title: Improved recombinant Api m 1- and Ves v 5-based IgE testing to dissect bee and yellow jacket allergy and their correlation with the severity of the sting reaction.
abstract: BACKGROUND
  No study has assessed the diagnostic sensitivity of rApi m 1 and rVes v 5 on Immulite testing system.
  
  
  OBJECTIVE
  To compare the diagnostic sensitivity of commercially available venom recombinant allergens between the currently available immunoassays [ImmunoCAP (CAP) and Immulite (LITE)] and establish their correlation with the severity of the sting reaction.
  
  
  METHODS
  This study evaluated 95 bee venom and 110 yellow jacket venom-allergic subjects. We measured the levels of sIgE to rApi m 1, rVes v 5 (LITE and CAP), rApi m 2 (LITE), rVes v 1 (CAP) and total IgE (CAP). Forty-nine healthy subjects served as controls.
  
  
  RESULTS
  The diagnostic sensitivity of rApi m 1 and rVes v 5 was significantly higher with the LITE than with the CAP system (71% vs. 88% and 82% vs. 93%). The specificity of both assays for both allergens was between 94% and 98%. Twenty-nine patients that tested negative for rApi m 1 or rVes v 5 with CAP were positive with LITE, but none of the patients that tested negative with LITE were positive with CAP. The positive values of rApi m 1 and rVes v 5 were on average 2.7 and 2.3 times higher, with the LITE than with the CAP system. The combination of rApi m 1 and rApi m 2 (LITE) and the combination of rVes v 5 (LITE) and rVes v 1 (CAP) almost matched the sensitivity of native venoms (95% and 97%, respectively), whereas the diagnostic sensitivity of the combination of rVes v 5 and rVes v 1 (CAP) did not reach the sensitivity of rVes v 5 (LITE) alone (90% vs. 93%). IgE levels to venom recombinants and total IgE did not correlate with the severity of sting reaction.
  
  
  CONCLUSIONS
  The use of rApi m 1 and rVes v 5 with the LITE system significantly enhanced diagnostic utility of venom recombinants and should improve the dissection of bee and yellow jacket venom allergy.
authors.affiliation: University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia.
authors.forename: J
authors.initials: J
authors.lastname: Šelb
authors.affiliation: University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia.
authors.forename: R
authors.initials: R
authors.lastname: Kogovšek
authors.affiliation: University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia.
authors.forename: M
authors.initials: M
authors.lastname: Šilar
authors.affiliation: University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia.
authors.forename: M
authors.initials: M
authors.lastname: Košnik
authors.affiliation: University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia.
authors.forename: P
authors.initials: P
authors.lastname: Korošec
mesh_terms: D000485:Allergens / Q000008:administration & dosage / Q000276:immunology*; D000818:Animals; D001514:Bee Venoms / Q000276:immunology; D001516:Bees; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000276:immunology*; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology*; D007299:Insect Bites and Stings; D019476:Insect Proteins / Q000276:immunology; D008297:Male; D010741:Phospholipases A / Q000276:immunology; D011933:Reagent Kits, Diagnostic; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014862:Wasp Venoms / Q000276:immunology; D014863:Wasps
chemical_list: D000485:Allergens; D001514:Bee Venoms; D019476:Insect Proteins; D011933:Reagent Kits, Diagnostic; C431905:Ves v 5 allergen; D014862:Wasp Venoms; D007073:Immunoglobulin E; D010741:Phospholipases A; C497838:Api m 1 allergen, Apis mellifera
keywords: Immulite; ImmunoCAP; comparison; enhanced sensitivity; rApi m 1; rVes v 5