Interest Groups

WG on Insect Venom Hypersensitivity

  • Insect Venom Hypersensitivity IG 2015 Report

    Insect Venom Hypersensitivity IG 2015 Report

    Contribution of IG board members to international multicenter studies and Task Forces of the other EAACI Interest Groups

    Publications:

    1. Siracusa A1Folletti IGerth van Wijk RJeebhay MFMoscato GQuirce SRaulf MRuëff FWalusiak-Skorupa JWhitaker PTarlo SM. Occupational anaphylaxis--an EAACI task force consensus statement.. 2015 Feb;70(2):141-52. doi: 10.1111/all.12541.

    2. Pitsios C, Demoly P, Bilò MB, Gerth van Wijk R, Pfaar O, Sturm GJ, Rodriguez del Rio P, Tsoumani M, Gawlik R, Paraskevopoulos G, Ruëff F, Valovirta E, Papadopoulos NG, Calderón MA.Clinical contraindications to allergen immunotherapy: an EAACI position paper. Allergy. 2015 Aug;70(8):897-909.

    3. Bonadonna P, Pagani M, Aberer W, Bilò MB, Brockow K, Oude Elberink H, Garvey L, Mosbech H, Romano A, Zanotti R, Torres MJ. Drug hypersensitivity in clonal mast cell disorders: ENDA/EAACI position paper. Allergy. 2015 Jul;70(7):755-63.

    Last updated: 13 November 2016
  • Minutes of the Insect Venom Hypersensitivity IG yearly Business Meeting, EAACI Congress Vienna 2016

    Minutes of the Insect Venom Hypersensitivity IG  yearly Business Meeting, EAACI Congress Vienna 2016: (if you press in the available talks you can see the pdf version)



    Business Meeting took place on Monday 13th of June from 17.30 to 18.40, Congress Venue room Schubert 4-6

    Chair: Gunter Sturm, Austria                                       This email address is being protected from spambots. You need JavaScript enabled to view it.

    Secretary: Ewa Cichocka-Jarosz, Poland                    This email address is being protected from spambots. You need JavaScript enabled to view it.

    The other Board members (in the alphabetical order):



    Dario Antolin Amerigo, Spain, additionally webmaster This email address is being protected from spambots. You need JavaScript enabled to view it.

    Ervin Mingomataj, Albania                                           This email address is being protected from spambots. You need JavaScript enabled to view it.

    Hanneke Oude Elberink, The Netherlands                  This email address is being protected from spambots. You need JavaScript enabled to view it.

    Franziska Ruëff, Germany                                          This email address is being protected from spambots. You need JavaScript enabled to view it.

    Betul Ayse Sin, Turkey                                                This email address is being protected from spambots. You need JavaScript enabled to view it.

    JMA Affiliate Elisa Boni, Italy                                       This email address is being protected from spambots. You need JavaScript enabled to view it.

    Sixty five persons attended the BM.

    Agenda was as follows:

    1.    Introductory lecture: Patrizia Bonadonna (Italy) as an invited speaker, gave a lecture entitled “Insect venom allergy and mastocytosis”. After the lecture there was a vivid discussion

    2.    Introduction Gunter Sturm, Austria

    3.    Polistes allergy

    a.       Situation in Italy – Elisa Boni, Italy

    b.      Situation in Spain - Dario Antolin Amerigo, Spain

    4.    Report on ongoing task forces:

    a.       “Self-medication and other recommendations for patients with hypersensitivity reactions to stings” - Maria Beatrice Bilo, Italy.

                                                      i.      Task Force Consensus Statement was published in Allergy 2016 Jul;71(7):931-43.

    b.      “Sting challenge” - Franziska Rueff, Germany. Next draft will be prepared soon.

    c.       Diagnosis of Hymenoptera venom allergy - Gunter Sturm, Austria – main chapters are finished, final draft is planned to be finished until September, 2016, next the review phase lasting for 6 weeks is planned

    d.      Update on the progress of EAACI Treatment guidelines” (chair Eva Maria Varga, Gunter Sturm) - Gunter Sturm, Austria. Time schedule is established as follows:

                                 i.      Phase 1 was ended by the publication of protocol for systematic review in Clinical Translational Allergy 2016 Feb 16;6:6

                                 ii.      Currently Phase 2: June 29-30: Meeting of all TF members in Venice, finalization  of systematic review,  publication of systematic review until October 2016.

                                 iii.      planned Phase 3: Creating a 1st draft of guidelines by the chairs. November 10-11: Meeting of all TF members as well as stakeholders, external experts/reviewers to achieve the final consensus. After the meeting, a 2nd draft of the guidelines will be prepared.  

     

    5.    Update on EADOAS-Study (The effect of antihypertensive drugs on severity of anaphylaxis and side – effects during venom immunotherapy) - Christoph Schrautzer, Austria, Gunter Sturm,

    a.       551 patients (42%) of 1319 were enrolled

    b.      Perfect proportion of patients with ACEI and BB: 29.8% (calc. 24%)

    c.       Inclusion phase should be finished in 2017.

    6.    Future projects - the scientific board of the Insect Venom Hypersensitivity IG welcomes suggestions for future scientific meetings. Everybody is invited to make proposals, even if he/she is not member of the steering committee.

    Last updated: 09 July 2016
  • Insect Venom Hypersensitivity IG 2016 Report

    Insect Venom Hypersensitivity IG 2016 REPORT

    Publications:

    1. Dhami S, Nurmatov U, Varga EM, Sturm G, Muraro A, Akdis CA, Antolín-Amérigo D, Bilò MB, Bokanovic D, Calderon MA, Cichocka-Jarosz E, Elberink JN, Gawlik R, Jakob T, Kosnik M, Lange J, Mingomataj E, Mitsias DI, Mosbech H, Pfaar O, Pitsios C, Pravettoni V, Roberts G, Ruëff F, Sin BA, Sheikh A. Allergen immunotherapy for insect venom allergy: protocol for a systematic review. Clin Transl Allergy. 2016 Feb 16;6:6.

    2. Bilò MB, Cichocka-Jarosz E, Pumphrey R, Oude-Elberink JN, Lange J, Jakob T, Bonadonna P, Fernandez J, Kosnik M, Helbling A, Mosbech H, Gawlik R, Niedoszytko M, Patella V, Pravettoni V, Rodrigues-Alves R, Sturm GJ, Rueff F. Self-medication of anaphylactic reactions due to Hymenoptera stings-an EAACI Task Force Consensus Statement. Allergy 2016 Jul;71(7):931-43.

    3. Dhami S, Zaman H, Varga E-M, Sturm G, Muraro A, Akdis CA, Antolín-Amérigo D, Bilò BM, Bokanovic D, Calderon MA, Cichocka-Jarosz E, Oude Elberink JNG, Gawlik R, Jakob T, Kosnik M, Lange J, Mingomataj E, Mitsias DI, Mosbech H, Ollert M, Pfaar O, Pitsios C, Pravettoni V, Roberts G, Ruëff F, Ayşe Sin B, Netuveli G, Sheikh A. Allergen immunotherapy for insect venom allergy: a systematic review and meta-analysis. Allergy 2016 - accepted for publication

    4. Contribution of IG board members to international multicenter studies and Task Forces of the other EAACI Interest Groups:

    ◦ Grabenhenrich LB, Dölle S, Moneret-Vautrin A, Köhli A, Lange L, Spindler T, Ruëff F, Nemat K, Maris I, Roumpedaki E, Scherer K, Ott H, Reese T, Mustakov T, Lang R, Fernandez-Rivas M, Kowalski ML, Bilò MB, Hourihane JO, Papadopoulos NG, Beyer K, Muraro A, Worm M. Anaphylaxis in children and adolescents: The European Anaphylaxis Registry. J Allergy Clin Immunol. 2016 Apr;137(4):1128-37.e1.

    ◦ Matricardi PM, Kleine-Tebbe J, Hoffmann HJ, Valenta R, Hilger C, Hofmaier S, Aalberse RC, Agache I, Asero R, Ballmer-Weber B, Barber D, Beyer K, Biedermann T, Bilò MB,
    Blank S, Bohle B, Bosshard PP, Breiteneder H, Brough HA, Caraballo L, Caubet JC, Crameri R, Davies JM, Douladiris N, Ebisawa M, EIgenmann PA, Fernandez-Rivas M, Ferreira F, Gadermaier G, Glatz M, Hamilton RG, Hawranek T, Hellings P, Hoffmann-Sommergruber K, Jakob T, Jappe U, Jutel M, Kamath SD, Knol EF, Korosec P, Kuehn A, Lack G, Lopata AL, Mäkelä M, Morisset M, Niederberger V, Nowak-Węgrzyn AH, Papadopoulos NG, Pastorello EA, Pauli G, Platts-Mills T, Posa D, Poulsen LK, Raulf M, Sastre J, Scala E, Schmid JM, Schmid-Grendelmeier P, van Hage M, van Ree R, Vieths S, Weber R, Wickman M, Muraro A, Ollert M. EAACI Molecular Allergology User's Guide. Pediatr Allergy Immunol. 2016 May;27 Suppl 23:1-250.

    ◦ Brockow K, Aberer W, Atanaskovic-Markovic M, Bavbek S, Bircher A, Bilo B, Blanca M, Bonadonna P, Burbach G, Calogiuri G, Caruso C, Celik G, Cernadas J, Chiriac A, Demoly P, Oude Elberink JN, Fernandez J, Gomes E, Garvey LH, Gooi J, Gotua M, Grosber M, Kauppi P, Kvedariene V, Laguna JJ, Makowska JS, Mosbech H, Nakonechna A, Papadopolous NG, Ring J, Romano A, Rockmann H, Sargur R, Sedlackova L, Sigurdardottir S, Schnyder B, Storaas T, Torres M, Zidarn M, Terreehorst I. Drug allergy
    passport and other documentation for patients with drug hypersensitivity - An ENDA/EAACI Drug Allergy Interest Group Position Paper. Allergy. 2016 May 4.

    ◦ Dhami S, Nurmatov U, Roberts G, Pfaar O, Muraro A, Ansotegui IJ, Calderon M, Cingi C, Demoly P, Durham S, van Wijk RG, Halken S, Hamelmann E, Hellings P, Jacobsen L,
    Knol E, Linnemann DL, Lin S, Maggina V, Oude-Elberink H, Pajno G, Panwankar R, Pastorello E, Pitsios C, Rotiroti G, Timmermans F, Tsilochristou O, Varga EM, Wilkinson
    J, Williams A, Worm M, Zhang L, Sheikh A. Allergen immunotherapy for allergic rhinoconjunctivitis: protocol for a systematic review. Clin Transl Allergy. 2016 Mar
    22;6:12.

    ◦ Mayorga C, Celik G, Rouzaire P, Whitaker P, Bonadonna P, Rodrigues-Cernadas J, Vultaggio A, Brockow K, Caubet JC, Makowska J, Nakonechna A, Romano A, Montañez
    MI, Laguna JJ, Zanoni G, Gueant JL, Oude Elberink H, Fernandez J, Viel S, Demoly P, Torres MJ; In vitro tests for Drug Allergy Task Force of EAACI Drug Interest Group. In
    vitro tests for drug hypersensitivity reactions: an ENDA/EAACI Drug Allergy Interest Group position paper. Allergy. 2016 Aug;71(8):1103-34.

    ◦ Hartmann K, Escribano L, Grattan C, Brockow K, Carter MC, Alvarez-Twose I, Matito A, Broesby-Olsen S, Siebenhaar F, Lange M, Niedoszytko M, Castells M, Oude Elberink JN, Bonadonna P, Zanotti R, Hornick JL, Torrelo A, Grabbe J, Rabenhorst A, Nedoszytko B, Butterfield JH, Gotlib J, Reiter A, Radia D, Hermine O, Sotlar K, George TI, Kristensen TK, Kluin-Nelemans HC, Yavuz S, Hägglund H, Sperr WR, Schwartz LB, Triggiani M, Maurer M, Nilsson G, Horny HP, Arock M, Orfao A, Metcalfe DD, Akin C, Valent P. Cutaneous manifestations in patients with mastocytosis: Consensus report of the European Competence Network on Mastocytosis; the American Academy of Allergy, Asthma & Immunology; and the European Academy of Allergology and Clinical Immunology. Allergy Clin Immunol. 2016 Jan;137(1):35-45.
    Last updated: 13 November 2016
  • Minutes of the Insect Venom Hypersensitivity IG yearly Business Meeting, EAACI Congress Barcelona 2015

    Minutes of the Insect Venom Hypersensitivity IG  yearly Business Meeting, EAACI Congress Barcelona 2015:



    Business Meeting took place on Monday 8th of June from 17.30 to 18.40, CCIB room 212

    Chair: Gunter Sturm, Austria                                              This email address is being protected from spambots. You need JavaScript enabled to view it.

    Secretary: Ewa Cichocka-Jarosz, Poland                            This email address is being protected from spambots. You need JavaScript enabled to view it.

    The other Board members (in the alphabetical order):



    Dario Antolin Amerigo, Spain NEW, additionally webmaster This email address is being protected from spambots. You need JavaScript enabled to view it.

    Ervin Mingomataj, Albania                                                   This email address is being protected from spambots. You need JavaScript enabled to view it.

    Hanneke Oude Elberink, The Netherlands                           This email address is being protected from spambots. You need JavaScript enabled to view it.

    Franziska Ruëff, Germany NEW                              This email address is being protected from spambots. You need JavaScript enabled to view it.

    Betul Ayse Sin, Turkey                                                         This email address is being protected from spambots. You need JavaScript enabled to view it.

    JMA Affiliate Elisa Boni NEW                                            This email address is being protected from spambots. You need JavaScript enabled to view it.

    Thirty nine persons attended  the BM.

    Agenda was as follows:

    1.    Prof. Margitta Worm as an invited speaker, gave a lecture entitled “Hymenoptera venom allergy, one of the most important triggers of anaphylaxis in Europe”. After the lecture there was a vivid discussion

    2.    Gunter Sturm gave a report on previous and current activities of IG, as well as future plans:

    a.        Previous activities

                                                      i.      Self-medication and other recommendations for patients with hypersensitivity reactions to stings (co-ordinator Beatrice Bilo). Work on it has started during EAACI Congress in Geneva 2012, currently final draft is awaiting for approval, and will be submitted for publication

                                                    ii.      Sting challenge (co-ordinator Franziska Rueff). Work on it has started during EAACI Congress in Geneva 2012, final draft is expected in September

    b.      Current activities and future plans

                                                      i.      Task force on updating the position paper Diagnosis of Hymenoptera venom allergy (published Allergy 2005) - set up in April 2014 – on going. Twelve members in total are involved. Manuscript Coordinators: Gunter Sturm (Austria) and Thilo Jakob (Germany). The review of literature was done for the first meeting, which took place on Sunday 8th of June during EAACI Congress in Copenhagen. The preliminary draft was prepared in November 2014 and chapter ouline was revised during the meeting in Vienna on 30th January 2015. Final draft is planned until August 1, 2015. Review phase is planned for 6 weeks,and submission to ExCom in September/October 2015.

                                                    ii.      Task force on updating the position paper Prevention and treatment of hymenoptera venom allergy: guidelines for clinical practice ( published Allergy 2005) - set up in April 2014 – currently on going as a part of EAACI TF on Allergen Immunotherapy Guidelines. Initially fifteen members were involved, manuscript coordinators: Gunter Sturm (Austria), Moises Calderon (UK). The review of literature was done for the first meeting, which took place on Sunday 8th of June during EAACI Congress in Copenhagen. The preliminary draft was prepared in November 2014 and chapter ouline was revised during the meeting in Vienna on 31th January 2015. Now the guidelines are part of EAACI AIT Guidelines, fulfilling the highest quality standards (AGREE II). Chairs – Gunter Sturm and Eva Maria Varga. The first meeting of the new TF took place on 30th April in Zurich. Finalization of clinical questions is planned until June 2015, while finalization of systematic review protocol is planned between July 2015 up to the end of October 2015. Draft finalization is planned within Nov 15 – Dec 16, and guidelines (e-book and hard-cover book) till June 2017.

     

                                                  iii.      EAACI multicenter study EADOAS-Study (The effect of antihypertensive drugs on severity of anaphylaxis and side –effects during venom immunotherapy) aiming to verify the association between the risk of more severe anaphylaxis and accumulated side-effects during VIT in patients simultaneously treated with antihypertensive drugs. Study co-ordinator Gunter Sturm. Approval of local ethical review board was obtained in July 10, 2014. Study has started on July 14,  2014.

     

    3.    Christoph Schrautzer (Department of Dermatology, Medical University of Graz, Austria)

    and Gunter Sturm presented an up-date of EADOAS-Study:

                                                      i.      Inclusion criteria: Subjects aged from 35 to 85 years with a history of systemic anaphylactic sting reaction (≥ grade I according to the classification by Ring and Messmer)

                                                    ii.      Planned sample size: 1319

                                                  iii.      Centers already included: 20: Austria – 5, Italy – 4, Poland – 3, Spain – 3, Turkey – 3, Germany – 1, Slovenia – 1.

                                                  iv.      Total number of patients currently recruited: 341 (73.3% without betablokers, while 26.7% with betablokers/ACE-inhibitors).

                                                    v.      Up-dosinig completed: in total: 273, 74.7% without betablokers, while 25.3% with betablokers/ACE-inhibitors.

                                                  vi.      Preliminary results of systemic reactions: in total 11.4%, 11.8% in the group without betablokers, while 10.1%  in group of with betablokers/ACE-inhibitors.

    4.    Franziska Rueff suggested planning the organization of Hymenoptera Venom Allergy School for 2017 which requires applying to EAACI ExCom in 2016.

    5.    The scientific board of the Insect Venom Hypersensitivity IG welcomes suggestions for future scientific meetings. Everybody is invited to make proposals, even if he/she is not member of the steering committee.

    Last updated: 05 July 2015
  • Minutes of the Insect Venom Hypersensitivity IG yearly Business Meeting EAACI 2014

    Business Meeting took place on 9th of June 15.45-17.15

    Chair: Gunter Sturm, Austria
    Secretary: Ewa Cichocka-Jarosz, Poland

    Board members:
    Betül Ayse Sin, Turkey

    Hanneke Oude Elberink, The Netherlands
    Ervin Mingomataj, Albania

    Dimitris Mitsias, Greece
    Edzard Spillner, Denmark

    Darío Antolín-Amérigo, Spain – JMA Affiliate& webmaster

    Forty three persons took part in the BM

    1. Prof. Franziska Rueff as an invited speaker, gave a lecture entitled Contraindications to venom immunotherapy - state of the art. Position paper on this topic within sharing activities of EAACI both Insect Venom Hypersensitivity IG and Immunotherapy Section remains under revision

    2. Gunter Sturm gave a report on previous activities of IG and future plans including updating current position papers and new multicenter study:

    a. Self-medication and other recommendations for patients with hypersensitivity reactions to stings (co-ordinator Beatrice Bilo). Work on it has started during EAACI Congress in Geneva 2012, currently final draft is awaiting for approval, and will be submitted for publication

    b. Sting challenge (co-ordinator Franziska Rueff). Work on it has started during EAACI Congress in Geneva 2012, currently draft remains under final revision

    c. Task force on updating the position paper Diagnosis of Hymenoptera venom allergy (published Allergy 2005) - set up in April 2014

    d. Task force on updating the position paper Prevention and treatment of hymenoptera venom allergy: guidelines for clinical practice ( published Allergy 2005) - set up in April 2014

    For both new task forces 15 members in totals take part, Chair – Gunter Sturm, secretary – Ewa Cichocka-Jarosz. The review of literature was done for the first meeting, which took place on Sunday 8th of June during EAACI Congress in Copenhagen. Revised drafts 2014 will be prepared for the meeting in November / January in Vienna. Submission is scheduled for August 2015

    e. New EAACI multicenter study EADOAS-Study (The effect of antihypertensive drugs on severity of anaphylaxis and side –effects during venom immunotherapy) aiming to verify the association between the risk of more severe anaphylaxis and accumulated side-effects during VIT in patients simultaneously treated with antihypertensive drugs. Study co-ordinator Gunter Sturm, has done short characteristics of study synopsis and three-steps design. Protocol / CRF is finished. Approval of local ethical review board is expected in July. Avarage study samples comprises of 1319 patients. Eighteen centers confirmed participation. Study will last from August 1st, 2014 till December 31st , 2018.

    f. Short vivid discussion with many speakers, concerning English translation of all necessary documents (among them case report form and Ethical Committee agreement) took place

    3. Proposal for creating new ICD-11, which is urgently needed due to different codes applied for venom anaphylaxis eg. X23 (contact with hornets, wasps and bees), X25 (contact with other venomous arthropods), T63 (toxic effect of contact with venomous animals), was performed. New ICD-11 would be helpful for speaking common language.

    4. Gabrielle Cortellini (Italy) gave a short report on difficulties in realization of study Outcome of re-stings in patients with a history of a large local reactions to Hymenoptera stings (co-ordinator Mauricio Severino).

    5. The scientific board of the Insect Venom Hypersensitivity IG welcomes all the suggestions for future scientific meetings. Everybody is invited to make proposals, even if he/she is not member of the steering committee.
    Last updated: 17 October 2014
  • Minutes of the 2013 Business Meeting. Milan. EAACI Congress

    • The Business Meeting during EAACI Congress in Milan gathered 43 participants.
    • Prof. David Golden gave an introductory lecture on “Venom immunotherapy in patients with large local reactions”.
    • Franziska Ruëff introduced the new chairman elected for 2013-2015, and presented the final report on IG activities 2011-2013.
    • New board members prepared acknowledgment for retired Franziska Ruëff
    • Gunter Sturm, current chairman, presented plans of future activities as follows:
      • Initiating a task force on up-dating our position paper on “Diagnosis of Hymenoptera venom allergy” (last version 2005)
      • Initiating task a force on up-dating our position paper on “Prevention and treatment of hymenoptera venom allergy: guidelines for clinical practice” (last version 2005).
      • Initiating phase I of the multicenter study on the effect of antihypertensive drugs on allergic reactions and side-effects of VIT (coordinator: Gunter Sturm)
    • Beatrice Biló reported on the Task Force Self-Medication of Anaphylaxis –the pre-final draft is prepared, final agreements are going to be achieved in 2013.
    • Many participants of the Business Meeting were interested in on- going and new initiatives:
      -Multicenter study on the effect of antihypertensive drugs on allergic reactions and side-effects of VIT (coordinator: Gunter Sturm)
      -Outcome of re-stings in patients with a history of a large local reactions to Hymenoptera stings (co-ordinators: Mauricio Severino, Beatrice Biló)
    • The scientific board of the IG Insect Venom Hypersensitivity welcomes suggestions for future scientific meetings. Everybody is invited to make proposals, even if he/she is not member of the steering committee.
    Last updated: 22 September 2014
  • Hymenoptera Venom Allergy School. Munich 2013

    Fifty-one participants and 15 speakers from twenty-two countries used the opportunity to improve their knowledge on Hymenoptera venom allergy. The Allergy School was organized by the Interest-Group on Hymenoptera Venom Hypersensitivity of the EAACI in collaboration with the DGAKI (German Association of Allergy and Clinical Immunology) and was held from the 11th to 13th of April in Munich, Germany.

    In the beginning, an interesting overview about the history of venom immunotherapy (VIT) was imparted by Ulrich Müller, followed by an insight of protective mechanisms of VIT by Cezmi Akdis. Knowledge on distribution and behaviour of Hymenoptera presented by Volker Mauss may help in the identification of insects. Markus Ollert and Thilo Jakob provided clues to a better diagnostics by using component resolved diagnosis for IgE-measurement. Beatrice Bilò examined the natural history of Hymenoptera venom allergy and delivered important take-home messages concerning anaphylaxis management. The first day ended with a warm welcome reception at the meeting venue, where attendants had the chance to share thoughts and learn.

    On the second day, Gunter Sturm stated that 60% of patients with negative tests can be diagnosed with the basophil activation test. Hanneke Oude Elberink remarked an elevated rate of false positive skin test reactions, when using a concentration of 1 mg venom/ml for the intradermal test, whereas the concentration 0.1 mg/ml is very specific. Franziska Ruëff pointed the important role of baseline tryptase concentration; the dose-dependent effectiveness of VIT supports the option to treat patients at risk for treatment failure with an elevated venom dose. Afterwards the Junior Member Dario Antolin-Amerigo reviewed a great variety of build-up protocols, concluding that there is still too few data to give a clear recommendation for or to advise against a specific build-up schedule. Ewa Cichocka-Jarosz underlined the safety of VIT in children. Marek Niedoszytko presented a thorough review about risk factors, prevention and management of side effects. Another active Junior Member, Byrthe Vos, gave insight to the frequency of mastocytosis (around 2-3%) in Hymenoptera venom allergic patients. In order to identify mastocytosis, it was recommended to measure baseline tryptase before starting VIT, and to perform a meticulous skin examination. The day finished with a review by Constantinos Pitsios about possible contraindications of VIT, a field, in which also data on clear influencing factors are rare. Interactive Practical courses about mastocytosis, in-vitro tests, different build-up schedules and difficult cases, gave the platform for intense discussion. The day ended with a typical Bavarian dinner at the Hofbräukeller with music and funny activities in a charming environment.



    On Saturday, interesting case reports and posters were followed by constructive discussions. The assessment of non-Hymenoptera insect bites was elegantly exposed by Peter Schmid-Grendelmeier. Finally, Ruëff talked about the available tools for monitoring the effects of VIT, and stated that the sting challenge test is the most reliable parameter to monitor efficacy of VIT.

    I would especially like to thank Franziska Ruëff for a wonderful Allergy School and I take the opportunity to invite you to consider attending such meetings where speakers and delegates get to know each other and even plan future projects!!

    Darío Antolín-Amérigo
    Last updated: 13 October 2014