title: Recombinant allergen-based IgE testing to distinguish bee and wasp allergy.
abstract: BACKGROUND
  The identification of the disease-causing insect in venom allergy is often difficult.
  
  
  OBJECTIVE
  To establish recombinant allergen-based IgE tests to diagnose bee and yellow jacket wasp allergy.
  
  
  METHODS
  Sera from patients with bee and/or wasp allergy (n = 43) and patients with pollen allergy with false-positive IgE serology to venom extracts were tested for IgE reactivity in allergen extract-based tests or with purified allergens, including nonglycosylated Escherichia coli-expressed recombinant (r) Api m 1, rApi m 2, rVes v 5, and insect cell-expressed, glycosylated rApi m 2 as well as 2 natural plant glycoproteins (Phl p 4, bromelain).
  
  
  RESULTS
  The patients with venom allergy could be diagnosed with a combination of E coli-expressed rApi m 1, rApi m 2, and rVes v 5 whereas patients with pollen allergy remained negative. For a group of 29 patients for whom the sensitizing venom could not be identified with natural allergen extracts, testing with nonglycosylated allergens allowed identification of the sensitizing venom. Recombinant nonglycosylated allergens also allowed definition of the sensitizing venom for those 14 patients who had reacted either with bee or wasp venom extracts. By IgE inhibition studies, it is shown that glycosylated Api m 2 contains carbohydrate epitopes that cross-react with natural Api m 1, Ves v 2, natural Phl p 4, and bromelain, thus identifying cross-reactive structures responsible for serologic false-positive test results or double-positivity to bee and wasp extracts.
  
  
  CONCLUSIONS
  Nonglycosylated recombinant bee and wasp venom allergens allow the identification of patients with bee and wasp allergy and should facilitate accurate prescription of venom immunotherapy.
authors.affiliation: Christian Doppler Laboratory for the Development of Allergen Chips, Medical University of Vienna, Vienna, Austria.
authors.forename: Irene
authors.initials: I
authors.lastname: Mittermann
authors.forename: Mihaela
authors.initials: M
authors.lastname: Zidarn
authors.forename: Mira
authors.initials: M
authors.lastname: Silar
authors.forename: Zora
authors.initials: Z
authors.lastname: Markovic-Housley
authors.forename: Werner
authors.initials: W
authors.lastname: Aberer
authors.forename: Peter
authors.initials: P
authors.lastname: Korosec
authors.forename: Mitja
authors.initials: M
authors.lastname: Kosnik
authors.forename: Rudolf
authors.initials: R
authors.lastname: Valenta
mesh_terms: D000485:Allergens / Q000235:genetics / Q000276:immunology / Q000378:metabolism; D000818:Animals; D052179:Antigens, Plant; D001516:Bees; D002478:Cells, Cultured; D003001:Cloning, Molecular; D003937:Diagnosis, Differential; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D007073:Immunoglobulin E / Q000276:immunology / Q000378:metabolism*; D019476:Insect Proteins / Q000235:genetics / Q000276:immunology / Q000378:metabolism; D008297:Male; D010741:Phospholipases A / Q000235:genetics / Q000276:immunology / Q000378:metabolism; D011994:Recombinant Proteins / Q000235:genetics / Q000276:immunology / Q000378:metabolism; D006255:Rhinitis, Allergic, Seasonal / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D012699:Serology; D014688:Venoms; D014863:Wasps
chemical_list: D000485:Allergens; D052179:Antigens, Plant; D019476:Insect Proteins; D011994:Recombinant Proteins; D014688:Venoms; C431905:Ves v 5 allergen; D007073:Immunoglobulin E; D010741:Phospholipases A; C497838:Api m 1 allergen, Apis mellifera