ALLERGY TO INSECT BITES (EXCLUDING HYMENO PTERA)

Allergic reactions and intolerance reactions to insect bites apart fro m wasps can be a source of concern for allergologists, who can be face d with systemic reactions and local reactions. Among the numerous fami lies of biting insects, the species most commonly responsible are bed bugs, triatoma, fleas, mosquitoes, black flies and gadflys. The featur es of local and systemic reactions are described, together with certai n features specific to the various species (nature of the bite, circum stances predisposing to bites, etc.). Recent progress in pathophysiolo gy concerns allergens of triatoma and mosquitoes mainly localized in t he saliva. An IgE mechanism is generally incriminated in the case of s evere anaphylactic reactions. Various mechanisms have been proposed fo r purely local reactions: IgE-related immediate responses, late cell-m ediated responses. Various therapeutic possibilities are available: pr evention of inset bites by the use of repellents, curative treatment o f anaphylactic shock, local curative treatment by means of topical pre parations, or even drug treatments using antihistaminics. Desensitizat ion treatments to blood-sucking insects are exceptional because of the complex pathophysiological mechanism of local reactions which are the most frequent, and also due to the fact that only non-standardized wh ole body extracts are available.