i73 Blood worm

Allergens within Insects

Print Print icon Tell a friend Tell a friend icon
  • Latin name: Chironomus thummi (C. riparius)
  • Family: Chironomidae
  • Source material: Larvae
The red larvae are used for fish food and may cause allergic sensitisation in fancy fish enthusiasts, researchers and fish food workers.

Allergen Exposure

The larvae are aquatic and, as an environmental source of allergen, the adult midges are frequent around lakes and rivers. The red larvae are used for fish food and may cause allergic sensitization in fancy fish enthusiasts, researchers and fish food workers. Chironomidae are known as non-biting midges. Five to ten thousand species are distributed world wide. In western countries, the species C. thummi, also identified as C. riparius, is mainly described, whereas in Japan, closely related species such as, for example,. C. plumosus, C. yoshimatsui and Tokunaga akamusi, are more predominant.

Potential Cross-Reactivity

Cross-reactivity between chironomid species has been extensively reported (6, 11, 12). In addition, cross-reactivity to other allergens, such as common mosquitoes (13), moths (5), house dust mite (14), shrimp, anisakis and cockroach (15), green nimmity, -  the wide-spread cause of asthma and rhinitis in Sudan, - (16), is reported. The predominant allergens are Hemoglobins and the two major allergens described in the literature are chi t1 and chi t1 component III (12). Species-specific antigen exists (5).

Clinical Experience

In Japan, chironomid midges are considered one of the most important allergens in asthma. In one study nearly 40% of the patients with asthma had high titers of specific IgE to chironomid (1). Similar findings are reported from other studies (2-3). Of patients with asthma living by an eutrophicated lake, 12-21% were positive in IgE testing to different chironomid species with Pharmacia CAP System (4). Out of 51 house dust mite asthmatic patients, 49 % were positive to C. yoshimasui with Pharmacia CAP System (5). Sera from 5 German asthmatic fish hobbyists (larvae) and 3 patients with rhinoconjunctivitis and/or asthma (midges) living near lakes in Wisconsin, USA, were all positive in RAST (6).

In Korea, 20% of 475 patients with respiratory allergy were positive when skin tested with chironomids. The authors suggested that chironomids should be considered as important respiratory allergens (7).

In the UK, in an eutrophicated lake-side-community near Oxford, where chironomid midges were investigated as one cause of asthma, around 8% of the entire community developed IgE antibodies. Although the incidence of allergic reactions in this community was low, Phadebas RAST correlated significantly with relevant symptoms (8).

There are some case reports in the literature. One report describes a 48 year-old woman living by a river, diagnosed with bronchial asthma caused by chironomid midges and positive in RAST (9). Another report presents a 43 year-old male researcher, positive in RAST, who developed allergic rhinitis when working with midges by eutrophic Japanese lakes (10).

A delayed allergy reaction was described in a 47 year-old fish hobbyist who developed erythema. Specific IgE was positive, and so was patch and scratch testing with extract from dried fish food containing chironomids. The facial localisation of the eczema was probably due to airborne contact dermatitis. Flying chironomid midges may also cause airborne contact dermatitis (11).
 
Review
Chironomidae are known as non-biting midges. Five to ten thousand species are distributed world-wide. In western countries, the species C. thummi, also identified as C. riparius, is mainly described, whereas in Japan, closely related species such as, for example. C. plumosus, C. yoshimatsui and Tokunaga akamusi are more predominant.

The larvae are aquatic and, as an environmental source of allergen, the adult midges are frequent around lakes and rivers. The red larvae are used for fish food and may cause allergic sensitisation in fancy fish enthusiasts, researchers and fish food workers.
 
In Japan, chironomid midges are considered one of the most important allergens in asthma. In one study, nearly 40% of the patients with asthma had high titers of specific IgE to chironomid (1). Similar findings are reported from other studies (2-3). Of patients with asthma living by an eutrophicated lake, 12-21% were positive in IgE testing to different chironomid species with Pharmacia CAP System (4). Out of 51 house dust mite asthmatic patients, 49 % were positive to C. yoshimasui with Pharmacia CAP System (5). Sera from 5 German asthmatic fish hobbyists (larvae) and 3 patients with rhinoconjunctivitis and/or asthma (midges) living near lakes in Wisconsin, USA, were all positive in RAST (6). In Korea, 20% of 475 patients with respiratory allergy were positive when skin tested with chironomids. The authors suggested that chironomids should be considered as important respiratory allergens (7).

In the UK, in an eutrophicated lake-side-community near Oxford, where chironomid midges were investigated as one cause of asthma, around 8% of the entire community developed IgE antibodies. Although the incidence of allergic reactions in this community was low, Phadebas RAST correlated significantly with relevant symptoms (8).

There are some case reports in the literature. One report describes a 48 year-old woman living by a river, diagnosed with bronchial asthma caused by chironomid midges and positive in RAST (9). Another report presents a 43 year-old male researcher, positive in RAST, who developed allergic rhinitis when working with midges by eutrophic Japanese lakes (10). A delayed allergy reaction was described in a 47 year-old fish hobbyist who developed erythema. Specific IgE was positive, and so was patch and scratch testing with extract from dried fish food containing chironomids. The facial localisation of the eczema was probably due to airborne contact dermatitis. Flying chironomid midges may also cause airborne contact dermatitis (11).

In addition, cross-reactivity between chironomid species has been extensively reported (6, 11, 12). Also cross-reactivity to other allergens, such as common mosquitoes (13), moths (5), house dust mite (14), shrimp, anisakis and cockroach (15), green nimmiti, - the wide-spread cause of asthma and rhinitis in Sudan, - (16) is reported.

The predominant allergens are Hemoglobins and the two major allergens described in the literature are chi t1 and chi t1 component III (12). Species-specific antigen exists (5). 

References:

    1. Edahiro T, Ohta N, Matsuoka H, Ishii A, Tanizaki Y, Kitani H, et al. Analysis of lymphocyte response to chironomid midge antigens in asthmatic and non-asthmatic individuals. Japanese Journal of Medical Science & Biology 1989;42(3):101-10.
    2. Igarashi T, Murakami G, Adachi Y, Matsuno M, Saeki Y, Okada T, et al. Common occurrence in Toyama of bronchial asthma induced by chironomid midges. Japanese Journal of Experimental Medicine 1987;57(1):1-9.
    3. Ito K, Suko M, Miyamoto T, Kobayashi S, Nakazawa T, Takahashi T, et al. [Study on the clinical usefulness of RAST using insect and mite allergen discs]. Arerugi - Japanese Journal of Allergology 1989;38(5):413-22.
    4. Hirabayashi K, Kubo K, Yamaguchi S, Fujimoto K, Murakami G, Nasu Y. Studies of bronchial asthma induced by chironomid midges (Diptera) around a hypereutrophic lake in Japan. Allergy 1997;52(2):188-95.
    5. Komase Y, Sakata M, Azuma T, Tanaka A, Nakagawa T. IgE antibodies against midge and moth found in Japanese asthmatic subjects and comparison of allergenicity between these insects. Allergy 1997;52(1):75-81.
    6. Baur X, Liebers V, Mazur G, Becker WM, Kagen SL, Kawai K. Immunological cross-reactivity of hemoglobins in the Diptera family Chironomidae. Allergy 1991;46(6):445-51.
    7. Kim YJ, Park HS. Skin reactivity and specific IgE antibody to two nonbiting midges in Korean respiratory allergy patients. Journal of Korean Medical Science 1994;9(1):21-8.
    8. McHugh SM, Credland PF, Tee RD, Cranston PS. Evidence of allergic hypersensitivity to chironomid midges in an English village community. Clinical Allergy 1988;18(3):275-85.
    9. Sakai T, Ishizaki T, Sasaki F, Ameshima S, Ohnishi T, Shigemori K, et al. [Adult case of bronchial asthma induced by chironomid midges]. Nihon Kyobu Shikkan Gakkai Zasshi. Japanese Journal of Thoracic Diseases 1993;31(12):1591-5.
    10. Teranishi H, Kawai K, Murakami G, Miyao M, Kasuya M. Occupational allergy to adult chironomid midges among environmental researchers. International Archives of Allergy & Immunology 1995;106(3):271-7.
    11. Brasch J, Bruning H, Paulke E. Allergic contact dermatitis from chironomids. Contact Dermatitis 1992;26(5):317-20.
    12. van Kampen V, Liebers V, Czuppon A, Baur X. Chironomidae hemoglobin allergy in Japanese, Swedish, and German populations. Allergy 1994;49(1):9-12.
    13. Galindo PA, Gomez E, Borja J, Feo F, Garcia R, Lombardero M, et al. Mosquito bite hypersensitivity. Allergologia et Immunopathologia 1998;26(5):251-4.
    14. Nagano T, Ohta N, Okano M, Ono T, Masuda Y. Analysis of antigenic determinants shared by two different allergens recognized by human T cells: house dust mite (Dermatophagoides pteronyssinus) and chironomid midge (Chironomus yoshimatsui). Allergy 1992;47(5):554-9.
    15. Pascual CY, Crespo JF, San Martin S, Ornia N, Ortega N, Caballero T, et al. Cross-reactivity between IgE-binding proteins from Anisakis, German cockroach, and chironomids. Allergy 1997;52(5):514-20.
    16. Tee RD, Cranston PS, Dewair M, Prelicz H, Baur X, Kay AB. Evidence for haemoglobins as common allergenic determinants in IgE-mediated hypersensitivity to chironomids (non-biting midges). Clinical Allergy 1985;15(4):335-43.

1999