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Venom immunotherapy in Europe and the United States

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Abstract

Background

Hymenoptera stings are accountable for significant morbidity and deterioration in health-related quality of life due to the allergic reactions they cause, the most severe of which can culminate in fatal anaphylaxis. The availability of high quality venom extracts for use in the diagnosis and treatment of insect venom allergy has improved the prognosis and the health-related quality of life of venom-allergic patients. All over the world subcutaneous venom immunotherapy is currently the most effective form of allergen-based immunotherapy with an early, sustained and long-term efficacy. Even though the type of insect responsible for allergic reactions may be different from Europe and US and therefore also the type of extract, nevertheless indications and contraindications are quite similar, as well as treatment protocols and treatment duration. However, neither the efficacy nor the safety of the treatment are optimal, especially with regard to bee venom immunotherapy, and so there is considerable room for further improvement in these important areas.

Purpose

This review presents the current practice of venom immunotherapy in Europe and United States discussed at the EAACI (European Academy of Allergy and Clinical Immunology) Allergy School on Insect Venom held in Groningen in April 2019.

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Abbreviations

EAACI:

European Academy of Allergy and Clinical Immunology

FAB:

Facilitated antigen binding

HB:

Honeybee

HBV:

Honeybee venom

HRQL:

Health-related quality of life

HVA:

Hymenoptera venom allergy

iTreg:

Inducible regulatory T cell

LLR:

Large local reaction

SLIT:

Sublingual immunotherapy

SR:

Systemic reaction

TGF‑β:

Transforming growth factor β

VIT:

Venom immunotherapy

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Acknowledgement

This work was partially presented as a lecture in the EAACI Allergy School on Insect Venom Allergy and Mastocytosis held in Groningen, The Netherlands, April 11–13, 2019.

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Authors and Affiliations

  1. Allergy Unit, Department of Internal Medicine, University Hospital – Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy

    M. Beatrice Bilò MD

  2. Allergy Unit, Department of Internal Medicine, University Hospital – Allergy and Clinical Immunology School, Polytechnic University of Marche, Ancona, Italy

    Matteo Martini & Alice Corsi

  3. Allergy Unit, Department of Internal Medicine, University Hospital, Ancona, Italy

    Chiara Tontini & Leonardo Antonicelli

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  1. M. Beatrice Bilò MD
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Correspondence to M. Beatrice Bilò MD.

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M.B. Bilò has received speaker’s honorarium and consultancy fees from ALK-Abello’. M. Martini, A. Corsi, C. Tontini and L. Antonicelli declare that they have no competing interests.

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Bilò, M.B., Martini, M., Corsi, A. et al. Venom immunotherapy in Europe and the United States. Allergo J Int 29, 29–37 (2020). https://doi.org/10.1007/s40629-020-00116-8

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