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


CONCLUSIONS
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.
Allergy Research Group, Department of Dermatology, University Medical Center Freiburg, Freiburg, Germany.
Julian
J
Köhler
Institute of Biochemistry and Molecular Biology, University of Hamburg, Hamburg, Germany.
Simon
S
Blank
Allergy Research Group, Department of Dermatology, University Medical Center Freiburg, Freiburg, Germany.
Sabine
S
Müller
Institute of Biochemistry and Molecular Biology, University of Hamburg, Hamburg, Germany.
Frank
F
Bantleon
Allergy Research Group, Department of Dermatology, University Medical Center Freiburg, Freiburg, Germany.
Marcel
M
Frick
Allergy Research Group, Department of Dermatology, University Medical Center Freiburg, Freiburg, Germany; Thermo Fisher Scientific, Freiburg, Germany.
Johannes
J
Huss-Marp
Thermo Fisher Scientific, Uppsala, Sweden.
Jonas
J
Lidholm
Institute of Biochemistry and Molecular Biology, University of Hamburg, Hamburg, Germany. Electronic address: spillner@chemie.uni-hamburg.de.
Edzard
E
Spillner
Allergy Research Group, Department of Dermatology, University Medical Center Freiburg, Freiburg, Germany. Electronic address: thilo.jakob@uniklinik-freiburg.de.
Thilo
T
Jakob
D000485:Allergens / Q000737:chemistry / Q000276:immunology*; D000818:Animals; D001514:Bee Venoms / Q000737:chemistry / Q000276:immunology*; D001516:Bees; D003429:Cross Reactions; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000276:immunology*; D007073:Immunoglobulin E / Q000276:immunology; D007074:Immunoglobulin G / Q000276:immunology; D007299:Insect Bites and Stings / Q000175:diagnosis / Q000276:immunology*; D019476:Insect Proteins / Q000737:chemistry / Q000276:immunology*; D008297:Male
D000485:Allergens; D001514:Bee Venoms; D007074:Immunoglobulin G; D019476:Insect Proteins; D007073:Immunoglobulin E
Apis mellifera; Hymenoptera venom; Vespula vulgaris; cross-reactive carbohydrate determinant; honeybee venom allergy; insect venom allergy; recombinant allergen