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Reactions to honeybee stings: an allergic prospective

Brown, Tyson C.

Current Opinion in Allergy and Clinical Immunology: August 2013 - Volume 13 - Issue 4 - p 365–371
doi: 10.1097/ACI.0b013e3283625144
ANAPHYLAXIS AND INSECT ALLERGY: Edited by Theodore Freeman and Ralf Heine

Purpose of review The purpose of this article is to provide a brief overview of the events involved in honeybee allergy and to concisely update the reader on progress toward knowledge of honeybee venom (HBV), strides in solving diagnostic difficulties, and advancements in improving safety and efficacy of HBV immunotherapy.

Recent findings It is well known that honeybee allergy is unique in venom allergen and protein composition, diagnostic challenges, and immunotherapy safety and efficacy. Many new honeybee allergens have been recognized. Advances in testing, evaluation, and extract manipulation methods, many using recombinant technology, have allowed a greater ability to help with honeybee allergy diagnosis and resultant improvement in immunotherapy safety and evaluation of immunotherapy efficacy.

Summary In an effort to address many honeybee allergy concerns, specific advances have been recently made. Some recently characterized honeybee allergens appear to be major contributors to honeybee allergy. In the setting of double-positivity, cross-reacting carbohydrate determinants and other cross-reacting components in HBV have made diagnosis of honeybee allergy challenging. Recombinant technology, including component-resolved diagnostics, and other evolving testing methods should help clarify double-positivity, if not now, in the very near future. Purified HBV and possibly depot formulations for immunotherapy appear to make it more well tolerated. Recombinant methods may help with evaluation of immunotherapy's safety and efficacy.

Department of Medicine, Allergy/Immunology Clinic, Keesler Medical Center, Biloxi, Mississippi, USA

Correspondence to Tyson C. Brown, MD, Major, USAF, MC, Allergy/Immunology Clinic, Keesler Medical Center, 301 Fisher St., Keesler AFB, Biloxi, MS 39534, USA. Tel: +1 228 376 3550; e-mail: tyson.brown@us.af.mil

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