Anaphylaxis to Vespa velutina nigrithorax: Pattern of Sensitization for an Emerging Problem in Western Countries

Abstract

Objective: To define the sensitization pattern of patients with anaphylaxis to Vespa velutina nigrithorax (VVN). Methods: One-hundred consecutive Spanish patients with Hymenoptera anaphylaxis were studied. We systematically determined specific IgE (sIgE) to whole venoms (Vespula spp., Polistes dominula, Apis mellífera, Vespa crabro, Dolichovespula maculata) and their molecular components (rApi m 1, rApi m 5, rApi m 10, rVes v 1, rVes v 5, rPol d 5, cross-reactive carbohydrates). Specific IgE to VVN venom and its antigen-5 (nVesp v 5) were measured in a subsample. Results: Seventy-seven patients had VVN anaphylaxis. Of these, only 16 (20.8%) reported previous VVN stings but were stung by other Hymenoptera. Positive (>0.35 kU A /L) sIgE to each of the whole venoms was detected in >70% of patients (Vespula spp. in 100%). Components showing >50% positivity were rApi m 5 (51.4%), rPol d 5 (80.0%), and rVes v 5 (98.7%). This pattern was similar to that of patients with Vespula spp. anaphylaxis (n=11) but different from that of Apis mellifera anaphylaxis (n=10). Specific IgE to nVesp v 5 was positive in all studied patients (n=15) with VVN anaphylaxis and was correlated with sIgE to both rVes v 5 (R=0.931) and rPol d 5 (R=0.887). Conclusions: VVN has become the commonest cause of Hymenoptera anaphylaxis in our area. Most cases report no previous VVN stings. Their sensitization pattern is similar to that of patients with anaphylaxis to other Vespidae. Specific IgE to antigen-5 from VVN, Vespula spp., and Polistes dominula are strongly correlated in patients with VVN anaphylaxis.

Vesp v 5 and glycosylated Vesp v 1 are relevant allergens in Vespa velutina nigrithorax anaphylaxis

“…Vespa velutina nigrithorax (VVN) , commonly known as ‘the yellow‐legged Asian wasp’, is one of the 12 colour variants of Vespa velutina (Lepeletier 1836) 1 . Despite being originally from Asia, it has rapidly spread across France, reaching the Basque Country in the north of Spain and Galicia in the northwest of Spain in 2014 [as revised in 2 ]. The presence of VVN in Great Britain was first confirmed in September 2016, and a mathematical model has predicted an invasion through the Atlantic and northern Mediterranean coasts 3 .…”

“…For that purpose, a high-capacity immunosorbent CAP coupled to streptavidin (o212, Thermo Fisher Scientific) bounded at 15 µg protein/ml for VVN venom and 4 µg protein/ml for the single allergens was used as previously described. 2,4 Positive (>0. and between sIgE to nVesp v 1 and rVes v 1 (Rho 0.556, P < .001) (Table S1). A strong correlation was also found between nVesp v 1 and the CCD marker (Rho 0.698, P < .001) (Table S1).…”

Human Fatalities Caused by Hornet, Wasp and Bee Stings in Spain: Epidemiology at State and Sub-state Level from 1999 to 2018

“…Introduction of this new species had impacted the number of hymenoptera stings seen in clinical toxicology units. 77% of the patients seen who had systemic allergic reactions had been stung by the Asian hornet [49].…”

Vespa-Watch: Invasiemonitoring van de Aziatische hoornaar met hobbyimkers en het publiek. Eindrapport in het kader van de oproep Citizen Science van het Departement Economie, Wetenschap en Innovatie (EWI) van december 2017

“…In Europa werden reeds meerdere dodelijke slachtoffers gerapporteerd als gevolg van het verstoren van nesten (Vidal et al 2019). Toch zijn er tot nu toe geen wetenschappelijke studies die aantonen dat het aantal (fatale) steekincidenten zijn toegenomen sinds de Aziatische hoornaar in Europa is (de Haro et al 2010), noch dat het gif van de Aziatische hoornaar krachtiger dan wel gevaarlijker is dan het gif van andere sociale wespen (Schwartz 2019).…”