title: Suitability of different glycoproteins and test systems for detecting cross-reactive carbohydrate determinant-specific IgE in hymenoptera venom-allergic patients.
abstract: BACKGROUND
  In hymenoptera venom allergy, about 75% of detected in vitro double positivity to yellow jacket and honeybee venom is ascribed to specific IgE (sIgE) directed against cross-reactive carbohydrate determinants (CCDs). To date, for the detection of CCD-sIgE, different carbohydrate antigens and methods are used. The most suitable one still has to be identified.
  
  
  METHODS
  Eighty-seven patients with confirmed hymenoptera venom allergy and venom sIgE values of ≥0.7 kU/l were investigated. Sixty-five patients showed sIgE reactivity to both yellow jacket and honeybee venom, 22 were venom mono positive and served as controls. Occurrence of CCD-sIgE was determined using bromelain, horseradish peroxidase (HRP) and MUXF(3) on system A, and ascorbic acid oxidase (AAO), bromelain and HRP on system B. Further, a reference standard for CCD-sIgE evaluation was created: CCD positivity was assumed when at least 4 of the 6 test results were positive.
  
  
  RESULTS
  According to the defined reference standard, 45/65 venom double positive patients exhibited CCD-sIgE. Using system A, comparison with the reference standard revealed sensitivity and specificity values of 96 and 97%, respectively, for MUXF(3), 100 and 100%, respectively, for bromelain, and 96 and 97%, respectively, for HRP. Using system B, sensitivity and specificity was 98 and 97%, respectively, for AAO, 62 and 95%, respectively, for bromelain, and 96 and 69%, respectively, for HRP. Results of the 3 test allergens obtained with system A showed strong correlations (r = 0.932-0.976), whereas results with system B showed lower correlations (r = 0.714-0.898).
  
  
  CONCLUSIONS
  All 3 test allergens used with system A are suitable for CCD-sIgE detection in hymenoptera venom allergy. With system B, only AAO seems to be a reliable tool.
authors: Department of Dermatology, University of Münster, Münster, Germany. allergologie @ med.net.uni-muenster.de
authors: Melanie
authors: M
authors: Mertens
authors: Randolf
authors: R
authors: Brehler
mesh_terms: D000485:Allergens / Q000737:chemistry / Q000276:immunology; D000818:Animals; D000918:Antibody Specificity; D001514:Bee Venoms / Q000737:chemistry / Q000276:immunology*; D001963:Bromelains / Q000737:chemistry / Q000276:immunology; D002240:Carbohydrate Sequence; D002241:Carbohydrates / Q000737:chemistry / Q000276:immunology*; D003429:Cross Reactions; D005260:Female; D006023:Glycoproteins / Q000737:chemistry* / Q000276:immunology*; D006735:Horseradish Peroxidase / Q000737:chemistry / Q000276:immunology*; D006801:Humans; D006927:Hymenoptera / Q000276:immunology; D006969:Hypersensitivity, Immediate / Q000175:diagnosis* / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood*; D008297:Male; D008969:Molecular Sequence Data; D011134:Polysaccharides / Q000737:chemistry / Q000276:immunology; D012882:Skin Tests; D014862:Wasp Venoms / Q000737:chemistry / Q000276:immunology*
chemical_list: D000485:Allergens; D001514:Bee Venoms; D002241:Carbohydrates; D006023:Glycoproteins; D011134:Polysaccharides; D014862:Wasp Venoms; D007073:Immunoglobulin E; D001963:Bromelains; D006735:Horseradish Peroxidase