White-faced hornet

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Code: i2
Latin name: Dolichovespula maculata
Source material: Venom
Family: Vespidae
Order: Hymenoptera
 
Some sting victims have been reported as suffering 2000 stings and surviving while others receive a single fatal sting.

Allergen Exposure

White-faced hornets live in large colonies of 50 to 2000 individuals. They often build aerial nests on or around human dwellings. Stinging incidents often occur when man accidentally disturbs a nest while engaged in yardwork or house repairs. The white-faced hornet is rare in Europe, but is of great importance in the North American continent.

Potential Cross-Reactivity

Insect allergic patients frequently show reactivity to more than one vespid venom by skin test, in vitro specific IgE measurements and/or RAST inhibition. This multiple reaction is due, in part, to multiple exposure to different vespids and, in part, to cross-reactivity of homologous venom proteins from different vespids. (1-13)

Clinical Experience

IgE-mediated reactions often present as large local reactions with swelling extending from the sting site. They sometimes include anaphylactic reactions with common symptoms such as urticaria, flushing and angioedema as well as more serious respiratory and cardiovascular symptoms. The reactions can be fatal. Reactions can be both of the immediate and/or delayed type (14, 15, 16).
 
Review
White-faced hornets live in large colonies of 50 to 2000 individuals. They often build aerial nests on or around human dwellings. Stinging incidents often occur when man accidentally disturbs a nest while engaged in yardwork or house repairs. The white-faced hornet is rare in Europe, but is of great importance in the North American continent.
 
Insect allergic patients frequently show reactivity to more than one vespid venom by skin test, in vitro specific IgE measurements and/or RAST inhibition. This multiple reaction is due, in part, to multiple exposure to different vespids and, in part, to cross-reactivity of homologous venom proteins from different vespids (1-13).

IgE-mediated reactions often present as large local reactions with swelling extending from the sting site. They sometimes include anaphylactic reactions with common symptoms such as urticaria, flushing and angioedema as well as more serious respiratory and cardiovascular symptoms.  The reactions can be fatal. Reactions can be the immediate and/or delayed type (14, 15, 16).
 
Allergens
Data on IgE binding to Dolichovespula maculata proteins indicate that there does not appear to be any single dominant allergen (5). Three known allergen proteins are;
  • Phospholipase, Dol m1(37 kDa): Vespid phospholipases are differ from bee phopholipases in both molecular weight and enzyme specificity. In studies, phospholipases appear to exhibit significantly less cross-reactivity than antigen 5s. (1, 6, 7, 8) Vespid phopholipase has partial sequence identity with mammalian lipase (10).
  • Hyaluronidase, Dol m2 (43 kDa): The hyaluronidases cross-react among bees, Vespula and Dolichovespula but probably not with the Polistes. Vespid hyaluronidase has partial sequence identity with mammalian sperm hyaluronidase. In BALB/C mice, Dol m2 and bee hyaluronidase showed cross-reactivity at both antibody and T cell level. These findings are relevant to some patients' multiple sensitivity to hornet and bee stings (6, 7, 8, 10, 12).
  • Antigen 5, Dol m5, is a basic protein of about 23 kDa: The antigen 5s are significantly cross-reactive among Vespula (Yellow jackets) Dolichovespula (hornets) and Polistes (paper wasps) (6, 7, 8, 9, 10, 11, 13). There is a sequence similarity of vespid Ag 5 to a mammalian protein from testis, which can be related to the fact that the stinger apparatus of vespid is a modified ovipositor that no longer functions in egg laying (12).
Of these three mentioned allergens only antigen 5 is without enzymatic activity (9).

References

  1. King TP, Sobotka AK, Alagon A, Kochoumian L, Lichtenstein LM. Protein allergerns of whitefaced hornet, yellow hornet, and yellow jacket. Biochemistry 1978;17:5165-74. 
  2. Hoffman DR. Allergens in Hymentoptera venom VI. Cross reactivity of human IgE antibodies to the three vespid venoms and between vespid and paper wasp venoms. Ann Allergy 1981;46:304-9. 
  3. Mueller U, Elliott W, Reisman R, Ishay J, Walsh S, Steger R et al. Comparison of biochemical and immunological properties of venoms from four hornet species. J Allergy Clin Immunol 1981;67:290-8. 
  4. Reisman RE, Muelle U, Wypych J, Elliott W, Arbesman CE. Comparison of the allergenicity and antigenicity of yellow jacket and hornet venoms. J Allergy Clin Immunol 1982;69:268-74. 
  5. Hoffman DR. Allergens in Hymentoptera venom XIV: IgE binding activities of venom proteins from three species of vespids. J Allergy Clin Immunol 1985;75:605-10. 
  6. Hoffman DR. Allergens in Hymentoptera venom XV: The immunologic basis of vespid venom cross reactivity. J Allergy Clin Immunol 1985;75:611-20. 
  7. King TP, Joslyn A, Kochoumian L. Antigenic cross reactivity of venom proteins from hornets, wasps, and yellow jacket. J Allergy Clin Immunol 1985;75:621-28. 
  8. Hoffman DR. Allergens in Hymentoptera venom XVI. Studies of the structures and cross-reactivities of vespid venom phospholipases. J Allergy Clin Immunol 1986;78:337-43. 
  9. King TP, Moran D, Wang DF, Kochoumian L, Chait BT. Structural studies of a hornet venom allergen antigen 5, Dol mV and its sequence similarity with other proteins. Protein Seq Anal 1990;3:263-6. 
  10. Soldatova L, Kochoumian L, King TP. Sequence similarity of a hornet (D. maculata) venom allergen phopholipase A1 with mammalian lipases. FEBS 1993;320:145-9. 
  11. Lu G, Villalba M, Coscia MR, Hoffman DR. Sequence analysis and antigenic cross-reactivity of a venom allergen, antigen 5, from hornets, wasps, and yellow jackets. J Immunology 1993;150: 2823-30. 
  12. King TP, Lu G, Hornet venom allergen antigen 5, Dol m5: Its T-cell epitopes in mice and its cross-reactivity with a mammalian testis protein. J Allergy Clin Immunol 1997;99:630-9. 
  13. Lu G, Kochoumian L, King TP. Sequence identity and antigenic cross-reactivity of white face hornet venom allergen, also a hyaluronidase, with other proteins. J Biol Chem 1995;270:4457-65.
  14. Reisman RE. Stinging insect allergy. Clinical Allergy 1992;76:883-94. 
  15. Mueller UR. Insect Sting Allergy. Clinical picture, diagnosis and treatment. Stuttgart New York: Gustav Fischer, 1990. 
  16. Fernándes J, Rodes F, Marti J, Blamca M. Wasp sting anaphylaxis as a cause of death: a case report. Allergol et Immunopathol 1992;20:40-1.

As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.