Bee and Wasp Stings

Effect of gamma-irradiated honey bee venom on gene expression of inflammatory and anti-inflammatory cytokines in mice

In this study, the effect of gamma-irradiated honey bee venom (doses of 0, 2, 4, 6, and 8 kGy, volume of 0.1 ml and concentration of 0.2 mg/ml) was evaluated on the reduction of allergen compounds and the gene expression of inflammatory and anti-inflammatory cytokines in mice. Hence, edema activity induced by the bee venom irradiated at 4, 6, and 8 kGy was reduced, compared with the control group and that irradiated at 2 kGy. In contrast, the paw edema induced by the bee venom irradiated at 8 kGy increased, compared with 4 and 6 kGy. At all the time periods, there was a significant decrease in the gene expression of interferon gamma (IFN-γ), interleukin 6 (IL-6), and interleukin 10 (IL-10) in the bee venoms irradiated at 4, 6, and 8 kGy, compared with the control group and that irradiated at 2 kGy. In contrast, there was an increase in the gene expression of IFN-γ and IL-6 in the bee venom irradiated at 8 kGy, compared with those irradiated at 4 and 6 kGy. Therefore, gamma irradiation at 4 and 6 kGy reduced the gene expression of cytokines at each time period by decreasing the allergen compounds of honey bee venom.

Outcomes of wasp and bee stings in Taiwan

BACKGROUND

The families of Hymenoptera causing commonly poisonous animal stings in Taiwan include Apoidea (bee) and Vespidae (wasp). This study aimed to investigate the epidemiologic, clinical characteristics, and outcomes of the severity of envenomation following wasp or bee stings in Taiwan.

METHODS

We conducted a retrospective study by identifying all wasp and bee sting-related envenomation reported to the Taiwan National Poison Control Center between January 2001 and November 2021. Data were reviewed and abstracted by two independent reviewers. We then used ordinal logistic regression analysis to find potential predictors of severe wasp and bee sting-related envenomation.

RESULTS

In Taiwan, bee or wasp stings mainly occur in late summer and autumn. A total of 611 patients were reported to the Taiwan National Poison Control Center with 7.5% resulting in severe or fatal envenomation. Four-hundred and forty-one patients were eligible for the final analysis of the predictors of severity. Logistic regression analysis showed that a greater number of stings, being stung by wasps, older age, and stings over the body were significant predictors for greater severity. The systemic effects following wasp and bee sting included anaphylactic reaction, prolongation of activated partial thromboplastin time, rhabdomyolysis, acute kidney injury, and elevated liver enzymes.

CONCLUSIONS

Wasps generally inflicted more severe envenomation than bees. Only 7.5% of patients had severe or fatal outcomes. Patients with older age, multiple stings, and/or multiple sites of stings were more likely to have severe outcomes.

Multiple Wasp Stings on a Child's Supraglottis

Hymenoptera stings are notorious for producing severe anaphylaxis; localized effects (edema, erythema) are far more common, especially in children. However, even an innocent focused lesion may be life-threatening when the sting is directed to the airway. We present the case of a child enduring consecutive wasp stings on the supraglottis.

A Case Report of Anaphylactic Shock Due to Hornet Sting with Multiple Organ Dysfunction Complications

BACKGROUND: Hornet venom has been recognized to induce lethal systemic effects such as anaphylaxis shock, bronchospasm, acute kidney or liver injury, disseminated intravascular coagulation (DIC), cardiovascular collapse, and even death. It consists of several enzymes and polypeptides with low molecular weights. It has been reported to contain the enzymes phospholipase A2, hyaluronidase, phosphomonoesterase acid ester, α-D-glucosidase, lysophospholipase, α-galactosidase, α-acetylamino-deoxsiglucosidase, and arylamidase. The venom will cause localized or systemic inflammation, an anticoagulant effect that may be fatal. CASE REPORT: Herewith, a survival case report suffered from DIC with multi-organ failure following severe anaphylaxis shock post a hundred or massive Hornet sting. CONCLUSION: We have reported a case of anaphylactic shock after a massive hornet sting with DIC that presented symptoms of shock, AKI, ALI, and multi-site bleeding. Although the mortality rate for similar cases is quite high, the outcome will be better with comprehensive and adequate treatment.

Phenotypic and Transcriptomics Analyses Reveal Underlying Mechanisms in a Mouse Model of Corneal Bee Sting

Corneal bee sting (CBS) is one of the most common ocular traumas and can lead to blindness. The ophthalmic manifestations are caused by direct mechanical effects of bee stings, toxic effects, and host immune responses to bee venom (BV); however, the underlying pathogenesis remains unclear. Clinically, topical steroids and antibiotics are routinely used to treat CBS patients but the specific drug targets are unknown; therefore, it is imperative to study the pathological characteristics, injury mechanisms, and therapeutic targets involved in CBS. In the present study, a CBS injury model was successfully established by injecting BV into the corneal stroma of healthy C57BL/6 mice. F-actin staining revealed corneal endothelial cell damage, decreased density, skeletal disorder, and thickened corneal stromal. The terminal-deoxynucleotidyl transferase mediated nick end labeling (TUNEL) assay showed apoptosis of both epithelial and endothelial cells. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis showed that cytokine–cytokine interactions were the most relevant pathway for pathogenesis. Protein–protein interaction (PPI) network analysis showed that IL-1, TNF, and IL-6 were the most relevant nodes. RNA-seq after the application of Tobradex^® (0.3% tobramycin and 0.1% dexamethasone) eye ointment showed that Tobradex^® not only downregulated relevant inflammatory factors but also reduced corneal pain as well as promoted nerve regeneration by repairing axons. Here, a stable and reliable model of CBS injury was successfully established for the first time, and the pathogenesis of CBS and the therapeutic targets of Tobradex^® are discussed. These hub genes are expected to be biomarkers and therapeutic targets for the diagnosis and treatment of CBS.

A honey bee can threat ear: Sudden sensorineural hearing loss

Sudden sensorineural hearing loss is an otologic emergency. Many etiological factors can lead to this pathology. Honey bee (Apis mellifera) sting may lead to local and systemic reactions due to sensitization of the patient. In this paper we described a sudden sensorineural hearing loss occurred after honey bee sting.

Acute Interstitial Nephritis Following Multiple Asian Giant Hornet Stings

Patient: Male, 42

Final Diagnosis: Acute interstitial nephritis

Symptoms: Difficulty breathing • headache • numbness • oliguria

Medication: Methylprednisolone

Clinical Procedure: Plasma exchange

Specialty: Nephrology

Cloning and molecular characterization of scorpion Buthus martensi venom hyaluronidases: a novel full-length and diversiform noncoding isoforms

Hyaluronidase is a common component of scorpion venom and has been considered as "spreading factor" that promotes a fast penetration of the venom in the anaphylactic reaction. In the current study, a novel full-length of hyaluronidase BmHYI and three noncoding isoforms of BmHYII, BmHYIII and BmHYIV were cloned by using a combined strategy based on peptide sequencing and Rapid Amplification of cDNA Ends (RACE). BmHYI has 410 amino acid residues containing the catalytic, positional and five potential N-glycosylation sites. The deduced protein sequence of BmHYI shares significant identity with venom hyaluronidases from bees and snakes. The phylogenetic analysis showed early divergence and independent evolution of BmHYI from other hyaluronidases. An extraordinarily high level of sequence similarity was detected among four sequences. But, BmHYII, BmHYIII and BmHYIV were short of stop-codon in the open reading frame and poly(A) signal in the 3' end.