ants and Asthma

Imported fire ant (IFA) whole-body extract subcutaneous immunotherapy (IT) is a safe and effective treatment for IFA hypersensitivity, with a recommended length of treatment of 3 to 5 years.. To evaluate long-term IFA IT adherence in patients with IFA allergy living in an endemic area.. During 2007 to 2014, patients with IFA-sting systemic reactions and a recommendation to start IFA IT were prospectively enrolled in this study. Subjects were contacted annually for interval IT adherence. Institutional review board approval was obtained.. A total of 87 subjects, ages 2 to 64 years, with a recommendation to initiate IFA IT, were enrolled. Subjects were predominantly adult (76%) and female (55%), and 30% had asthma. Of these patients, 77 (89%) initiated treatment within 1 year of recommendation; 18 (23%) adhered to a 3-year course; and 10 (13%) adhered to a 5-year course. At 3 years, there were no significant differences in adherence between male and female subjects (28% vs 19%, P = .33), children and adults (25% vs 22%, P = .79), or those with or without asthma (30% vs 20%, P = .31). Adherence in subjects with mild initial reactions was lower than in subjects with moderate-to-severe reactions (0% vs 25%, P = .05) at 3 years only. Conventional buildup and concurrent flying Hymenoptera venom immunotherapy were predictive of adherence. Reasons for discontinuation were relocation to a nonendemic area (29%) and inconvenience (27%).. This study showed poor long-term adherence to IFA IT at 3 and 5 years. Initial sting severity, buildup protocol, and concurrent flying Hymenoptera venom immunotherapy were predictors for long-term IT adherence.

Topics: Adolescent; Adult; Animals; Ant Venoms; Ants; Asthma; Child; Child, Preschool; Desensitization, Immunologic; Female; Humans; Hypersensitivity; Immunotherapy; Insect Bites and Stings; Male; Middle Aged; Young Adult

Subcutaneous Immunotherapy (SCIT) provides long-lasting benefits when administered for 3 to 5 years.. We evaluated SCIT adherence and factors associated with adherence in a military health care system with no out-of-pocket expenses.. We performed a combined retrospective and prospective observational electronic medical record review of SCIT from 2005 to 2012 to determine the start of therapy, time to maintenance dose (MD), duration of MD, and associated factors.. We enrolled 897 patients selected for SCIT. A total of 421/897 (47%) were of male sex, 269/897 (30%) had asthma, and 113/897 (13%) had a systemic reaction. Ages ranged from 1 to 74 years (mean 34.8). There were 751/897 (84%) who were on aeroallergen immunotherapy, 108/897 (12%) on imported fire ant immunotherapy, and 54/897 (6%) on venom immunotherapy. Therapy was not initiated in 130/897 (14%) patients. There were 538/897(60%) who received at least 1 MD; 307/897 (34%) completed 3 or more years of MD SCIT, 26% completed 4 or more years of MD SCIT, and 19% completed 5 years or more of MD SCIT. For those reaching MD, the mean total duration was 4.23 years and the mean time on MD was 3.17 years. Men were 271/421 (64%) more likely to reach MD (P = .01). The presence of asthma, age, venom immunotherapy/fire ant immunotherapy vs aeroallergen immunotherapy, and systemic reaction were not associated with reaching MD. After achieving MD, none of the identified factors were associated with SCIT duration.. Even with no out-of-pocket expenses, adherence to an adequate course of SCIT was 34%. Only the male sex was significantly associated with reaching MD. No factors were associated with the duration of SCIT after MD.

Topics: Adolescent; Adult; Aged; Allergens; Animals; Ants; Asthma; Child; Child, Preschool; Desensitization, Immunologic; Health Expenditures; Humans; Immunotherapy; Infant; Injections, Subcutaneous; Male; Middle Aged; Retrospective Studies; Young Adult

Topics: Adult; Anaphylaxis; Animals; Ant Venoms; Anti-Allergic Agents; Ants; Asthma; Erythema; Female; Histamine H1 Antagonists; Humans; Immunoglobulin E; Ketotifen; Mast Cells; Mastocytosis; Pruritus; Syndrome

The nonstinging house ant, Monomorium pharaonis (pharaoh ant), was recently identified as a cause of respiratory allergy. This study was performed to evaluate the extent of sensitization to pharaoh ant, and its clinical significance in asthmatic patients. We carried out skin prick tests in 318 patients with asthma. Specific IgE (sIgE) to pharaoh ant was measured by ELISA, and cross-reactivity was evaluated by ELISA inhibition tests. Bronchial provocation testing was performed using pharaoh ant extracts. Fifty-eight (18.2%) of 318 patients showed positive skin responses to pharaoh ant, and 25 (7.9%) had an isolated response to pharaoh ant. Positive skin responses to pharaoh ant were significantly higher among patients with non-atopic asthma than among those with atopic asthma (26.0% vs. 14.9%, p<0.05). There was significant correlation between sIgE level and skin responses to pharaoh ant (rho=0.552, p<0.001). The ELISA inhibition tests indicated that pharaoh ant allergens had various pattern of cross-reactivity to house dust mites and cockroaches. Bronchial provocation tests to pharaoh ant were conducted for 9 patients, and eight showed typical asthmatic reactions. In conclusion, pharaoh ant is an important source of aeroallergens, and it should be included in the skin test battery for screening the causative allergens in patients with asthma.

Topics: Administration, Inhalation; Adolescent; Adult; Allergens; Animals; Ants; Asthma; Bronchial Hyperreactivity; Bronchial Provocation Tests; Female; Humans; Immunoglobulin E; Male; Middle Aged; Skin Tests