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I didn’t even know they had venom!

I didn’t even know they had venom!

By:  Sasha Klemawesch, MD

Most people know the Duckbill Platypus as one of the only two mammals that lay eggs rather than give birth to live offspring (the other being the Echidna (spiny anteater) but no one remembers him!).   However, they are ALSO some of the few mammals who produce venom.  Others on the list include vampire bats, hedgehogs, shrews, and moles.

Researchers in Australia have discovered that the Platypus’s venom contains a hormone called GLP-1.  Humans also have a form of it, but ours has a very short half-life, while theirs is much more durable.  Both of them function similarly though, by stimulating production of insulin, which in turn helps to lower blood sugar, so researchers are studying the monotreme hormone to see if they can manipulate it to use in management of type 2 diabetes.  While there are already several GLP-1 Agonists on the market, (think Trulicity, Saxenda, et al), experts hope that the more natural derivation may provide further benefits; perhaps it may be able to be compounded in an oral tablet, since all the current GLP-1 medications are injections, or perhaps it may even be able to be used in a wider variety of patients, such as those with renal or pancreas dysfunction (in whom use of current GLP-1A’s is still considered controversial). 

Q – Tips: fire ant venom

Q – Tips: fire ant venom

  • Not to be outdone by Duke, scientists at Emory have discovered two beneficial aspects of a protein in fire ant venom: solenopsin. This protein helps human skin maintain its resilient barrier function and may be useful in people experiencing thinning and easy bruisability of the skin.  Solenopsin also seems to have anti-cancer properties and may provide a mechanism to lessen skin cancers.
Yellow jacket sting vs risk of immunization — relative

Yellow jacket sting vs risk of immunization — relative

Dear Dr. K:  My father, who is 70, has had two near-fatal anaphylactic reactions to yellow jacket stings. His cardiologist says he shouldn’t see an allergist for venom immune therapy (VIT) because he‘s on a beta-blocker since he had a heart attack. What should I tell him?

Tell him it’s a matter of relative risk and he should see an allergist. This is a complex problem, but not a rare one, so a little explanation will help.

First of all, when studies are done on people who die from insect stings, it is actually more frequent in people over 50. It seems that the anaphylaxis from the sting is more liable to be fatal because of underlying cardio-vascular disease. Your father falls into this category.

When VIT was first introduced in the 1970s the standard recommendation was to not give it to people on beta-blockers. The reason for this is that there is greater risk for a severe reaction to the shot itself as it’s being built up. Keep in mind VIT involves giving the venom that caused anaphylaxis (via the sting) in the first place.

However, as time has passed and more deaths have occurred in untreated patients, this recommendation has been re-thought.

In fact, a number of academic research centers have undertaken controlled trials of VIT in patients on beta-blockers. From their vantage point it has been learned that VIT can be safely done. A large study by the University of Bern found that their patients on beta-blockers had fewer shot reactions than their patients not on beta-blockers, and there were no deaths.

Which brings us back to the concept of relative risk. Your father has much greater risk from the sting than from the shot.

In general, when VIT is done on patients on a beta-blocker a more gradual build-up is followed, thus reducing risk even further.

Q – Tips: venom

Q – Tips: venom

  • Stanford researchers found an interesting paradox: Individuals with venom allergy (bees, wasps, etc.) are less likely to die from the toxic poison effect of venoms, such as from hundreds of bee stings or snake bites (!) Reason: The chemicals released by mast cells (the allergy cells that cause allergic symptoms), inactivate the biologic poison of the venom.