title: Improved sensitivity to venom specific-immunoglobulin E by spiking with the allergen component in Japanese patients suspected of Hymenoptera venom allergy.
abstract: BACKGROUND
  Ves v 5 and Pol d 5, which constitute antigen 5, are recognized as the major, most potent allergens of family Vespidae. Several studies have reported the diagnostic sensitivity of the novel recombinant (r)Ves v 5 and rPol d 5 allergens in routine clinical laboratory settings by analyzing a group of Vespula and Polistes venom-allergic patients. In this study, we analyzed the sensitivity to venom specific (s)IgE by spiking with rVes v 5 and rPol d 5 in Japanese patients suspected of Hymenoptera venom allergy.
  
  
  METHODS
  Subjects were 41 patients who had experienced systemic reactions to hornet and/or paper wasp stings. Levels of serum sIgE against hornet and paper wasp venom by spiking with rVes v 5 and rPold d 5, respectively, as improvement testing, compared with hornet and paper wasp venom, as conventional testing, were measured by ImmunoCAP.
  
  
  RESULTS
  Of the 41 patients, 33 (80.5%) were positive (≥0.35 UA/ml) for hornet and/or paper wasp venom in conventional sIgE testing. sIgE levels correlated significantly (P < 0.01) between hornet (R = 0.92) or paper wasp venom (R = 0.78) in improvement testing and conventional testing. To determine specificity, 20 volunteers who had never experienced a Hymenoptera sting were all negative for sIgE against these venoms in both improvement and conventional testing. Improved sensitivity was seen in 8 patients negative for sIgE against both venoms in conventional testing, while improvement testing revealed sIgE against hornet or paper wasp venom in 5 (total 38 (92.7%)) patients.
  
  
  CONCLUSIONS
  The measurement of sIgE following spiking of rVes v 5 and rPol d 5 by conventional testing in Japanese subjects with sIgE against hornet and paper wasp venom, respectively, improved the sensitivity for detecting Hymenoptera venom allergy. Improvement testing for measuring sIgE levels against hornet and paper wasp venom has potential for serologically elucidating Hymenoptera allergy in Japan.
authors.affiliation: Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Naruo
authors.initials: N
authors.lastname: Yoshida
authors.affiliation: Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University, Tochigi, Japan. Electronic address: hirokuni@dokkyomed.ac.jp.
authors.forename: Hirokuni
authors.initials: H
authors.lastname: Hirata
authors.affiliation: Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Mineaki
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Department of Pulmonary Medicine, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan.
authors.forename: Kumiya
authors.initials: K
authors.lastname: Sugiyama
authors.affiliation: Department of Developmental Genetics, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Arima
authors.affiliation: Department of Pulmonary Medicine, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan.
authors.forename: Yasutsugu
authors.initials: Y
authors.lastname: Fukushima
authors.affiliation: Department of Pulmonary Medicine and Clinical Immunology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Ishii
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000485:Allergens / Q000276:immunology*; D000818:Animals; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood; D007564:Japan; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000276:immunology*; D012680:Sensitivity and Specificity; D014688:Venoms / Q000276:immunology*; D014863:Wasps / Q000276:immunology
chemical_list: D000485:Allergens; D011994:Recombinant Proteins; D014688:Venoms; C431905:Ves v 5 allergen; D007073:Immunoglobulin E
keywords: Hymenoptera venom; Specific IgE; Spiking; rPol d 5; rVes v 5