title: Wasp venom allergy screening with recombinant allergen testing. Diagnostic performance of rPol d 5 and rVes v 5 for differentiating sensitization to Vespula and Polistes subspecies.
abstract: BACKGROUND
  The appropriate therapeutic management of patients with wasp-induced allergic reactions necessitates an accurate allergologic workup, entailing differentiation between sensitization against Vespula or Polistes venoms.
  
  
  METHODS
  We studied 52 consecutive adult subjects diagnosed with hypersensitivity to wasp venoms. Cap inhibition was performed using UniCAP Specific IgE. The concentration of serum IgE against two recombinant constituents of Antigen 5 (rVes v 5 and rPol d 5) was also measured using Immuno CAP 250. The ratio between values of specific IgE against recombinant allergens was calculated and a percentage difference >50% was considered significant for specific immunization against one of the two venoms.
  
  
  RESULTS
  The diagnostic agreement between recombinant allergens testing and CAP inhibition was 54% (kappa statistics, 0.34; 95% CI, 0.18-0.50) in the whole study population. In the 24 patients with recombinant allergens ratio >50% and non dubious results of CAP inhibition assay the diagnostic agreement was perfect (100%; kappa of agreement, 1.00; 95% CI; 1.00-1.00).
  
  
  CONCLUSIONS
  The results of this study show that the assessment of specific IgE against rVes v 5 and rPol d 5 may be regarded as a low-cost screening, providing valuable diagnostic information for differentiating the sensitization against Vespula or Polistes venoms. In patients with suggestive clinical history and ratio >50% between specific IgE against rVes v 5 and specific IgE against and rPol d 5, the CAP inhibition assay may be safely withheld, thus allowing to achieve an early diagnosis at lower cost.
authors.affiliation: Laboratory of Clinical Chemistry and Hematology, University Hospital of Verona, Verona, Italy.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Caruso
authors.affiliation: Allergology Unit, University Hospital of Verona, Verona, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Bonadonna
authors.affiliation: Medical Direction, University Hospital of Verona, Verona, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Bovo
authors.affiliation: Laboratory of Clinical Chemistry and Hematology, University Hospital of Verona, Verona, Italy.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Melloni
authors.affiliation: Allergology Unit, University Hospital of Verona, Verona, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Lombardo
authors.affiliation: Allergology Unit, University Hospital of Verona, Verona, Italy.
authors.forename: Gianenrico
authors.initials: G
authors.lastname: Senna
authors.affiliation: Laboratory of Clinical Chemistry and Hematology, University Hospital of Verona, Verona, Italy; Section of Clinical Biochemistry, University of Verona, Verona, Italy. Electronic address: giuseppe.lippi@univr.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lippi
mesh_terms: D000328:Adult; D000485:Allergens / Q000276:immunology*; D000818:Animals; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D013045:Species Specificity; D014862:Wasp Venoms / Q000276:immunology*; D014863:Wasps / Q000276:immunology*
chemical_list: D000485:Allergens; D014862:Wasp Venoms
keywords: Allergy; Recombinant allergen; Sensitization; Vespid venom