- D1.524 - StingReady: a safe and alternative method for controlled sting challenge tests

Hymenoptera venom allergy is a serious medical condition that can lead to severe allergic reactions and, in some cases, death following stings from venomous insects such as bees, wasps, and hornets.

Venom immunotherapy (VIT) is the cornerstone treatment for individuals with a history of severe allergic reactions to Hymenoptera stings, as it significantly reduces the risk of future systemic reactions. 

The sting challenge test (SCT) with Hymenoptera venom involves the provocation of a real sting with a live insect in an allergic patient as an essential tool for assessing the efficacy of VIT. 

In order to provide an alternative method for performing SCT which avoids the anesthetization of insects and the removal of wings and legs to facilitate application on the patient’s skin, we present the StingReady device. 

The StingReady device is a 3D-printed tool specifically designed for capturing and safely handling Hymenoptera insects, such as Vespa velutina, for its use in clinical practice. The device consists of two main components: a containment chamber and a gliding component that fits together to confine the insect while allowing controlled interaction. 

The StingReady device was used for the SCT with 20 patients allergic to Vespa velutina and treated with VIT. Firstly, Vespa velutina specimens were captured the day before and maintained under controlled conditions until the test (darkness and fed ad libitum) ensuring that the insects remained healthy and ready for the SCT. Next, StingReady was applied on the forearm of patients and following the sting application, the skin reactions were observed and documented. One patient experienced a systemic reaction, while the others only experienced a local reaction.

Regardless of whether the sting was tolerated or not, the method proved successful, demonstrating itself to be an alternative to the well-known traditional method and without the need to handle the insect.