PubMed · 10922021
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J Curtis. 2000. Insect sting anaphylaxis.. https://doi.org/10.1542/pir.21-8-256
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The pathophysiological responses to immune stress (IS) include activation of several processes which are dependent on cytosolic Ca2+ elevation. Magnesium frequently acts as a natural Ca2+ antagonist. In this study we have observed that Mg2+ can protect guinea-pigs against IS. Antigen-sensitized guinea-pigs, which had been fed a magnesium-deficient diet, were given a single dose (15 mg) of MgCl2 intraperitoneally 1 h before antigen challenge. The development of anaphylactic shock (AS) was observed during the next 2 h, and the hearts were subsequently examined histologically for signs of cardiac myolysis (CM). Magnesium (i) reduced the incidence of CM from 40% to 10% (p < 0.05); (ii) reduced the incidence of AS from 61% to 35% (p < 0.05); (iii) attenuated the severity of the AS; and (iv) lowered mortality from 39% in the control to 19% in the Mg(2+)-treated group (p = 0.1). Serum and tissue total [Mg2+] were not affected by the administration of MgCl2. Also, the serum and heart Mg2+ levels were the same whether or not the guinea-pigs developed AS or CM. In cell culture we demonstrated that by elevating the [Mg2+] in the medium bathing sensitized rat basophilic leukemia (RBL) cells, the increase in cytosolic [Ca2+] subsequent to antigen challenge was reduced from 174 +/- 23.28% (1 mM) to 82.74 +/- 13.22% (3 mM). We conclude that a single treatment with Mg2+ can considerably diminish damage induced by immune stress, probably by its altering the Ca2+: Mg2+ ratio. Since the physiological reaction to different types of stress is similar, Mg2+ could prove beneficial in preventing stress-induced shock in general. Studies examining the mechanisms by which Mg2+ exerts its effects thus provide a scientific basis for the current clinical use of Mg2+ in acute myocardial infarction (AMI) and asthma.
Systemic anaphylactic reactions to bee or wasp stings are potentially life-threatening. Up to 5% of the population are affected. In the large majority of patients, an insect venom allergy can be diagnosed on the basis of the medical history, skin tests and determination of venom-specific serum IgE antibodies. Sensitization to insect venom (only "positive" test results) and insect venom allergy ("positive" test results and a history of systemic reactions of the immediate type to stings) must be carefully differentiated. Hyposensitization with bee or wasp venom reliably protects almost all patients with systemic sting reactions of the immediate type. Nevertheless, this unproblematic treatment of a potentially life-threatening allergy fails to reach many patients. If a sting challenge or a "field sting" is tolerated during the period of desensitization, treatment can be terminated after three to five years. If, however, the individual patient is at a particular risk, hyposensitization must be continued for a longer period, possibly even life-long.