血浆置换及大剂量甲泼尼龙治疗蜂螫伤致溶血性贫血的疗效分析

目的比较血浆置换(PE)与大剂量甲泼尼龙治疗蜂螫伤致溶血性贫血的疗效。方法蜂螫伤导致溶血性贫血患者35例,入院后除常规的对症处理外,拒绝行PE治疗的患者分为大剂量甲泼尼龙治疗组(n=13),其余的22位患者采用PE方法治疗,比较两组的溶血控制时间、并发症发生率、死亡率、平均住院天数。结果与大剂量甲泼尼龙治疗组相比,PE治疗组溶血控制的时间相当,差异没有统计学意义,但该组患者的并发症发生率、死亡率、平均住院天数均低于前者,差异有统计学意义(P0.05)。结论 PE治疗能够有效治疗蜂螫伤所致溶血性贫血,且降低并发症的发生率,从而减低死亡率,缩短病程,减少平均住院天数,是早期治疗蜂螫伤中毒的有效手段。     

Influence of the histamine control on skin reactivity in skin testing

We investigated the effect of the histamine control (1 mg/ml) on the results of skin prick and intradermal testing with bee and wasp venom. Skin tests were done on the patients' forearms: on the right arm the histamine control and the bee venom dilutions, on the left arm the wasp venom dilutions only, at distances of 4-5 cm. In intradermal testing 11 (9%) of 122 patients showed a positive wheal and flare reaction to the bee venom solution positioned next to the histamine control. The subsequent solutions in higher concentrations did not produce any skin reactions. The results of intradermal testing with bee venom did not occur in intradermal testing with wasp venom or in skin prick testing with both allergens. Our results show clearly that in skin prick tests a distance of 4-5 cm is sufficient to avoid false positive skin reactions. However, using the same distance in intradermal testing showed that histamine affects the skin reactions produced by adjacent allergen solutions. Therefore false positive results may occur.     

Structural and biological characterization of three novel mastoparan peptides from the venom of the neotropical social wasp Protopolybia exigua (Saussure).

The venom of the Neotropical social wasp Protopolybia exigua(Saussure) was fractionated by RP-HPLC resulting in the elution of 20 fractions. The homogeneity of the preparations were checked out by using ESI-MS analysis and the fractions 15, 17 and 19 (eluted at the most hydrophobic conditions) were enough pure to be sequenced by Edman degradation chemistry, resulting in the following sequences: Protopolybia MPI I-N-W-L-K-L-G-K-K-V-S-A-I-L-NH2 Protopolybia-MP II I-N-W-K-A-I-I-E-A-A-K-Q-A-L-NH2 Protopolybia-MP III I-N-W-L-K-L-G-K-A-V-I-D-A-L-NH2 All the peptides were manually synthesized on-solid phase and functionally characterized. Protopolybia-MP I is a hemolytic mastoparan, probably acting on mast cells by assembling in plasma membrane, resulting in pore formation; meanwhile, the peptides Protopolybia-MP II and -MP III were characterized as a non-hemolytic mast cell degranulator toxins, which apparently act by virtue of their binding to G-protein receptor, activating the mast cell degranulation.     

Hymenoptera venom allergy

For most people, hymenoptera stings produce only a transient and bothersome local inflammatory reaction characterized by pain, redness and swelling. However, for those who are allergic to components of the venom, a re-sting may cause life-threatening, even fatal reactions. In such patients, correct diagnosis is a prerequisite for effective management (i.e., specific venom immunotherapy) and generally consists of appropriate skin testing and quantification of venom-specific immunoglobulin E antibodies. In spite of the high efficiency of properly administered venom immunotherapy, the molecular and cellular mechanisms of the desensitization process remain incompletely understood.     

ST Elevation Myocardial Infarction With No Structural Lesions After a Wasp Sting

Background: Acute coronary syndromes after hymenoptera stings and other environmental exposures are referred to as the Kounis syndrome or allergic myocardial ischemia and infarction. Case Report: We report the case of a 58-year-old man with transient inferior ST-segment elevation consistent with myocardial ischemia after a single wasp sting. Urgent cardiac catheterization revealed normal coronary arteries with a normal left ventriculogram. The evaluation and treatment of cardiac ischemia associated with an allergic reaction is discussed. Conclusion: ST elevation myocardial infarction after wasp envenomation is an exceptional and interesting pathology with a partially elucidated pathogenesis. The management of cardiac ischemia in this setting is uncertain.     

Wind-borne insects mediate directional pollen transfer between desert fig trees 160 kilometers apart

The question of how far pollen can move between plants has implications for topics as diverse as habitat fragmentation, conservation management, and the containment of genetically modified crops. The monoecious African fig tree Ficus sycomorus L. relies on the small, short-lived, night-flying, host-specific fig wasp Ceratosolen arabicus Mayr for pollination. We used microsatellite markers to characterize a geographically isolated riparian population of F. sycomorus growing along the Ugab River in the Namib Desert, Namibia, together with paternity analysis of seedlings from known mothers, to map pollen movement within this population. In this way we tracked insect movements between individually recognizable trees by means of their pollen cargo and documented the movement of C. arabicus between known trees separated by more than 160 km, with a mean distance for confirmed successful pollination events of 88.6 km. The predominant observed movement of pollinators was in a westerly direction, toward the sea, reflecting seasonal nighttime wind direction and the wind-borne dispersal of fig wasps. Our results suggest the existence of an extensive panmictic population of trees that are well suited to overcome the effects of geographical isolation.     

秦巴山区714例胡蜂蜇伤流行特征及临床分析

<正>胡蜂蜇伤是夏秋季常见临床急症之一,临床表现复杂,伴随局部及全身多种症状。局部反应多为蜇伤处红肿刺痛,出现水泡、淤血,皮肤进而变色,坏死;常伴有口唇及眼睑肿胀,喉痒水肿,通气不畅,皮肤荨麻疹,过敏性休克等症状,严重者发展为多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS),危及生命~([1,2])。本文旨在分析胡蜂蜇伤流行病学情况及临床特点,为胡蜂蜇伤的诊疗     

Side-effects of insect venom immunotherapy: results from an EAACI multicenter study. European Academy of Allergology and Clinical Immunology

BACKGROUND: The effect of venom immunotherapy (VIT) is well documented, but fear of systemic side-effects (SE) may prevent its use. The study aimed to analyze the character and frequency of SE and risk factors. METHODS: In a prospective study, 19 European centers included patients starting on VIT for systemic reactions to insect stings. Various dose regimens were applied. RESULTS: Data from 840 patients with a total of 26 601 injections were obtained. Seventy-one percent were treated with Vespula-venom extract and 27% with honeybee-venom extract. Twenty percent of patients had SE corresponding to 1.9% of injections during dose increase and 0.5% during the maintenance phase. The vast majority of the 280 reactions were mild: only one-third required medical treatment. Injected or inhaled adrenaline was applied in six patients, of whom only one had a drop in blood pressure and collapse. Female sex, bee-venom extract, and rapid dose increase, but not severity of insect sting reactions, increased the risk of SE. The severity of SE was less in males but was not related to age, treatment phase, species of insect, or severity of insect sting reactions. CONCLUSIONS: The frequency of SE was low, and the majority of these could be managed without treatment. Risk was increased in females, in bee-venom-treated patients, and in those with rapid dose increase.