History of Hymenoptera Allergy

Systemic reactions to stinging insects have been described since ancient times. These reactions were not well understood until the turn of the twentieth century. Around that time, advances in the understanding of anaphylaxis, skin testing, and immunotherapy were applied to patients with stinging insect allergy. By the 1930s, whole-body extracts were described and utilized for diagnosis and treatment. Supporting evidence was often limited to small case series, retrospectively designed trials, and/or trials with limited controls. These limitations and a limited understanding of the natural history of hymenoptera allergy allowed several decades to pass before whole-body extract for flying hymenoptera was demonstrated to be ineffective. In the 1970s, investigators reapplied and expanded earlier described success with venom leading to the establishment of effective venom immunotherapy. Also in the latter half of the twentieth century, ants were increasingly recognized and studied as important causes of hymenoptera allergy.