- D1.525 - Implementation of allergen-specific immunotherapy for insect allergy

Aim of the Study:

Development and introduction into clinical practice of innovative approaches for the diagnosis, treatment, and prevention of life-threatening complications associated with insect allergy.

In Uzbekistan, current clinical protocols indicate that the prevalence of insect sting allergy is approximately 5%.

According to data from the Scientific and Clinical Department of Toxicology of the Republican Scientific Center for Emergency Medical Care, between March and November each year, 2,700 to 3,500 patients with insect allergy seek care at toxicology emergency departments. Of these, 10–12% develop life-threatening complications, including angioedema and anaphylactic shock.

Furthermore, according to data from the Center of Allergology (2025), the prevalence of insect allergy in the Republic of Uzbekistan is estimated to range between 10% and 17%

Clinical Case Management:

A 47-year-old woman developed a severe allergic reaction following a single wasp sting. Her husband is a beekeeper. Her medical history is notable for three episodes of anaphylactic shock caused by wasp stings and two episodes of anaphylactic shock following honeybee stings.

Within 20 seconds of the most recent sting, she developed generalized urticaria, intense pruritus, extensive angioedema, dyspnea, blurred vision, hypotension, and loss of consciousness—clear clinical signs of anaphylaxis.

Notably, after receiving the initial dose of allergen-specific immunotherapy (week 13 of treatment), she was stung by 7–8 bees but did not develop any clinical symptoms.

Laboratory investigations were performed using the Phadia 250 ImmunoCAP system and revealed the following results:

• Total IgE: 47.1 kU/L
• Allergen component rVes v 5: 7.52 kU/L
• Allergen component rPol d 5: 16.4 kU/L
• Allergen component rApi m 1: 34.00 kU/L

The patient was provided with an emergency action plan, including epinephrine auto-injectors, and venom immunotherapy was recommended due to wasp venom allergy. In 2025, she initiated allergen-specific immunotherapy.

After 1.5 months of treatment, she was stung by a wasp again; however, no clinical symptoms were observed, not even a local reaction. She is currently continuing the course of venom immunotherapy, planned for up to five years.

At present, five patients are receiving wasp venom immunotherapy at the Republican Center of Allergology, including two pediatric patients aged 13 and 11 years