Bee population is declining because of pesticides, climate and environmental change and due to the emergence of new predators, such as mites. This is a serious problem because bees are beneficial to our ecosystem, as they pollinate flowers and allow for vegetation to grow. Understanding how important bees are, we believe that it is vital to support them with more beekeepers and pollinator friendly habitats. However, many people are fearful of bees because an allergy to bee stings can be very severe. Related swelling and anaphylaxis can be fatal. We believe that with research and education, severe allergies to bee stings can be prevented.

We hypothesize that beekeepers are at increased risk of anaphylaxis because of more frequent stings while working with their hives. This could result in less people being willing to take care of bees long-term due to a fear of a serious reaction to a bee sting.

We will be researching using Google and Immune - Philipp Dettmer using the keywords: allergies, bee, stinger, venom, treating, preventing, immunology, tolerance, symptoms, and reaction. Our sources will be Google, Youtube

Introduction

The honeybee (Apis mellifera) is a fuzzy black and yellow insect that lives in colonies of up to 80,000 bees working together to help their colony thrive. Honeybees, as well as other species of bees, are beneficial to our ecosystem as they pollinate flowers and allow for vegetation to grow. Unfortunately, bee populations are declining because of pesticides, climate and environmental change and due to the emergence of new predators, such as mites. Understanding how important bees are, we believe that it is vital to support them with more beekeepers and pollinator-friendly habitats.

Allergies

Currently, scientists do not fully understand why some people develop allergies and others do not. However, studies do show that genetics and environment are contributing factors.

In the case of beekeepers, up to 32% will have a systemic allergic reaction to insect stings in their lifetime while only 5% of the general population is affected. A systemic allergic reaction is when your immune system overreacts to a target that may not be a dangerous intruder. In the case of a bee venom allergy, the resulting reaction is more damaging than what the venom alone would cause. 

Allergens are the molecules of a substance your immune system reacts to. When an allergen enters your system, B Cells (found in your skin, lungs and intestines) are activated and start to produce IgE Antibodies against the allergen. These antibodies are not problematic on their own, but when they attach to Mast Cells, chemicals like histamine can be released causing massive inflammation. Mast Cells collect IgE Antibodies like a magnet, covering their cell surface for weeks to months. The second time you are exposed to that specific allergen the IgE-covered Mast Cells can recognise and connect to it. This triggers Mast Cells to release all of their inflammatory chemicals, especially histamine. This is what causes redness, heat, swelling, itching, and unwellness. Histamine also stimulates mucus production in the respiratory system and causes smooth muscles in your lungs to contract, affecting your ability to breathe. Mast Cells also release other signaling molecules (Cytokines) that activate additional immune cells such as Basophils. These cells together can cause a continued hypersensitivity reaction that results in significant damage to surrounding tissues. In the most severe case, called anaphylaxis, the life-threatening reaction can compromise your breathing and circulation.

What is in venom?

MCD (Mast Cell Degranulating) Peptide

Melittin 

Apamin

Adolapin

PLA2

Hyaluronidase

These are the main chemicals in bee venom.

An average reaction to a bee sting includes swelling and redness where stung and the area feeling warm or itchy, swelling can be quite severe.

When a bee venom sac is full, it contains around 0.15-0.3 mg of venom

Bees live 8-114h after stinging

On average, 140–150 μg of venom is delivered in a stinging

event.

Venom is one of the most important parts of a bee's defense, and to understand an allergy, we must know what is in the venom, some chemicals in the venom include MCD (Mast Cell Degranulating) Peptide, Melittin Apamin, Adopalin, PLA2, Hyaluronidase. An average reaction to these includes swelling and redness where stung and the area feeling warm or itchy and swelling can be severe. At most, a bee's venom sac has around 0.15-0.3 mg of venom.

In the abdominal cavity of a bee, two one-way valves in the venom bulb fold and open when the lancet is digging into the flesh

Muscles connected to a part of the abdominal cavity in a bee, called the lancet, slowly dig into flesh using backward-facing barbs when muscles extend and contract, moving the lancet. As the lancets move, they are connected to one-way valves that extend when they push down and retract when they are pulled up, the venom is pushed by the valves and flows through the inside area of the stylet and lancet, which are watertight. This venom is produced in the venom glands

Allergies

Histamine is generally the cause of swelling and bronchoconstriction

A bee allergy can be triggered when bee venom comes in contact with mast cells in the human body, degranulating the mast cells.

Specialized Plasma Cells create IgE antibodies when they come into contact with an allergen for the first time

Allergies occur when an allergen is in contact with a specialized plasma cell that produces IgE antibodies, which stick themselves to mast cells. Then, after mast cells are primed, you will have an allergic reaction the second time you are exposed.

An allergy develops when a special Plasma cell makes IgE antibodies for the substance, which attach to mast cells.

It is estimated that between 0.4% - 3.3% of people have bee or wasp sting allergies

Histamine is known for causing: Itchy skin, Vasodilation, Hypotension, Increased heart rate, And bronchoconstriction.

The prevalence of having an allergy is about 8 - 10% worldwide

Bee Sting Reactions

Mild:

Mild reactions are minor and most common, these include:

• Sharp and burning pain
• A red welt where stung
• Slight swelling

Moderate: 

Some people occasionally get stronger reactions, these include:

• Significant redness
• Swelling that expands beyond the immediate area of the sting and enlarges over a few days

Severe (Anaphylaxis):

A small percentage of people develop a life-threatening systemic reaction, that may include:

• Full-body skin reactions such as hives, flushing or pale skin
• Swollen throat, tongue and lips
• Difficulty breathing
• Low blood pressure and fast heart rate
• Nausea, vomiting and diarrhea
• Dizziness or loss of consciousness

These reactions require immediate medical treatment.

Stingers & Venom

What is bee venom?

Venom is one of the most important parts of a bee's defence, and to understand a bee sting allergy, we must know what is in the venom. Some chemicals in the venom include MCD (Mast Cell Degranulating) Peptide, Melittin, Apamin, Adolapin, Phospholipase A₂, and Hyaluronidase. 

- MCD Peptide encourages Mast Cells to release their toxic substances. This causes cellular damage, resulting in unpleasant symptoms, such as redness, heat, swelling and itching. 

- Melittin destroys skin cells and red blood cells and also activates pain receptors.

- Apamin is a calcium-activated potassium channel inhibitor, a type of central nervous system neurotoxin.

- Adolapin is an anti-inflammatory and anti-platelet chemical.

- Phospholipase A₂ can promote the release of histamine, cause inflammation and pain and disrupt cell membranes.

- Hyaluronidase breaks down connective tissue and allows other venom components to be absorbed quicker.

The stinger is the part of a bee that digs further into the flesh and puts venom into the body. First, through the venom gland of the stinger complex, the venom is pushed into the venom bulb, an enlarged part of the stylet. Next, the venom is pushed into the canal in between the lancet and stylet by a venom pump, which is directly connected to the lancet and is moved by the muscle connecting to the lancet. The venom is pushed simultaneously with the digging of the lancet. A full venom sack can contain 0.15-0.3 mg of fluid, which is made by the venom glands. Our model will demonstrate how all these components work together to pump the venom. 

Preventing Bee Allergies

Reducing Exposure:

You can prevent developing an allergy by reducing exposure to bees. Sometimes our scents and clothing can attract bees. Some ways to reduce the chance of being stung by a bee is to: Avoid strong scents when working outside or hiking. Honeybees communicate using pheromones and are very sensitive to smell. Avoiding soaps, shampoos and perfumes that are strongly scented can attract bees. Citrus smells also are known to make bees angry. Bees are angered by colours and textures that are similar to their predators, like bears and skunks. Light-coloured clothing is best when outdoors, when hiking or near a colony. Be careful when with pets. Keeping your pet under control can prevent it from disturbing and angering a bee colony. For beekeepers, wear all your protective clothing when working with bees, remove your gear immediately if entering your house and wash your gear separately from other clothing to prevent alarm pheromones from spreading.

Venom Immunotherapy (VIT)

Venom immunotherapy is administering a small amount of pure venom subcutaneously to a person who is allergic, to produce immunological tolerance to an allergen. The doses of insect venom are gradually increased and given over a monitored treatment interval (ranging from several weeks to up to five years). Venom immunotherapy is effective in reducing the risk of a systemic reaction to a bee sting in 77-84% of individuals treated.

Natural tolerance

Interestingly, some beekeepers that are highly exposed to bee stings may develop a natural tolerance. Although different immunological mechanisms are responsible for a natural and acquired tolerance (VIT) to bee sting allergen. Studies of this have helped identify new biomarkers that would be useful in identifying an individual’s response to venom immunotherapy.

Treating Bee Stings:

Mild:

• Put a cold material, such as an ice pack, on the sting area
• Clean where stung with soap and water
• Take the stinger out of your skin as soon as possible

Moderate:

• Put a cold material, such as an ice pack, on the sting area
• Clean where stung with soap and water
• Take the stinger out of your skin as soon as possible
• Take a pain reliever, such as ibuprofen
• If you are stung on a limb, elevate the limb
• Put hydrocortisone cream on the sting
• Do not scratch the sting area

Severe:

• Use an epinephrine autoinjector if you have one, and if you don’t feel better after 15 minutes, give yourself a second injection
• Call 911 immediately after being stung
• Give CPR if the person can't breathe

(See research section)

As our research has shown beekeepers are at increased risk for a severe bee allergy, but fortunately, there are now many ways to avoid or minimize the severity. Educating yourself about how bees behave within the colony, what may trigger a bee to sting and ways in which you can protect yourself from a bee sting will assist in the prevention of an allergy. In the rare case that an allergy does develop, knowledge of how to treat minor stings and monitor for signs of a systemic reaction allows a beekeeper to be aware of when they may need urgent care. If those reactions occur, beekeepers should know there are options to reduce the severity, such as venom immunotherapy.

During our research, we discovered that some beekeepers develop severe allergies, while others do not. These tolerant beekeepers may give some information on how other beekeepers can avoid reaction. Fortunately, there is an upcoming study that may help answer this question in the next few years. The study is looking into factors in the blood that protect individuals who experience multiple bee stings each year from anaphylactic reactions