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Poisonous animals imply a risk to human life, because their venom is a complex mixture of low molecular weight components, peptides and proteins. Hornets use the venom for self-defence, to repel intruders and to capture prey, but they can cause poisoning and allergic reactions to people. In particular, they seem to be a health problem in the countries where they are native due to their sting, which in the most severe cases can lead to severe or fatal systemic anaphylaxis. But this situation is being an emerging problem for new countries and continents because hornet incursions are increasing in the global change scenario, such as in Europe and America. Furthermore, 55 detailed cases of hornet sting were found in 27 papers during the current review where 36.4% died due to, mainly, a multi-organ failure, where renal failure and liver dysfunction were the most common complications. Moreover, the great taxonomic, ecological diversity, geographical distribution and the wide spectrum of pathophysiological symptoms of hornets have been the focus of new research. Considering this, the present systematic review summarizes the current knowledge about the components of Vespa venom and the epidemiology of its sting to serve as reference for the new research focused on the development of techniques for diagnosis, new drugs and treatments of its sting.

Birch bark dry extract (BBDE) containing no less then 70% of betulin was studied in complex tests on mice and guinea pigs. Administered perorally in doses of 100 and 1000 mg/kg (p.o.), BBDE exhibited neither immunotoxic nor allergenic effects. In luminol-dependent chemiluminescence tests, BBDE administered in mice in a dose of 100 mg/kg (p.o.) during 14 days inhibited the production of reactive oxygen species by neutrophils. Upon a single administration in doses of 100 and 1000 mg/kg, BBDE suppressed a model inflammation induced by concanavalin A in mice. BBDE administered to guinea pigs in doses of 100 and 1000 mg/kg reduced the intensity of systemic anaphylaxis.

The aqueous extract ofSiegesbeckia pubescens (SPAE) inhibited compound 48/80-induced systemic anaphylaxis 100% with the dose of 1.0, 0.5 mg/g body weight (BW) at 1 h before or 5 min, 10 min after intraperitoneal injection of compound 48/80. The passive cutaneous anaphylaxis (PCA) reaction also inhibited to 78.5% by oral administration of SPAE (1.0 mg/g BW). When SPAE pretreated on mice at concentrations ranging from 0.0001 to 1.0 mg/g BW, the serum histamine levels were reduced in a dose-dependent manner. Moreover, SPAE (100-800 mug/ml) dose-dependently inhibited the histamine release from peritoneal mast cells (RPMC) by compound 48/80 (5 mug/ml). Analysis by microscopic appearance observation revealed that SPAE (500 mug/ml) stabilized the RPMC membrane. Therefore, these findings indicate that SPAE inhibits anaphylactic reactions through stabilization of mast cell membrane.

Anaphylactic shock as a result of trauma is very rare. We report the clinical and radiologic findings of a 10-year-old boy who developed systemic anaphylaxis due to traumatic rupture of hepatic hydatid cyst into a pericystic blood vessel. In regions where hydatid disease is endemic, rupture of a hydatid cyst might be taken into consideration in patients who have post-traumatic anaphylactic shock. Likewise, this pathology should be kept in mind when evaluating an immigrant from an endemic area in nonendemic regions.