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Allergy in beekeepers.

Beekeepers represent a high-risk group for allergic disorders. They are affected by beestings but only a very limited fraction of the population develops severe anaphylactic symptoms. On the other hand several beekeepers have slight anaphylactic symptoms when they start working. Immunologically they are like "spontaneously desensitized subjects". They often have bee-venom specific IgE and all of them have very high titers of bee-venom specific IgG. Beekeepers may present an atopic sensitization to bee-hive dust and develop asthma and rhinitis. Finally, they may present a contact dermatitis to a bee-product: the propolis. This type of allergy is not very frequent.

Anaphylaxis↗

Epidemiology of allergic reactions in beekeepers: a lower prevalence in subjects with more than 5 years exposure.

Beekeepers (Bks) represent a high allergic risk population against Hymenoptera because of their frequent exposure to bee stings. Most published studies show different percentage of sensitization and systemic reactions with to another groups of population. With the aim to know the prevalence and type of allergic reaction in Bks from the Canary Islands, 246 subjects were studied prospectively. A questionnaire was developed and skin test and specific IgE determination against Apis mellifera, Vespula and Polistes venom were performed. One hundred and twenty eight subjects had presented at least one reaction greater than merely local. In 83.5% of these subjects subsequent stings caused reactions of lesser intensity. Specific IgE in serum for Apis mellifera was positive in 126 BKs, for Vespula in 27 and for Polistes in 9. We found that the group of BKs sensitized to Apis was significantly higher among atopics BKs (p < 0.001) and with fewest years of working experience in beekeeping (p = 0.0134). This study showed that sensitization to Hymenoptera is higher in beekeepers with less than 5 years working experience and who are sensitized to another allergens.

Adult↗

Acquired immunity to Africanized honeybee (Apis mellifera) venom in Brazilian beekeepers.

Seventy-eight Brazilian beekeepers who had been stung on average six times per month were studied. Sixty-eight beekeepers (87.1%) showed restricted local clinical reactions; nine individuals (11.5%) had extensive local reactions, and only one (1.2%) suffered anaphylactic shock. The humoral immunologic pattern of these individuals were studied by using immunoenzymatic methods to determine the serum titles of specific IgE and specific IgG4. Three groups of beekeepers presenting different humoral immunologic patterns were identified, in which the predominant pattern was the absence of specific IgE and high levels of specific IgG4 (38.4%). There was a positive correlation between the high levels of specific IgG4 and the number of bee stings. This correlation was not found in either specific or total IgE. The results of the present study suggest: i) the immunologic response to the number of exposures to Africanized honey-bee venom is not related to the number of exposures; and, ii) other nonhumoral and/or nonimmunologic factors may be involved in the reaction to the insect sting, which are responsible for both the clinical symptoms and protection.

Adolescent↗

Sensitivity to bee venom antigen phospholipase A2: association with specific HLA class I and class II alleles and haplotypes in beekeepers and allergic patients.

Bee venom hypersensitivity is a clinical entity of outstanding importance because bee stings are a leading cause of mortality worldwide. Individuals with immediate-type bee venom hypersensitivity, beekeepers, and healthy controls were examined for HLA-DRB1, DQB1, and DQA1 alleles by sequence-specific oligonucleotide probe typing. Defined hypersensitivity to bee venom antigen phospholipase A2 (vbPLA2) is significantly associated with the presence of susceptible HLA class II alleles: DRB1*0101 (RR = 2.7, p < 3 x 10(-3)), DRB1*0103 (RR = 21.2, p < 7.5 x 10(-11)), DQA1*0101 (RR = 1.2, p < 38.52 x 10(-10)), and DQB1*0501 (RR = 4, p < 2.18 x 10(-10)). Some HLA class I alleles were also associated with risk to bee venom allergy: A*01 (RR = 2.4, p < 7.5 x 10(-4)), B*57 (RR = 35.1, p < 3.5 x 10(-7)), and B*5901 (p < 3.5 x 10(-5)), but they are probably of secondary significance. Three- (DRB1*0103-DQA1*0101-DQB1*0501) (RR = 21.24, p < 7.5 x 10(-11)) and five-loci (A*01-B*59-DRB1*0103-DQA1*0101-DQB1*0501) (p < 2.3 x 10(-6)) extended haplotypes are also significantly carried by vbPLA2 allergic patients. When HLA allele frequencies from patients are compared with those from beekeepers, only HLA-DRB1*0103 (RR = 11.7, p < 8.5 x 10(-5)) and HLA-DQA1*0101 (p < 0.02) were significantly increased in the former. These observations emphasize the importance of the DRB1*0103-DQA1*0101-DQB1*0501 haplotype as a strong candidate for susceptibility to vbPLA2 hypersensitivity, at least in our region.

Bee Venoms↗

Comparison of the atopic background between allergic and non-allergic beekeepers.

A study was carried out on beekeepers and their families. 34 subjects with a history of bee sting allergy and also a positive radioallergosorbent test (RAST) to honey bee venom were compared with 47 subjects with neither. 16 subjects in the bee allergy group (47%) had a history of atopic diseases as compared to 6 (13%) in the control group (p less than 0.01). 15 in the bee allergy group (44%) had at least one positive RAST to three common inhalant allergens as compared to 5 (11%) in the control group (p less than 0.01). These results suggest that, although bee sting allergy frequently affects non-atopic subjects, sensitization among beekeepers and their families occurs more readily in atopics. It is notable that a large proportion of patients injected with foreign proteins (the control group) either never develop venom-specific IgE antibodies or have suppressed their production.

Adult↗

Bee venom induces high histamine or high leukotriene C4 release in skin of sensitized beekeepers.

Histamine is the principal mediator released in the skin during immediate bee venom allergy but the significance of cysteinyl leukotrienes in these reactions is not known. We measured skin histamine and cysteinyl leukotriene release induced by bee venom in six sensitized beekeepers with the skin microdialysis technique. The skin was dialyzed for 2 h after skin prick test with bee venom, and the release of histamine and leukotriene C4 (LTC4) into the microdialysis fractions was measured. Leukotriene E4 (LTE) and methylhistamine excretion into the urine was assayed and whole blood histamine release test was performed. The release of histamine in the skin was variable: either high delayed, high immediate and delayed, weak release or no marked release. The histamine releasability in the skin correlated with that in whole blood. The three subjects with low histamine release exhibited high LTC4 release in the skin as well as high LTE4 excretion into the urine. Thus, the histamine and LTC4 releases were inversely associated with each other. These differences may explain the variation in the clinical reaction by bee stings in sensitized beekeepers.

Animals↗

[A descriptive clinical study of a type of arthritis in beekeepers of the Badajoz area of La Siberia Extremeña].

BACKGROUND: The appearance of episodes of arthritis has been detected in beekeepers in the Siberia Extremadura (Spain) related to working with the hives. This present work describes the clinical features of such arthritic syndrome. METHODS: Sixty cases were selected at random from a previous epidemiological study to undergo a clinical protocol that included, anamnesis, physical signs, haematological, biochemical and immunological analyses, and radiological exploration of hands, wrists, feet, and pelvis. RESULTS: The picture is characterized by episodes of oligoarthritis associated with bee-stings in the affected joints or nearby. The most frequent radiologic lesions are pinched articular lines, sclerosis, and the presence of geodes. Analytically, there was frequent eosinophilia, abnormalities in haemostasis tests, and a rise in serum alkaline phosphatase. CONCLUSIONS: An acute inflammatory oligoarthritis of unknown cause has been described which affects the hands asymmetrically, and which is found in beekeepers in relation to their work with the hives. It occasionally involves into a chronic localized arthropathy capable of provoking ankylosis and permanent articular disability.

Acute Disease↗

Clinical and immunologic survey in beekeepers in relation to their sensitization.

Beekeepers often present allergic symptoms and represent a natural and experimental model of anaphylaxis and specific immunotherapy. Two hundred BKs were investigated. Both allergic and nonallergic subjects were selected very carefully in terms of immunologic status and exposure to bee stings. They were surveyed by a questionnaire, the titration of total serum IgE, and bee venom-specific IgE and IgG. Skin tests to HBV were performed in 176 subjects. Skin test sensitivity to HBV and allergic symptoms were significantly (p less than 0.0001) related to the estimated number of annual stings. BKs did not have allergy for more than 200 bee stings received in a year, and skin tests were negative in all cases. Many subjects who received between 50 and 200 annual stings had positive skin tests, and 9% of them had a systemic allergic history. Systemic anaphylaxis was present in 20% of BKs who received between 25 to 50 annual stings, and in 45% of BKs who are stung less than 25 times a year. Specific IgE was present in 42% of BKs whatever the number of stings received, but the titer was lower when the number of stings increased. The presence of specific IgE in subjects who are stung numerous times and who do not present allergic symptoms at the time of the stings suggests that outbreaks of anaphylaxis may be possible in nonallergic BKs. Specific IgG titrated by the Pharmacia IgG-RAST was less than 150 U/ml in most allergic subjects and over this level in most nonallergic BKs.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibody Specificity↗

A novel inhalation allergen present in the working environment of beekeepers.

BACKGROUND: Inhalation allergies, caused by allergens from various kinds of pollen, house dust mites, animal epithelium, and mould fungi, are strongly increasing in frequency. In 2.6% of the cases the allergen source remains unidentified. The present paper describes a so far unknown inhalation allergy which was observed in the case of a patient working with hives. METHODS AND RESULTS: The allergen was characterized by immunoblotting, enzyme-linked immunosorbent assay inhibition, and isoelectrofocusing, using the serum of the patient. It is present in both the bee bodies and the larvae, has a molecular mass of 13 kDa, and an isoelectric point of 5.85. It is thermolabile and does not cross-react with allergens from birch, mugwort and timothy grass pollen, mould fungi, or bee venom. The N-terminal amino acid sequence of allergen from larvae was determined to be (2)QIEELKTRLHT(12). A similar allergen of 13 kDa was also found in Varroa mite accompanying bee populations. CONCLUSION: Honey bees (including the larva stadium) and Varroa mite contain a 13-kDa protein causing an allergic reaction. Presently, there is no evidence whether the case described is a singular phenomenon or whether this allergen is a more common inducer of allergies among subjects exposed to honey bees. However, a bee and Varroa mite allergy has to be considered for beekeepers after exclusion of known inhalation allergies.

Administration, Inhalation↗