Personalized Immunotherapy by bee allergy
Lethal Sting: who is allergic to bee venom, can die in a single stitch. Immunotherapy can help, but not every patient responds to it. Doctors are now trying to tailor the treatment to the affected individual.
When Florian Westermann in the evening in the hospital is, he is happy that he is still alive. In the morning he still looked forward to a relaxing day at the lake. He had made himself comfortable with his wife and small daughter on a picnic blanket. But suddenly he winced, he knows yet, something had stung him in the upper arm. Anywhere on his body, it started to itch, it went black. When his wife called an ambulance, he almost stayed awake. The physician injected drugs, after half an hour it went Westermann better. “Lucky,” the doctor tells him later in the hospital, “you should control your allergy – Next time it might be too late”.
For three to five percent of the population, an insect bite is very dangerous: Like Westermann whole body reacts to the venom. An itchy rash that looks as if you fell into nettles, spreads within minutes in the body. Nausea and shortness of breath are added. In the worst case, the sets of hard breathing and the heart stops to beat.
Bee or wasp sting?
According to the Federal Statistical Office about 20 people die each year due to stings from bees, wasps or hornets. “In reality, it could be much more, because the deaths are sometimes not due to insect bites,” says Markus Ollert, senior physician in dermatology and allergy researcher at the Technical University of Munich (Germany ). He still remembers exactly Westermann, who later register himself in his station allergy. “He was firmly convinced that he was stung by a wasp, because he ate ice cream.”
Wasps love sweet things – but usually only sting when they are annoyed or disturbed. Bees, however, people meet them rather close to their bee hives or on flowers. Ollert did not rule out that his patient had been stung while playing with his child in the grass by a bee. Skin and blood tests agreed with him: Westermann is allergic to bee venom.
“Reacts someone with circulatory collapse or respiratory distress on insects, he should be making an immunotherapy,” says Peter Schmid-Grendelmeier, Professor of Allergology, University Hospital Zurich. “The affects four out of five patients, and the most they tolerate well.”
An unusual allergy test
For the treatment, the doctor injects the patient several years every month exactly defined quantities of the poison under the skin. Gradually as the body gets used to the venom (foreign substance). After therapy more than 80 percent of patients dont react on bee venom or only with redness and swelling of the skin on a stitch. “Unfortunately, currently there is no blood test that tells us for shore how good you are protected,” says Schmid-Grendelmeier.
Still there are risks … Schmid-Grendelmeier sent blood samples of patients who didn’t react on Immunotherapy for analysis in the laboratory of Mark Ollert to Munich. He was not surprised that the patient did not respond to immunotherapy. “The man is allergic against a protein in bee venom that occurs in today’s immune solution at low concentrations,” says allergist. That was one of the main reasons why the immunotherapy doesn’t work on two out of ten patients, he explained in an interview with SPIEGEL ONLINE.
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