How is it possible that one person may be stung by many bees (over time) and not have strong reactions (think beekeeper). And another person might be stung for the first time, not have any reaction, then gets stung again and goes into anaphylactic shock?
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It’s mostly unknown as of yet. Per [this 2021 review](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8395074/) (I could find no more recent article in my 5-minutr pubmed crawl that said much about actual mechanisms, just a lot of clinical stuff), there’s about 20% of the general population that has IgE specific to some bee venom component, and while that’s elevated in those with bee venom allergy (30%), it is not a clear causative link. It also mentions that some of those venom components are also found in honey, which *might* contribute to tolerance (ingesting an antigen vs having it injected under the skin makes a world of difference to how dendritic cells respond to it). However, it’s *also* mentioned that some of the venom components are crossreactive with IgE in a nonspecific way, so that sounds problematic either way.
tl;dr it’s complicated, we don’t know, stay tuned for another decade probably
It’s mostly unknown as of yet. Per [this 2021 review](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8395074/) (I could find no more recent article in my 5-minutr pubmed crawl that said much about actual mechanisms, just a lot of clinical stuff), there’s about 20% of the general population that has IgE specific to some bee venom component, and while that’s elevated in those with bee venom allergy (30%), it is not a clear causative link. It also mentions that some of those venom components are also found in honey, which *might* contribute to tolerance (ingesting an antigen vs having it injected under the skin makes a world of difference to how dendritic cells respond to it). However, it’s *also* mentioned that some of the venom components are crossreactive with IgE in a nonspecific way, so that sounds problematic either way.
tl;dr it’s complicated, we don’t know, stay tuned for another decade probably
It’s mostly unknown as of yet. Per [this 2021 review](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8395074/) (I could find no more recent article in my 5-minutr pubmed crawl that said much about actual mechanisms, just a lot of clinical stuff), there’s about 20% of the general population that has IgE specific to some bee venom component, and while that’s elevated in those with bee venom allergy (30%), it is not a clear causative link. It also mentions that some of those venom components are also found in honey, which *might* contribute to tolerance (ingesting an antigen vs having it injected under the skin makes a world of difference to how dendritic cells respond to it). However, it’s *also* mentioned that some of the venom components are crossreactive with IgE in a nonspecific way, so that sounds problematic either way.
tl;dr it’s complicated, we don’t know, stay tuned for another decade probably
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