TY - JOUR A1 - Stoevesandt, Johanna A1 - Hofmann, Bernd A1 - Hain, Johannes A1 - Kerstan, Andreas A1 - Trautmann, Axel T1 - Single venom-based immunotherapy effectively protects patients with double positive tests to honey bee and Vespula venom JF - Allergy, Asthma & Clinical Immunology N2 - Background Referring to individuals with reactivity to honey bee and Vespula venom in diagnostic tests, the umbrella terms “double sensitization” or “double positivity” cover patients with true clinical double allergy and those allergic to a single venom with asymptomatic sensitization to the other. There is no international consensus on whether immunotherapy regimens should generally include both venoms in double sensitized patients. Objective We investigated the long-term outcome of single venom-based immunotherapy with regard to potential risk factors for treatment failure and specifically compared the risk of relapse in mono sensitized and double sensitized patients. Methods Re-sting data were obtained from 635 patients who had completed at least 3 years of immunotherapy between 1988 and 2008. The adequate venom for immunotherapy was selected using an algorithm based on clinical details and the results of diagnostic tests. Results Of 635 patients, 351 (55.3%) were double sensitized to both venoms. The overall re-exposure rate to Hymenoptera stings during and after immunotherapy was 62.4%; the relapse rate was 7.1% (6.0% in mono sensitized, 7.8% in double sensitized patients). Recurring anaphylaxis was statistically less severe than the index sting reaction (P = 0.004). Double sensitization was not significantly related to relapsing anaphylaxis (P = 0.56), but there was a tendency towards an increased risk of relapse in a subgroup of patients with equal reactivity to both venoms in diagnostic tests (P = 0.15). Conclusions Single venom-based immunotherapy over 3 to 5 years effectively and long-lastingly protects the vast majority of both mono sensitized and double sensitized Hymenoptera venom allergic patients. Double venom immunotherapy is indicated in clinically double allergic patients reporting systemic reactions to stings of both Hymenoptera and in those with equal reactivity to both venoms in diagnostic tests who have not reliably identified the culprit stinging insect. KW - Anaphylaxis KW - Double sensitization KW - Field sting KW - Honey bee KW - Hymenoptera venom KW - Immunotherapy KW - Relapse KW - Risk factor KW - Treatment failure KW - Vespula Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-96808 UR - http://www.aacijournal.com/content/9/1/33 ER - TY - THES A1 - Hendriksma, Harmen P. T1 - Non-target effects of a multiple insect resistant Bt-maize on the honey bee (Apis mellifera L.) T1 - Nichtzieleffekte eines Bt-Mais mit multipler Insektenresistenz auf Honigbienen (Apis mellifera L.) N2 - Neue methodische Entwicklungen zur Untersuchung der Ursachen des weltweit beobachteten Bienensterbens sind nötig, um die lebenswichtige Ökosystemdienstleistung der Bestäubung zu gewährleisten. Die ökologisch und wirtschaftlich bedeutsame Honigbiene (Apis mellifera) ist ein wichtiger Nichtziel-Organismus im Zulassungsverfahren für gentechnisch veränderte Pflanzen. Bisher sind vor allem Methoden zur Testung erwachsener Bienen unter Laborbedingungen verwendet worden, aber für eine Risikobewertung mit Hilfe von standardisierten Bienenkolonien oder in vitro gezüchteten Honigbienenlarven sind keine robusten Methoden oder standardisierte Protokolle vorhanden. In dieser Arbeit wurde eine Vielzahl an neuen methodischen Ansätzen für die Biosicherheitsforschung entwickelt: eine Mortalitäts-Falle (Kapitel II), ein "Full-Life-Cycle" Test (III), eine robuste in vitro Aufzucht-Methodik (IV), ein standardisierter in vitro Test für Bt-Pollen (V), eine gemischte Toxizitätsprüfung für transgene Reinproteine (VI) und eine Überprüfung der Darmmikroflora sowie der Pollenverdauungrate (VII). Die Ergebnisse dieser Studien zeigten keine nachteiligen Wirkungen von Bt-Maispollen oder Bt-Reinproteinen im "Worst-Case" Szenario auf Honigbienen. In Anbetracht der Datenlage ist eine Schädigung der Honigbiene durch den getesteten Bt-Mais Mon89034xMon88017 unwahrscheinlich. Die Anwendung der Untersuchungsmethoden in zukünftigen Biosicherheitsstudien für transgene Pflanzen wird empfohlen. N2 - Honey bee pollination is an ecologically and economically important ecosystem service. New methodological developments are needed to research the underlying factors of globally observed bee losses. The honey bee (Apis mellifera) is a key non-target arthropod species for environmental risk assessment of genetically modified (GM) crops. For GM-crop risk assessments, mainly methods for monitoring adult honey bees under laboratory conditions are documented. However, protocols with robust methods for standardized colonies or in vitro reared honey bee larvae are currently lacking. Within the research, presented in this this dissertation, multiple methodological developments are achieved; a mortality trap (Chapter II), a ‘full life cycle test’ (III), a novel in vitro rearing methodology (IV), a standardized in vitro test for Bt-pollen (V), a mixed toxicity test for purified transgenic proteins (VI), and a bacterial flora test with pollen digestion rate monitoring (VII). Overall, the studies did not indicate a detrimental effect caused by Bt-maize pollen, or by purified Bt-proteins at worst case exposure levels. Considering the risk for honey bees and larvae, we conclude that the tested Bt-maize Mon89034xMon88017 is not likely to cause harm to honey bee colonies. The study methods presented are highly recommended for future environmental risk assessment studies testing GM-crop biosafety on honey bees. KW - Biene KW - Bt-Mais KW - Nichtzielorganismen KW - Bestäubung KW - Umwelttoxikologie KW - Honey bee KW - Apis mellifera KW - Environmental Risk Assessment KW - Bt-maize KW - Non-target effects KW - Öko-Toxikologie Y1 - 2011 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-70304 ER -