Immune responses to mosquito saliva in 14 individuals with acute systemic allergic reactions to mosquito bites

Peng, Zhikang; Beckett, Andrew N.; Engler, Renata J.; Hoffman, Donald R.; Ott, Nancy L.; Simons, F. Estelle R.

doi:10.1016/j.jaci.2004.08.014

« Previous Next »The Journal of Allergy and Clinical Immunology
Volume 114, Issue 5 , Pages 1189-1194, November 2004

Immune responses to mosquito saliva in 14 individuals with acute systemic allergic reactions to mosquito bites

Zhikang Peng, MD
- From the Section of Allergy and Clinical Immunology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg
- Reprint requests: Zhikang Peng, MD, Department of Pediatrics and Child Health, University of Manitoba, 532-715 McDermot Ave, Winnipeg, Manitoba, Canada, R3E 3P4.
Andrew N. Beckett, BSc
- From the Section of Allergy and Clinical Immunology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg
Renata J. Engler, MD
- Walter Reed Army Medical Center, Washington
Donald R. Hoffman, PhD
- Department of Pathology and Laboratory Medicine, East Carolina University, Greenville
Nancy L. Ott, MD
- Southdale Pediatric Associates, Ld, Edina
F. Estelle R. Simons, MD, FRCPC
- From the Section of Allergy and Clinical Immunology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg

Received 3 June 2004; received in revised form 5 August 2004; accepted 6 August 2004.

Winnipeg, Manitoba, Canada, Washington, DC, Greenville, NC, and Edina, Minn

Background

Mosquito bite–induced acute systemic allergic reactions are an increasing clinical concern and have not been optimally characterized immunologically.

Objective

We wanted to study the immunologic basis of these reactions.

Methods

Sera were received from 14 individuals with a history of acute systemic allergic reactions to mosquito bites, defined as the presence of one or more of the following: urticaria, angioedema, wheezing, dyspnea, hypotension, and decrease or loss of consciousness. Ten individuals were from the United States and one each was from Canada, Germany, Japan, and Switzerland. An indirect ELISA was developed to measure specific IgE and IgG antibodies to saliva from 5 common mosquito species with different geographic distributions: Aedes aegypti, Aedes vexans, Aedes albopictus, Anopheles sinensis, and Culex quinquefasciatus. Twenty-nine individuals with negative bite test results from laboratory-reared mosquitoes served as control subjects.

Results

Mosquito saliva–specific IgE levels to all 5 species were significantly increased in the individuals with systemic allergic reactions compared with the control subjects (P < .061 for Aedes vexans and P < .008 for the remaining 4 species). By using the mean of the control subjects plus 1 SD as a cut-off level, 11 individuals had positive results to Aedes albopictus and up to 4 additional species; 3 individuals had positive results to only one species. Saliva-specific IgG levels were not significantly increased in the individuals with systemic allergic reactions compared with levels seen in the control subjects (P>.05).

Conclusion

Acute systemic allergic reactions to mosquito bites involve mosquito saliva–specific IgE and can be characterized immunologically. Aedes albopictus is the most common species associated with systemic allergic reactions to mosquito bites.

Key words: Acute systemic allergic reaction, Aedes aegypti, Aedes albopictus, Aedes vexans, Anopheles sinensis, anaphylaxis, angioedema, Culex quinquefasciatus, mosquito allergy, mosquito saliva-specific IgE

Supported by the Children's Hospital Foundation of Manitoba, Inc, and the Paul H. T. Thorlakson Research Fund for Andrew Beckett's BSc medicine studentship.

PII: S0091-6749(04)02218-3

doi:10.1016/j.jaci.2004.08.014