Insect venoms

Insect venoms applied by stings of social Hymenoptera, like honey bees, vespids or ants are -together with foods and drugs - the most frequent elicitors of anaphylaxis in humans. Besides taxonomy, the biology of the responsible social Hymenoptera is important: guidelines based upon its knowledge allow to reduce the risk of further stings in patients with a history of venom anaphylaxis. Epidemiology of venom anaphylaxis has special aspects with regard to prevalence, fatality and natural history. An estimated 200 individuals die every year in Europe from anaphylaxis following Hymenoptera stings. Most of the relevant venom protein allergens have been identified and many of them have been expressed in recombinant form. Proof of venom sensitization is based on skin tests with venoms and serum venom-specific IgE antibodies as standard diagnostic tests. Allergen-specific immunotherapy with Hymenoptera venoms is highly effective and therefore recommended for all patients with a history of Hymenoptera sting anaphylaxis and positive diagnostic tests with the respective venom. Frequent cross-reactions to venoms of different Hymenoptera species may cause difficulties in identifying the responsible species and the selection of the respective venom for immunotherapy.