Caterpillars and moths

Occupational Exposure of Forest Workers to the Urticating Setae of the Pine Processionary Moth Thaumetopoea pityocampa

The larvae of the pine processionary moth are a threat to public health because they produce detachable setae that are about 200 µm long and 6 µm wide, reaching a total number of up to 1 million per mature individual. The setae are intended to be released to protect the larvae from predators but become a public health issue when in contact with humans and warm-blooded animals. Symptoms associated with the setae are typically urticaria and local swelling erythema, although edema of the skin, conjunctivitis or respiratory mucosa may occur. Occupational exposure concerns mainly forest workers but also farmers and gardeners. In the present study, we quantify the exposure to the setae of forest workers in a district of Northern Italy. The pine processionary moth represents a real case of occupational exposure as the urticating setae produced by the larvae caused symptoms in most forest workers directly in contact with the infested trees. In addition, the urticating setae were detected on the body of the chainsaw operators and in the surroundings of the felled trees during the operations. The non-exposed workers of the same agency did not report symptoms, with only one exception, likely linked to a non-occupational exposure. As the risk is not immediately perceived by the workers because direct contact with the larvae is unlikely, a campaign of information to workers and the general population living nearby infested forestry areas about the risk associated with airborne exposure is recommended. This becomes especially important in the areas of recent expansion of the insect, where people are inexperienced.

1H NMR Profiling of the Venom from Hylesia continua: Implications of Small Molecules for Lepidopterism

Lepidopterism caused by caterpillar contact is considered a public health problem around the world. The local and systemic responses of this pathology include short- and long-term inflammatory events. Although the proteolytic activity of the venoms from caterpillars is strongly associated with an inflammatory response in humans and murine models, fast and acute symptoms such as a burning sensation, itching, and pain should be related to the presence of low-weight hydrophilic molecules which easily influence cell metabolism. This investigation reports on the ¹H-Nuclear Magnetic Resonance (NMR) profiling of the venom from the larva of Hylesia continua, a caterpillar linked to frequent cases of lepidopterism in the northern highlands of Puebla, Mexico. According to one-dimensional (1D) and two-dimensional (2D) NMR data, the venom of H. continua contained 19 compounds with proven pain-inducing activity (i.e., acetic acid, lactic acid, formic acid, succinic acid, 2-hydroxyglutaric acid, ethanol, and glutamate), inflammatory activity (i.e., cadaverine, putrescine, and acetoin), as well as natural immunosuppressive activity (i.e., O-phosphocholine and urocanic acid). The levels of the 19 compounds were calculated using quantitative-NMR (qNMR) and extensively discussed on the basis of their toxic properties which partially explain typical symptoms of lepidopterism caused by the larvae of H. continua. To the best of our knowledge, this is the first investigation reporting a complex mixture of small molecules with inflammatory properties dissolved in the venom of a lepidopteran larva.

On the evolution of mimicry in avian nestlings

Batesian mimicry (BM), where a nontoxic species resembles a toxic species with aposematic coloring, has been recently described for a Neotropical species of the suboscine passerine (Laniocera hypopyrra). Understanding the order and series in which these characteristics evolved is unknown and requires character information from closely related taxa. Here, we trace the origin of mimetic traits and how they evolved by examining antipredator characteristics using images and other field‐collected trait data from nest and nestlings along with data available in the literature for the Laniisominae clade and closely related taxa. We found that morphological modifications of the downy feathers appeared first in the broader clade leading to the Laniisominae clade followed by further morphological and behavioral characteristics within the Laniisominae clade leading to the full BM. Images of nestlings in the Laniisominae and closely related clades demonstrated the extent of antipredator and camouflage characteristics. We found a complex set of behavioral and morphological traits in this clade for reducing predation from hiding to camouflage to mimicry. We further propose the evolution of two distinctive mimicry strategies in the Laniisominae clade: (1) Batesian Mimicry, as described above and (2) Masquerade, resemblance to inedible objects commonly found in their local environment. This complex set of antipredator traits shed light on the diversity of antipredator characteristics in avian nestlings, particularly in neotropical areas where the avian diversity is highest. Unfortunately, there are hundreds of species in the neotropics that lack basic natural history information on nesting traits, and therefore, we are likely missing critical information on the diversity of antipredator characteristics across avian nestlings.

Float like a Butterfly, Sting like One Too

Rash after contact with butterflies has not been previously reported in the medical literature to our knowledge. We describe potentially the first suspected case of a cutaneous reaction to the Compton tortoiseshell butterfly (Nymphalis vaualbum) in a young boy who developed urticaria after the modified hairs of the butterfly embedded within his finger. His urticaria improved through treatment with oral and topical steroids as well as systemic antihistamines. This case report expands the variety of insect species that may cause human disease and should raise awareness for this possible reaction.

Moth hair in cornea in a case of seasonal hyperacute panuveitis

Seasonal Hyperacute Panuveitis (SHAPU) is a seasonal and cyclic uveitic disease reported only from Nepal occurring every odd year. Untreated eyes go blind and phthisis within a week. Circumstantial evidence for the role of moths has been reported earlier. Herein for the first time, we describe a SHAPU case in a healthy young Nepalese patient where the exposure to white moth was followed by the development of the uveitis and the moth hair particles was detected in the corneal and presence was confirmed with anterior segment optical coherence topography.

Identification of Novel Toxin Genes from the Stinging Nettle Caterpillar Parasa lepida (Cramer, 1799): Insights into the Evolution of Lepidoptera Toxins

Simple Summary

Many caterpillar species can produce toxins that cause harmful reactions to humans, varying from mild irritation to death. Currently, there is very limited knowledge about caterpillar toxin diversity, because only a few species have been investigated. We used the transcriptome technique to identify candidate toxin genes from the nettle caterpillar Parasa lepida (Cramer, 1799). It is a common pest of oil palm, coconut, and mango in South and South-East Asia, which can cause severe pain and allergic responses to those in contact with them. We reported 168 candidate toxin genes. Most of them are members of the toxin genes families commonly recruited in animal venoms such as serine protease and serine protease inhibitors. However, we identified 21 novel genes encoding knottin-like peptides expressed at a high level in the transcriptome. Their predicted 3D structures are similar to neurotoxins in scorpion and tarantula. Our study suggests that P. lepida venom contains diverse toxin proteins that potentially cause allergic reactions and pain. This study sheds light on the hidden diversity of toxin proteins in caterpillar lineage, which could be future fruitful new drug sources.

Abstract

Many animal species can produce venom for defense, predation, and competition. The venom usually contains diverse peptide and protein toxins, including neurotoxins, proteolytic enzymes, protease inhibitors, and allergens. Some drugs for cancer, neurological disorders, and analgesics were developed based on animal toxin structures and functions. Several caterpillar species possess venoms that cause varying effects on humans both locally and systemically. However, toxins from only a few species have been investigated, limiting the full understanding of the Lepidoptera toxin diversity and evolution. We used the RNA-seq technique to identify toxin genes from the stinging nettle caterpillar, Parasa lepida (Cramer, 1799). We constructed a transcriptome from caterpillar urticating hairs and reported 34,968 unique transcripts. Using our toxin gene annotation pipeline, we identified 168 candidate toxin genes, including protease inhibitors, proteolytic enzymes, and allergens. The 21 P. lepida novel Knottin-like peptides, which do not show sequence similarity to any known peptide, have predicted 3D structures similar to tarantula, scorpion, and cone snail neurotoxins. We highlighted the importance of convergent evolution in the Lepidoptera toxin evolution and the possible mechanisms. This study opens a new path to understanding the hidden diversity of Lepidoptera toxins, which could be a fruitful source for developing new drugs.

Identification of the major allergenic proteins from silkworm moth (Bombyx mori) involved in respiratory allergic diseases

INTRODUCTION AND OBJECTIVES

Moths are a significant source of indoor and outdoor aeroallergens. High prevalence of IgE-mediated sensitization was demonstrated in a group of patients with allergic respiratory diseases. There are no studies on adult stage of these moth species allergens involved in allergic respiratory reactions - the aim of this study.

MATERIAL AND METHODS

36 participants were included in an experimental study, submitted to skin prick test with Bombyx mori wing extract and six other common allergens, as well as Western blot analysis with incubated nitrocellulose membrane impregnated with silkworm moth extract and human IgE-antibody. The participants were divided into 3 groups: 1) 21 allergic patients whose skin prick test was positive to Bombyx mori wing extract, 2) eight allergic patients whose skin prick test was positive to mite and negative to Bombyx mori extract 3) seven negative non-allergic subjects.

RESULTS

Among the 21 participants from group 1, 19 serum samples reacted to Bombyx mori extract by Western blot. All of them reacted to a protein at 80 kDa and five other proteins (66, 50, 45, 37 and 30 kDa) were identified in more than 50% of the individuals tested, considered as major allergenic proteins. Sera from seven out of eight patients sensitized to house dust mite demonstrated IgE-reactivity to Bombyx mori extract by Western blot analysis. Serum samples from healthy participants did not react at all.

CONCLUSION

Six major reactive proteins by immunoblot analysis from moth's wings sensitized patients can be potential allergens. The one at 80 kDa is the major protein, seen in all IgE-reactive patients from group 1 and in none from group 2, yet to be identified. Future studies should be conducted to better characterize these proteins.

In vitro antitumor, pro-inflammatory, and pro-coagulant activities of Megalopyge opercularis J.E. Smith hemolymph and spine venom

Contact with stinging spines venom from several Lepidoptera larvae may result in skin lesions. In Mexico, envenomation outbreaks caused by Megalopyge opercularis were reported between 2015 and 2016. The aim of this study was to identify the venomous caterpillars in Nuevo Leon, Mexico and evaluate several biological activities of their hemolymph (HEV) and spine setae (SSV) venoms. M. opercularis was identified by cytochrome oxidase subunit (COI) designed primers. HEV and SSV extracts cytotoxic activity was assessed on the L5178Y-R lymphoma cell line. For apoptotic cells number and apoptosis, cells were stained with acridine orange/ethidium bromide and validated by DNA fragmentation. Human peripheral blood mononuclear cells (hPBMC) cytokine response to the extracts was measured by the cytometric bead array assay. Extracts effect on pro-coagulation activity on human plasma was also evaluated. HEV and SSV extracts significantly inhibited (p < 0.01) up to 63% L5178Y-R tumor cell growth at 125–500 µg/mL, as compared with 43% of Vincristine. About 79% extracts-treated tumor cells death was caused by apoptosis. Extracts stimulated (p < 0.01) up to 60% proliferation of resident murine lymphocytes, upregulated IL-1β, IL-6, IL-8, and TNF-α production by hPBMC, and showed potent pro-coagulant effects. The pharmacological relevance of these venoms is discussed.

Variation in Morphology and Airborne Dispersal of the Urticating Apparatus of Ochrogaster lunifer (Lepidoptera: Notodontidae), an Australian Processionary Caterpillar, and Implications for Livestock and Humans

True setae borne on the abdominal tergites of Ochrogaster lunifer Herrich-Schӓffer caterpillars are the agents of an irritating contact dermatitis, osteomyelitis, ophthalmia, and severe allergic reactions in humans, and are the cause of Equine Amnionitis and Fetal Loss in Australia. The setae are detached and readily dislodge from the integument whereby they disperse throughout the environment. To better understand the true setae of O. lunifer as agents of medical and veterinary concern, we studied their characteristics and distance dispersed. Whereas members of the European Thaumetopoeinae have been widely studied, their southern-hemisphere counterparts such as O. lunifer are not well known despite their harmfulness and known medical and veterinary importance. The caterpillar's investment in true setae increased with age and size, and two distinct size classes co-occurred in setae fields. A previously undescribed morphological type of true seta was found on the first abdominal segment. All true setae were calculated to travel long distances in the air even under light breeze conditions. Our results show there is a high risk of exposure to airborne urticating setae within 100 m of elevated caterpillar activity, and a likely risk of exposure for some kilometers in the direction of the prevailing breeze. This information should be used to inform management strategies in areas where urticating processionary caterpillars are active, and especially during periods of an outbreak.

Human-mediated disturbance in multitrophic interactions results in outbreak levels of North America's most venomous caterpillar

Anthropogenic environmental change is predicted to disrupt multitrophic interactions, which may have drastic consequences for population-level processes. Here, we investigate how a large-scale human-mediated disturbance affects the abundance of North America's most venomous caterpillar species, Megalopyge opercularis. Specifically, we used a natural experiment where netting was deployed to cover the entire canopies of a subset of mature southern live oak trees (Quercus virginiana) to exclude urban pest birds (grackles and pigeons), throughout an 8.1 km² area encompassing a medical centre in Houston, Texas. We used this experimental exclusion to test the following hypothesis: release from avian predators increases caterpillar abundance to outbreak levels, which increases the risk to human health. Results from a multi-year survey show that caterpillar abundance increased, on average, more than 7300% on netted versus non-netted trees. Thus, increases in caterpillar abundance due to anthropogenic enemy release increase human exposure to this venomous pest, and should be considered a health threat in the area. This study emphasizes the unforeseen consequences of ecological disturbance for species interactions and highlights the importance of considering ecology in urban planning.

Management of severe pain after dermal contact with caterpillars (erucism): a prospective case series

CONTEXT

Erucism, envenomation caused by dermal contact with larval forms of moths, may result in intense local pain, mainly after contact with puss caterpillars (family Megalopygidae).

OBJECTIVE

To evaluate the response to different treatments for controlling severe pain in a case series of erucism in Campinas, southeastern Brazil.

PATIENTS AND METHODS

Prospective cohort study. A Numeric Pain Rating Scale (NPRS 0-10) was used to assess pain intensity in the Emergency Department (ED). Pain was considered as severe upon ED admission (T0) when the NPRS was ≥8.

INCLUSION CRITERIA

age ≥8 years old, severe pain at T0, with continuous assessment of pain intensity in all patients using the NPRS during the ED stay (T5, T15, T30, T60 min and at discharge).

RESULTS

Fifty-five patients fulfilled the inclusion criteria and were divided into three groups according to the initial treatment at T0: local anesthesia alone with 2% lidocaine (group 1, n = 15), local anesthesia and analgesics (group 2, n = 26) and analgesics without local anesthesia (group 3, n = 14). Most patients were admitted within 2 h after dermal contact with the stinging bristles of caterpillars (median =90 min, IQR: 40-125 min). In 22 cases (40%), the caterpillar was brought for identification (Podalia spp., n = 18; Megalopyge spp., n = 4). There was a significant decrease in pain from T5 onwards with all of the treatments. When the short-term response (T5 and T15) was considered, analgesia was more effective in groups 1 and 2 compared to group 3 (p < .01). Additional analgesia (from T5 until discharge) was frequently required (n = 25/55), mainly in group 1 (n = 11/15). The median length of stay in the ED was 120 min (IQR: 80-173 min).

CONCLUSIONS

The association of local anesthesia with analgesics was apparently a good combination for the rapid management of severe pain in the ED.

Venomous caterpillars: From inoculation apparatus to venom composition and envenomation

Envenomation by the larval or pupal stages of moths occurs when the victim presses their hairs. They penetrate the subcutaneous tissue, releasing toxins such as proteolytic enzymes, histamine and other pro-inflammatory substances. Cutaneous reactions, including severe pain, oedema and erythema are frequent local manifestations of caterpillar envenomation, but, in some cases, the reactions can evolve into vesicles, bullae, erosions, petechiae, superficial skin necrosis and ulcerations. Alternatively, some individual can develop allergic reactions, renal failure, osteochondritis, deformity and immobilization of the affected joints and intracerebral bleeding. Caterpillars produce venom to protect themselves from predators; contact with humans is accidental and deserves close attention. Their venoms have not been well studied, except for toxins from some few species. The present review brings together data on venomous caterpillars of moths, primarily addressing the available literature on diversity among the different families that cause accident in humans, the structures used in their defense, venom composition and clinical aspects of the envenomations. Understanding the molecular mechanisms of action of caterpillars' toxins may lead to the development of more adequate treatments.

Population Explosions of Tiger Moth Lead to Lepidopterism Mimicking Infectious Fever Outbreaks

Lepidopterism is a disease caused by the urticating scales and toxic fluids of adult moths, butterflies or its caterpillars. The resulting cutaneous eruptions and systemic problems progress to clinical complications sometimes leading to death. High incidence of fever epidemics were associated with massive outbreaks of tiger moth Asota caricae adult populations during monsoon in Kerala, India. A significant number of monsoon related fever characteristic to lepidopterism was erroneously treated as infectious fevers due to lookalike symptoms. To diagnose tiger moth lepidopterism, we conducted immunoblots for tiger moth specific IgE in fever patients' sera. We selected a cohort of patients (n = 155) with hallmark symptoms of infectious fevers but were tested negative to infectious fevers. In these cases, the total IgE was elevated and was detected positive (78.6%) for tiger moth specific IgE allergens. Chemical characterization of caterpillar and adult moth fluids was performed by HPLC and GC-MS analysis and structural identification of moth scales was performed by SEM analysis. The body fluids and chitinous scales were found to be highly toxic and inflammatory in nature. To replicate the disease in experimental model, wistar rats were exposed to live tiger moths in a dose dependant manner and observed similar clinico-pathological complications reported during the fever epidemics. Further, to link larval abundance and fever epidemics we conducted cointegration test for the period 2009 to 2012 and physical presence of the tiger moths were found to be cointegrated with fever epidemics. In conclusion, our experiments demonstrate that inhalation of aerosols containing tiger moth fluids, scales and hairs cause systemic reactions that can be fatal to human. All these evidences points to the possible involvement of tiger moth disease as a major cause to the massive and fatal fever epidemics observed in Kerala.

FILHO WILSONS, FRONZA EDEGAR, MIELKE CARLOSG. Abdominal macrochaetae of female Hylesia oratex Dyar, 1913 (Insecta: Lepidoptera: Saturniidae): external morphology and medical significance

The representatives of the genus Hylesia Hübner, [1820] are significant among the medically important Lepidoptera. Adult females use abdominal setae to wrap and protect the eggs that remain for months in nature. These setae, in contact with human skin, may cause allergic reactions including swelling, itching and local erythema, known as lepidopterism. The morphology of the abdominal scales and setae from the female H. oratex Dyar, 1913 is herein described and aspects related to their medical significance are discussed. Portions of each abdominal segment were examined through a scanning electron microscope. Two types of scales without medical importance, and two types of setae with medical importance, classified as "true setae" and "modified setae" were found. The true setae, which are slightly fusiform and have radially arranged lateral projections, are responsible for the allergic reactions caused by skin penetration. The modified setae, which are larger, curved, with the median enlarged and serrated margins, can be responsible for the release of chemical substances. This information provides a better understanding of the structure of the urticating setae, which are responsible for lepidopterism outbreaks in humans, and contributes towards the identification of the moth species involved.

Size and dispersion of urticating setae in three species of processionary moths

Larvae of the processionary moths of the Palaearctic region bear urticating setae that are released against vertebrate predators, especially insectivorous birds. A few species are pests of forest and urban trees and, consequently, may threaten human and animal health during outbreaks, causing dermatitis, conjunctivitis and respiratory distress. Although some studies provide detailed information about the setae, particularly those of the pine processionary moth Thaumetopoea pityocampa, there is little knowledge on the morphological traits of the setae and their release by the larvae. In the present study we identify major traits of the setae of 3 species of processionary moth, T. pityocampa, T. pinivora and T. processionea, which are potentially helpful in the understanding of setae dynamics in the environment: (i) diameter and length of setae and (ii) analysis of dynamical properties of the setae in the airborne state. Setae are highly variable in size, with bimodal distribution in T. pityocampa and T. pinivora; in these 2 species, short and long setae are interspersed within the integument fields where they occur. The difference in the seta size has important consequences in dispersion, as smaller setae can spread 5 times further than their bigger counterparts. This information is relevant for a full understanding of the defensive importance of larval setae against natural enemies of the processionary moths, as well for elucidating the importance of the processionary setae as air pollutants, both close to the infested trees and at longer distances.

Helminthes and insects: maladies or therapies

By definition, parasites cause harm to their hosts. But, considerable evidence from ancient traditional medicine has supported the theory of using parasites and their products in treating many diseases. Maggots have been used successfully to treat chronic, long-standing, infected wounds which failed to respond to conventional treatment by many beneficial effects on the wound including debridement, disinfection, and healing enhancement. Maggots are also applied in forensic medicine to estimate time between the death and discovery of a corpse and in entomotoxicology involving the potential use of insects as alternative samples for detecting drugs and toxins in death investigations. Leeches are segmented invertebrates, famous by their blood-feeding habits and used in phlebotomy to treat various ailments since ancient times. Leech therapy is experiencing resurgence nowadays in health care principally in plastic and reconstructive surgery. Earthworms provide a source of medicinally useful products with potential antimicrobial, antiviral, and anticancer properties. Lumbrokinases are a group of fibrinolytic enzymes isolated and purified from earthworms capable of degrading plasminogen-rich and plasminogen-free fibrin and so can be used to treat various conditions associated with thrombotic diseases. Helminth infection has been proved to have therapeutic effects in both animal and human clinical trials with promising evidence in treating many allergic diseases and can block the induction of or reduce the severity of some autoimmune disorders as Crohn's disease or ulcerative colitis. What is more, venomous arthropods such as scorpions, bees, wasps, spiders, ants, centipedes, snail, beetles, and caterpillars. The venoms and toxins from these arthropods provide a promising source of natural bioactive compounds which can be employed in the development of new drugs to treat diseases as cancer. The possibility of using these active molecules in biotechnological processes can make these venoms and toxins a valuable and promising source of natural bioactive compounds. The therapeutic use of helminthes and insects will be of great value in biomedicine and further studies on insect toxins will contribute extensively to the development of Biomedical Sciences.

Seasonal hyperacute panuveitis: an update

PURPOSE OF REVIEW

Seasonal hyperacute panuveitis (SHAPU), a mysterious disease of Nepal, has increased the burden of childhood blindness ever since it was described in 1975. Although moths are suspected as the cause, this source is not yet proven. The management of this disease is still not well outlined. This article reviews recent developments in the understanding of SHAPU pathogenesis, clinical features, cause, and preventive measures as well as curative management.

RECENT FINDINGS

Smaller summer outbreaks occur every even year together with larger autumn outbreaks every odd year. Vitreous fluid from some cases grew bacteria on culture. Viruses were isolated in one case. Tiny hair follicles have been identified in ocular structures. Several cases had decreased corneal sensation and few cases had iris atrophy. Early vitrectomy is beneficial. Intravitreal vancomycin, amikacin, and dexamethasone injection have given good results. Unlike previous reports, the use of repeated subconjunctival dexamethasone injection was also claimed to reverse the eye disease. However, treatment helped to save the vision in one eye or both only if cases presented early enough (within 7 days) for treatment.

SUMMARY

Recent findings have shown a correlation between SHAPU and moths (probably Gazalina); therefore, more research on this moth is urged. Various new findings also hint towards the involvement of microbes; thus, further advanced studies are required to confirm this involvement.

[Skin reactions on exposure to the pine processionary caterpillar (Thaumetopoea pityocampa)]

The pine processionary caterpillar is the larval form of the Thaumetopoea pityocampa moth. Mediterranean forests regularly suffer plagues of this insect, which has been moving north as a result of global warming. When the small urticating hairs that develop during the last 3 larval stages are shed and can become airborne. If they come in contact with skin, they can cause a variety of reactions, notably contact urticaria and papular rashes. Irritation can also occur if the hairs lodge in the mucosa of the conjunctiva or in the respiratory tract. Several cases of anaphylactic reactions have been reported in recent years. Mechanical (irritative) mechanisms may be involved in the pathogenesis of lesions, or immunoglobulin E-mediated allergic hypersensitivity reactions may be implicated when the process is rapid, recurrent, and progressively more severe.

Urticating hairs in arthropods: their nature and medical significance

The ecological phenomenon of arthropods with defensive hairs is widespread. These urticating hairs can be divided into three categories: true setae, which are detachable hairs in Lepidoptera and in New World tarantula spiders; modified setae, which are stiff hairs in lepidopteran larvae; and spines, which are complex and secretion-filled structures in lepidopteran larvae. This review focuses on the true setae because their high density on a large number of common arthropod species has great implications for human and animal health. Morphology and function, interactions with human tissues, epidemiology, and medical impact, including inflammation and allergy in relation to true setae, are addressed. Because data from epidemiological and other clinical studies are ambiguous with regard to frequencies of setae-caused allergic reactions, other mechanisms for setae-mediated disease are suggested. Finally, we briefly discuss current evidence for the adaptive and ecological significance of true setae.

Immune response profiles after caterpillar exposure: a case report

Rationale

The role of the immune response to caterpillar exposure is not well described. This case study is the first to report a patient who presented with an allergic reaction after exposure to the larvae of the sycamore tussock moth, Halysidota harrisii Walsh, 1864.

Methods

Blood was collected from an allergic asthmatic adult (m/42 y/o) at 2 hrs – 2 wks after contact urticaria with associated dyspnea after exposure to the larvae of the sycamore tussock moth, Halysidota harrisii Walsh, 1864. Distributions of blood lymphocytes (CD4⁺, CD8⁺, CD8⁺CD60⁺, CD19⁺, CD23⁺, CD16/56⁺, CD25, CD45RA⁺, CD45RO⁺), monocytes (CD1d⁺), levels of serum immunoglobulins (IgM, IgG, IgA, IgE), and cytokines (IFN-γ, IL-4, TNF-α) were studied (flow cytometry, nephelometry, UniCAP Total IgE Fluoroenzymeimmunoassay, cytokine ELISA, clinical toxicology).

Results

Numbers of CD4⁺ T cells, CD25⁺ cells, CD19⁺ B cells, and CD1d⁺ monocytes decreased (22, 27, 33, 20%, respectively) one week post reaction, CD45RA⁺ naïve T cells decreased at 36 hours (21%),while CD8⁺CD60⁺ T cells and CD23⁺ cells decreased 48 hrs (33, 74%, respectively) post reaction. In contrast, numbers of CD16/56⁺ NK precursor cells increased (60%) 12 hrs, then decreased (65%) 48 hrs post reaction; other lymphocyte subsets were unaffected. Serum IgM, IgG and IgA were within normal range; however, serum IgE demonstrated a bimodal elevation at 2 hrs (15%) and one week post reaction. Levels of IFN-γ, IL-4, and TNF-α were not detected in serum pre-exposure (<1.0–4.0 pg/mL). However, high levels of IFN-γ (187–319 pg/mL) and TNF-α (549–749 pg/mL) were detected in serum 24–36 hrs and 3.5–24 hrs post reaction, respectively. In contrast, levels of IL-4 were undetected (<1.0 pg/mL) in serum at all time points.

Conclusions

Exposure to the larvae of the sycamore tussock moth, Halysidota harrisii Walsh, 1864 may result in increased cytokine levels and blood CD16/56⁺ NK precursor cells.