SAR incidence was 11.9% during VIT and 9.7% after VIT.
• Severe SARs were more frequent after VIT cessation and with repeated stings; only 8.7% of SAR patients had elevated basal serum tryptase.

Conclusions:

• Venom immunotherapy (VIT) exceeding 3 years provides effective protection for most patients.
• Predicting individual patient responses to field stings remains challenging.
• Increased severity of SARs is primarily observed after therapy completion and following subsequent stings.