Immunity Poll

[Karol]

Common guys - play nice!

There's a serious element to this poll. It's not scientific - polls rarely are. However, polls can be useful tools as crude indicators to test hypotheses.

Partners of beekeepers are at elevated risk of anaphylaxis because they are exposed to sensitizing levels of bee proteins from beekeeping kit brought into the home by their beekeeping partners. When partners are then stung they are at heightened risk of developing anaphylaxis partly because they are stung too infrequently to develop 'immunity'.

Beekeepers on the other hand that get regularly stung by bees become 'immune' and are therefore not as prone to anaphylaxis.

This also may help explain why beekeepers are more prone to developing anaphylaxis in response to wasp stings rather than bee stings.

 

[REDWOOD]

But as you're not in a minority group you're stuffed!

Sometimes it's not a bad thing to blend in with the crowd, sort of urban camouflage.

 

[For want of a better word]

Common guys - play nice!

There's a serious element to this poll. It's not scientific - polls rarely are. However, polls can be useful tools as crude indicators to test hypotheses.

Partners of beekeepers are at elevated risk of anaphylaxis because they are exposed to sensitizing levels of bee proteins from beekeeping kit brought into the home by their beekeeping partners. When partners are then stung they are at heightened risk of developing anaphylaxis partly because they are stung too infrequently to develop 'immunity'.

Beekeepers on the other hand that get regularly stung by bees become 'immune' and are therefore not as prone to anaphylaxis.

This also may help explain why beekeepers are more prone to developing anaphylaxis in response to wasp stings rather than bee stings.

Can you give a reference for that info... as I am sure the consultant immunologist in charge of the Eden Unit at Derriford and treating SWMBO for wasp and honeybee allergy... would be really interested

Yeghes da

 

[Karol]

Quite a bit available on this topic:

http://www.medscape.com/viewarticle/807101_4

Page 2 - various routes of sensitization - child reacted after drinking from a glass handled by their beekeeping father (traces of dried honey bee venom)

http://www.wicwas.com/sites/default/files/articles/Bee_Culture/BC2009-08.pdf

http://www.medscape.com/viewarticle/778244_1

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1961691/

http://www.ncbi.nlm.nih.gov/pubmed/15985817

http://www.ncbi.nlm.nih.gov/pubmed/9824397

So, even though more beekeepers are sensitized to bee stings, frequent bee stings appear to have a protective effect (help develop/sustain immunity) which is not seen in family members exposed to honey bee proteins.

 

[Hivemaker.]

Why do some people react to bee stings and others not, regardless of whether they are beekeepers or not, are the ones that have a reaction abnormal or vise versa.

 

[B+.]

Why do some people react to bee stings and others not, regardless of whether they are beekeepers or not, are the ones that have a reaction abnormal or vise versa.

Some beekeepers become sensitive too. I have known beekeepers who, after many years beekeeping, suddenly develop a sensitivity.
I don't think we can view this are "you are sensitive, or you're not". I think each challenge to the immune system has the potential to cause a systemic effect (which we call anaphylaxis).

 

[Karol]

Why do some people react to bee stings and others not, regardless of whether they are beekeepers or not, are the ones that have a reaction abnormal or vise versa.

Good question which is still being answered, i.e. no one fully understands why this happens and it's multifactorial.

There is a school of thought that suggests that our immune system has evolved to accommodate endoparasitic infestation. With clean living we rarely live with endoparasites now which makes part of our immune system redundant and without suppression from endoparasites that part of the immune system becomes over active.

I don't think you can call the reaction (whatever that happens to be) as being abnormal. It is just the way it is. And it shouldn't be forgotten that bee (and wasp) venom is a poison which has evolved to work the way that it does. So unlike other allergies which are incidental and accidental (idiosyncratic) with bee (and wasp) venom the reactions are intentional.

So for example, Kounis syndrome, which is an area of specific interest to me (professionally) is an area causing great confusion. Most people universally link Kounis syndrome to anaphylaxis or anaphylactoid reactions. And that is understandable when viewed at the cellular level because Kounis syndrome is caused by mast cell degranulation, i.e. when a particular species of immune cells release their immune response chemicals. This happens during anaphylaxis for example when bee venom is recognised by antibodies coated to the surface of the mast cells.

The confusion comes from the fact that bee (and wasp) venom also attacks mast cells directly not through the antibody mechanism. This direct action also causes the mast cells to degranulate and this has the potential to cause silent heart attacks without any sign of an allergic reaction and usually several days later.

This second mechanism of action is really quite interesting because it should follow normal receptor theory for biological reactions, i.e. that repeated exposure to the venom dulls the reaction (called down regulation of receptors). If this is the case then we would expect to see fewer beekeepers suffering or dying from heart attacks than their related persons.

Clearly the poll in this regard is a non-sense because beekeepers who have passed away due to a heart attack can't vote! However, fatality rates in heart attacks run at approximately 50% and therefore we could expect to see a ratio of 2 to 1 reported heart attacks in related persons to beekeepers (adjusted for population of related persons).

The more beekeepers that participate the in poll the better the crude indication becomes.

 

[For want of a better word]

How many beekeepers who have had Guillan Barre Syndrome have had bad reactions to bee stings before compared to after?
Wondering as T helper cells have some relevance to mast cell response... immunologically speaking???

Nos da

 

[Karol]

Wow, there's a question I don't mind saying that I don't have the answer to.

I imagine the same rules apply that following frequent stings the T helper cell population matures in favour of more regulatory T helper cells that help to suppress (down regulate) the immune response. I imagine that beekeepers who are frequently stung are less likely to develop Guillan Barre syndrome (and conversely related persons are more likely to develop Guillain Barre in response to bee stings).

I doubt that mast cells play as significant a role in Guillain Barre syndrome which appears to be mediated through the production of antibodies by T lymphocytes and B lymphocytes which 'attack' the nervous system most likely in response to bee venom haptens associating with the myelin sheath on neurons helping to confuse the self recognition system.

I also imagine that the recovery process which can take quite some time, is dependant in a large part on down modulation of the immune response through an elevated population of regulatory T helper cells. That being the case then one might expect to see less of a reaction to subsequent bees stings after an episode of Guillain Barre. (That's purely conjecture on my part based on my understanding of the etiology of Guillain Barre).

I do however accept the connection between T helper cells and mast cells given that the same antibodies will be expressed on the surface of mast cells and triggering these antibodies with bee venom may on occasion lead to anaphylaxis and also may predispose the patient to Guillain Barre several days later.

What I don't understand however is whether there is any connection between innate stimulation of mast cells by bee venom via 'toll like receptors' and whether or not the bee venom still has the opportunity to act as a hapten to cause an autoimmune response that attacks the myelin sheath on neurones without causing anaphylaxis. My suspicion is that it does and that being the case one could expect to get silent Guillain Barre reactions in the same way that we expect people to develop silent heart attacks post bee (and wasp) stings.

Sorry - got carried away and I'm rambling! so I'll stop here.

 

[oliver90owner]

My votes are for second and fourth, although maybe not entirely correct.

My heart attack was genetic related, so likely absolutely nothing to do with keeping of bees.

My wife, although she collapsed unconcious about two minutes after being stung, was administered oxygen, transported to hospital (and had adrenaline administered en-route for failing blood preessure), was covered in rashes and blothes all over her body, was not diagnosed as more than 'severe allergic reaction' at the hospital and was discharged after about two or three hours.

Her reaction was, I believe, down to me leaving my bee suit in the house.

I am sensitive to stings in that the area swells up, but that lessens through the season. I have needed to change medication due to getting an irritating cough after being stung. It has been no reoccurrence so far.

Hope that helps.

 

[Karol]

Thanks Oliver90owner. Even though your heart attack was genetically related it would still have required a trigger to have set it off. Multiple bees stings in the fortnight before hand could have been the trigger as could a single bee sting if you normally don't get stung that often as could a wasp sting. Silent Kounis heart attacks are incredibly difficult to diagnose because quite frequently the patient has a pre-existing condition such as hardening of the arteries or have a stent fitted.

 

[For want of a better word]

Having suffered GBS I note that my reaction to bee stings is about the same as before I had GBS ( now diagnosed as CIDP)
Strange thing is the neuropathy in hands.. as I do not feel the sting instantly, but still get a slight swelling in the sting region
I have not noticed any other change following a sting.
However breathing oxygen and nitrogen under increased partial pressure does give some lessening the neuropathy.

Thanks Karol for your answers, bee venom is clearly a very complex substance!

Yeghes da

 

[Karol]

I'm sorry to hear about your affliction. Might be worth looking at dietary behaviour as an adjunct to any treatment that you might be on. Suggest you avoid sweeteners as they may exacerbate the condition. Difficult if repeated exposure to venom or bee proteins is the culprit especially because they are present in honey.

 

[For want of a better word]

Tried the veggie way when being investigated at the Royal Free... due to the fact that the Indonesian Veggie cooks were fantastic... I think the hospital meat supplies at the time were sourced from Kitty Cat at Southall!...
That of course was after the PPP diet... Pancakes, Pizza and Plaice.. or anything else that would fit under the door!

I avoid sweeteners on my consultants advice... particularly Aspertame!

Mytten da

 

[Karol]

Sweeteners are sulphonamides and you might find this interesting:

http://www.rightdiagnosis.com/t/toxic_polyneuropathy_sulphonamide/intro.htm

Clearly different sulphonamides will have a different scale of effect.

 

[For want of a better word]

Thanks for that Karol... the dangers of sugary (tasting) drinks!

Is there any research you are aware of on people who undergo bee sting therapy for cosmetic or homeopathological reasons?
Would be an interesting group to follow as far as severe reaction after low exposure over time.

For now I will stick to my home ~ brew cider... only treatment that worked for GBS was plasma exchange ( and you won't get that at the local pharmacy!!)

Yeghes da

 

[Karol]

Not an area that I've looked into. The difficulty with the homeopathic bee venom group is that any research would have to be product specific, ie it would be a waste of effort including those products without any trace of bee proteins in the research group. I am aware of reports of reactions to cosmetics and hbv products that contain bee proteins but not any research specifically following these groups.

 

[Stevie Day]

Until very recently in my mere 3 yrs of beekeeping I haven't had a bad reaction to a bee sting.

But in late April I caught shingles & a couple of wks later as the worst of the swelling over left eye was clearing. I got stung on the forehead, back of hand & finger. Back of hand swelled up, finger ok & I looked like an English Bull Terrier.

Then on Monday (not wearing protection) just having a quick peek I got stung on the neck by adams apple. This too reacted, swelled & a large tear drop rash down to top of chest.

Is there any known relation between shingles & bee sting reactions?

Thanks,
Steve

 

[Briarfield]

Until very recently in my mere 3 yrs of beekeeping I haven't had a bad reaction to a bee sting.

But in late April I caught shingles & a couple of wks later as the worst of the swelling over left eye was clearing. I got stung on the forehead, back of hand & finger. Back of hand swelled up, finger ok & I looked like an English Bull Terrier.

Then on Monday (not wearing protection) just having a quick peek I got stung on the neck by adams apple. This too reacted, swelled & a large tear drop rash down to top of chest.

Is there any known relation between shingles & bee sting reactions?

Thanks,
Steve

What analgesic are you using? There is a view that non steroidal antiinflamatories such as ibuprofen may increase the risk.

 

[Stevie Day]

What analgesic are you using? There is a view that non steroidal antiinflamatories such as ibuprofen may increase the risk.

Hi Briarfield,
I was prescribed an antiviral drug & eyedrops for the shingles. Also as my joint pain had increased, I also used diclofenac (nsaid) for a week or 2.

I used to use this long term for joint pain & stopped using 9mths ago. I didn't have any allergic reaction with bee stings, when I was previously on this nsaid. And the last reaction to the bee sting was after I stopped using it again.

Regards,
Steve