The analysis of the pharmaceutical supply with medicines used in insect allergy therapy and approaches to the development of new medicines in the form of a gel for the local treatment

According to the World Allergy Organization, allergies occur in 10 % to 40 % of the world’s population. Currently, the number of such patients in Europe is about 150 million people. It is projected that in the next decade there will be more than 250 million people, 5 % of whom have a predisposition to insect allergies (IA).Aim. To analyze the range of drugs used in the local treatment of IA and approaches to the development of new domestic drugs in the form of a gel.Materials and methods. The scientific publications of domestic and foreign authors, data from official sites on the subject, ICD-10, materials of the State Register of Medicines of Ukraine, directory Compendium, Protocol for medical care for insect allergies, as well as methods of the system analysis, comparison, graphical, analytical and the content analysis were used.Results. The regimen of IA treatment has been studied depending on the severity (mild, moderate, severe, anaphylactic shock), which is given in the Protocol of medical care for insect allergies in accordance with the Order of the Ministry of Health of Ukraine from 03.07.2006 No.432. It is considered that IA is treated with the subgroup “D04A A – Antihistamines for topical application”, which has only 5 drugs (including release forms); among them 80 % of medicines are foreign, 60 % are produced in the form of a gel. It is very insufficient because of the fact that there are consequences of insect bites during the local therapy of children since constant scratching of the bite sites is a threat of infection of wounds and delay their healing.Conclusions. On the example of the pharmaceutical composition in the form of a gel, the expediency for developing new domestic drugs that are available compared to foreign ones for the local therapy in IA, and manifestations of allergic reactions to insect bites has been proven.

Allergic diseases at an early age

In recent years, there has been a sharp increase in the incidence of allergic diseases (ADs), mainly in countries with a high level of development. Particularly noted is the increase in the prevalence of AZs in young children, among which cutaneous and gastrointestinal manifestations of allergy are the most common. These include atopic dermatitis (ATD), urticaria, gastrointestinal manifestations associated in most cases with food allergy, as well as contact allergic dermatitis, and insect allergy. The leading mechanism of development is immunoglobulin E (IgE)-mediated reactions. There are three main factors that predispose to AZ: genetic, direct contact with an allergen, and external environmental factors. The article deals with the causes, manifestations, therapy and diagnosis of a number of allergic diseases: urticaria, allergic contact dermatitis, insect allergy and some methods of therapy.

Allergens from Edible Insects: Cross-reactivity and Effects of Processing

Purpose of Review The recent introduction of edible insects in Western countries has raised concerns about their safety in terms of allergenic reactions. The characterization of insect allergens, the sensitization and cross-reactivity mechanisms, and the effects of food processing represent crucial information for risk assessment. Recent Findings Allergic reactions to different insects and cross-reactivity with crustacean and inhalant allergens have been described, with the identification of new IgE-binding proteins besides well-known pan-allergens. Depending on the route of sensitization, different potential allergens seem to be involved. Food processing may affect the solubility and the immunoreactivity of insect allergens, with results depending on species and type of proteins. Chemical/enzymatic hydrolysis, in some cases, abolishes immunoreactivity. Summary More studies based on subjects with a confirmed insect allergy are necessary to identify major and minor allergens and the role of the route of sensitization. The effects of processing need to be further investigated to assess the risk associated with the ingestion of insect-containing food products.

Allergy and Immunology

The chapter on allergy and immunology reviews the risk factors, clinical presentation, diagnostic evaluation, and management of atopic diseases and immunodeficiency diseases. The material is presented in an engaging clinical vignette and question-and-answer format. The key medical conditions covered in the chapter include allergic and atopic diseases such as asthma, food allergy, anaphylaxis, urticaria/angioedema, drug allergy, and stinging insect allergy; it also touches on rarer primary immunodeficiency diseases. It highlights key clinical features to enable differentiation of allergic disorders from their mimickers; it provides a diagnostic approach to evaluate primary immunodeficiency diseases, and it covers both acute/urgent and long-term disease management.

Diagnostics of insect allergy in clinical practice

.

Stinging insect allergy and venom immunotherapy

The Hymenoptera order is divided into three families: Apidae, Vespidae, and Formicidae. Apidae include the honeybee, bumblebee, and sweat bee, which are all docile and tend to sting mostly on provocation. The Africanized killer bee, a product of interbreeding between the domestic and African honeybee, is very aggressive and is mostly found in Mexico, Central America, Arizona, and California. The yellow jacket, yellow hornet, white (bald) faced hornet, and paper wasp all belong to the Vespidae family. The Formicidae family includes the harvester ant and the fire ant. When a “bee” sting results in a large local reaction, defined as >10 cm induration and lasting > 24 hours, the likelihood of anaphylaxis from a future sting is approximately 5%. For comparison, when there is a history of anaphylaxis from a previous Hymenoptera sting and the patient has positive skin test results to venom, at least 60% of adults and 20‐32% of children will develop anaphylaxis with a future sting. Both patient groups should be instructed about avoidance measures and about carrying and knowing when to self-inject epinephrine, but immunotherapy with Hymenoptera venom is indicated for those patients with a history of anaphylaxis from the index sting and not for patients who have experienced a large local reaction. Immunotherapy is highly effective in that, by 4 years of injections, the incidence of subsequent sting-induced reactions is 3%. This incidence may increase modestly after discontinuation of injections but has not been reported to be > 10% in follow up.