Hymenoptera Venom Extracts in Clinical Practice

Publication date: Available online 1 September 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): James M. Tracy, David BK. Golden

Abstract

Venom immunotherapy is the only treatment for the prevention of anaphylaxis and remains the prototypical model for its diagnosis and management. Unlike other causes of anaphylaxis, such as foods and drugs, preventative treatment is highly effective and widely available. Hymenoptera venoms are also unique in that the primary allergens are directly measurable in terms of micrograms, rather than labeled based on potency. As such, venoms were the first truly standardized extracts. However, Hymenoptera venom presents unique challenges in collection, processing and stabilization of the venom extract product. Historically, there have been minor variations in insect composition in venom extract content. These differences were in part, based on variation of insect availability and venom collection and have created minor challenges. However, it is a recognized need that venom extracts contain an optimal and complete repertoire of relevant venoms so as to be assured of appropriate diagnosis and treatment. As such, insect availability and collection, as well as storage, stability and sterility of venom extracts have remained critical components to appropriate diagnosis and prevention of venom induced anaphylaxis. In recent years there has been concerns of adequate supplies of venom for appropriate diagnosis and treatment of venom allergy, but these concerns seem to have stabilized, with the movement to a single venom supplier. This movement to a single supplier may provide its own challenges.