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J Allergy Clin Immunol. 2014 May;133(5):1383-9, 1389.e1-6. doi: 10.1016/j.jaci.2013.10.060. Epub 2014 Jan 17.

Component resolution reveals additional major allergens in patients with honeybee venom allergy.

Author information

1
Allergy Research Group, Department of Dermatology, University Medical Center Freiburg, Freiburg, Germany.
2
Institute of Biochemistry and Molecular Biology, University of Hamburg, Hamburg, Germany.
3
Allergy Research Group, Department of Dermatology, University Medical Center Freiburg, Freiburg, Germany; Thermo Fisher Scientific, Freiburg, Germany.
4
Thermo Fisher Scientific, Uppsala, Sweden.
5
Institute of Biochemistry and Molecular Biology, University of Hamburg, Hamburg, Germany. Electronic address: spillner@chemie.uni-hamburg.de.
6
Allergy Research Group, Department of Dermatology, University Medical Center Freiburg, Freiburg, Germany. Electronic address: thilo.jakob@uniklinik-freiburg.de.

Abstract

BACKGROUND:

Detection of IgE to recombinant Hymenoptera venom allergens has been suggested to improve the diagnostic precision in Hymenoptera venom allergy. However, the frequency of sensitization to the only available recombinant honeybee venom (HBV) allergen, rApi m 1, in patients with HBV allergy is limited, suggesting that additional HBV allergens might be of relevance.

OBJECTIVE:

We performed an analysis of sensitization profiles of patients with HBV allergy to a panel of HBV allergens.

METHODS:

Diagnosis of HBV allergy (n = 144) was based on history, skin test results, and allergen-specific IgE levels to HBV. IgE reactivity to 6 HBV allergens devoid of cross-reactive carbohydrate determinants (CCD) was analyzed by ImmunoCAP.

RESULTS:

IgE reactivity to rApi m 1, rApi m 2, rApi m 3, nApi m 4, rApi m 5, and rApi m 10 was detected in 72.2%, 47.9%, 50.0%, 22.9%, 58.3%, and 61.8% of the patients with HBV allergy, respectively. Positive results to at least 1 HBV allergen were detected in 94.4%. IgE reactivity to Api m 3, Api m 10, or both was detected in 68.0% and represented the only HBV allergen-specific IgE in 5% of the patients. Limited inhibition of IgE binding by therapeutic HBV and limited induction of Api m 3- and Api m 10-specific IgG4 in patients obtaining immunotherapy supports recent reports on the underrepresentation of these allergens in therapeutic HBV preparations.

CONCLUSION:

Analysis of a panel of CCD-free HBV allergens improved diagnostic sensitivity compared with use of rApi m 1 alone, identified additional major allergens, and revealed sensitizations to allergens that have been reported to be absent or underrepresented in therapeutic HBV preparations.

KEYWORDS:

Apis mellifera; Hymenoptera venom; Vespula vulgaris; cross-reactive carbohydrate determinant; honeybee venom allergy; insect venom allergy; recombinant allergen

PMID:
24440283
DOI:
10.1016/j.jaci.2013.10.060
[Indexed for MEDLINE]
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