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Indications for and preparing and administering Hymenoptera vaccines
Published in Richard F. Lockey, Dennis K. Ledford, Allergens and Allergen Immunotherapy, 2020
David B.K. Golden, Farnaz Tabatabaian, Ulrich Müller-Gierok, Richard F. Lockey
IFAs in the United States could build over 500 mounds per acre with multiple queens in each colony. However, since South American predators for IFAs have been introduced into the United States, the proliferation of these ants has been severely limited. Because of these natural predators, such colonies are no longer common. However, IFA colonies are found both in cities, i.e., lawns, playgrounds, under pavements, next to buildings, and in the country. Disturbing the colony results in activation of the worker ants that sting the cause for the disturbance. The IFA attaches to the skin by means of a powerful mandible and stings, releasing venom that produces a characteristic “fire-like” pain. If not removed, the IFA will continue to rotate in a pivotal fashion, repeatedly injecting small amounts of venom. An initial local reaction begins as a 25–50 mm erythematous flare. This is followed a few minutes later by a larger wheal, and within the next 24 hours, an umbilicated pustule forms which usually remains for 3–10 days, later rupturing and leaving a residual macule, nodule, or scar. Immediate sting effects are caused by toxic alkaloids present in more than 95% of ant venom. The allergic reaction is due to venom proteins that make up about 5% of the aqueous venom solution [96,98].
Clinician’s Guide to Common Arthropod Bites and Stings *
Published in Gail Miriam Moraru, Jerome Goddard, The Goddard Guide to Arthropods of Medical Importance, Seventh Edition, 2019
Gail Miriam Moraru, Jerome Goddard
Fire ants produce stings that are quite characteristic and whose clinical signs coincide well with the attack. In all individuals stung with adequate amounts of ant venom, the sting may be marked by a small puncta followed almost immediately by a local wheal and flare (local hive) reaction resulting from vasoactive amines in the venom. This is followed by development of a papule which becomes a sterile pustule within 24 hours. In some individuals, the pustule becomes surrounded by a large, erythematous, painful, and pruritic reaction called a late-phase allergic reaction. This lesion may persist for days. Fire ant venom contains a number of glycoprotein allergens that sensitize the majority of individuals who are stung, although only a small number of those individuals end up having systemic allergic reactions, some of which may be life-threatening. Adults who develop generalized urticaria, and all individuals who develop angioedema, laryngospasm, mental status changes, hypotension, or other life-threatening symptoms of anaphylaxis, should be given intramuscular epinephrine immediately and referred to an allergist for immunotherapy which is very effective.13 Stings and bites from other arthropods which are associated with these symptoms should be managed in a similar fashion (Figure 9.14).
Immunotherapy for Hymenoptera Venom Hypersensitivity
Published in Richard F. Lockey, Dennis K. Ledford, Allergens and Allergen Immunotherapy, 2014
Ulrich Müller, David B. K. Golden, Richard F. Lockey, Byol Shin
Only whole-ant body extracts are used for ant immunotherapy. However, a double-blind placebo-controlled crossover study on VIT in patients allergic to the jack jumper ant, Myrmecia pilosula was reported from Tasmania, Australia [80]. Of 29 patients on placebo, 21 (72%) developed a systemic allergic skin reaction, whereas only 1 of the 35 (3%) on ant venom developed a mild urticarial reaction when purposely stung. When the placebo group switched to VIT, all 26 patients except 1 (mild urticaria) tolerated a sting challenge. Ant VIT for the jack jumper ant, Myrmecia pilosula, could offer some benefit to prevent life-threatening sting anaphylaxis in southeastern Australia. Such impressive evidence of the efficacy of VIT for the jack jumper ant, Myrmecia pilosula supports more research investment in this area. Currently, ant venom products are not commercially available for immunotherapy.
Advances in venom peptide drug discovery: where are we at and where are we heading?
Published in Expert Opinion on Drug Discovery, 2021
Taylor B. Smallwood, Richard J. Clark
Many venom-derived peptides have been discovered from a range of venomous animals for potential therapeutic treatments of human diseases. Yet, despite several venom-derived peptides approved for market, the full potential of venom as a therapeutic is still at its infancy. While FDA-approved venom-derived drugs has seen great success, there has not been a novel FDA-approved venom-derived drug since exenatide in 2005. However, the improvement in technology over the past decade will likely see the pipeline of discovery for venom-derived peptides expand in future years. In particular, toxin driven discovery techniques will allow for the identification of bioactive peptides from even the smallest venomous animals that have for years remained untapped. Among these, insects represent a diverse group of organisms that until recently have not been extensively explored. For example, ants have developed and evolved venom to hunt their prey and to defend their nest against predators, competitors and microbial pathogens. Ant venom is found to be more complex and heterogenous than initially thought. Although the extent of their venom remains largely unexplored, recent transcriptomic and proteomic studies reveal ant venoms to contain mixtures of many bioactive molecules including short linear peptides (<5 kDa) and complex peptides with disulfide bonds [101]. Some of these peptides have been shown to be antimicrobial but are also believed to possess paralytic, cytolytic, hemolytic and/or insecticidal properties [102].