Bee/Vespula venom-specific IgE ratio ≥5:1 indicates culprit insect in double-sensitized patients.

Simon Tischler, Axel Trautmann, Matthias Goebeler, Johanna Stoevesandt
{"title":"Bee/Vespula venom-specific IgE ratio ≥5:1 indicates culprit insect in double-sensitized patients.","authors":"Simon Tischler, Axel Trautmann, Matthias Goebeler, Johanna Stoevesandt","doi":"10.1016/j.jaip.2024.10.029","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Venom-allergic patients are frequently double-sensitized to honeybee venom (BV) and Vespula venom (VV); genuine double allergy is uncommon.</p><p><strong>Objectives: </strong>To assess if quantitative comparison of BV and VV-specific IgE levels permits to identify the culprit venom in double-sensitized patients; to evaluate whether independent sensitization to BV- and VV-specific components corresponds to an indication for double immunotherapy.</p><p><strong>Methods: </strong>This single centre observational study evaluates 1069 consecutive patients; 490 non-allergic controls were available for statistical comparison. The diagnosis (BV allergy, VV allergy, double allergy) based on a comprehensive allergological work-up including patient history, IgE serology, intradermal skin test, and - if required - basophil activation testing. Quantitative allergen-specific IgE to BV, VV, rApi m 1, rVes v 5 was retrospectively compared with the final diagnosis; the ratio of BV/VV-specific IgE levels was considered in double-sensitized venom-allergic patients.</p><p><strong>Results: </strong>Sensitization to whole venom preparations and components was frequent in patients and asymptomatic controls, with higher specific IgE levels in the patient group. An at least 5:1-dominance of the specific IgE to either BV or VV was documented in 239 (52.1 %) of 459 double-sensitized venom-allergic patients; 232 (97.1%) of these patients were diagnosed mono-allergic to only the venom they were dominantly sensitized to.</p><p><strong>Conclusions: </strong>Five:1-dominant specific IgE indicates the culprit venom in double-sensitized allergic patients. Additional component-resolved diagnostic testing can be restricted to cases with double sensitization to whole venoms at a ratio less than 5:1. Double sensitization to rApi m 1 and rVes v 5 per se does not justify double venom immunotherapy.</p>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":null,"pages":null},"PeriodicalIF":8.2000,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Allergy and Clinical Immunology-In Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jaip.2024.10.029","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ALLERGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Venom-allergic patients are frequently double-sensitized to honeybee venom (BV) and Vespula venom (VV); genuine double allergy is uncommon.

Objectives: To assess if quantitative comparison of BV and VV-specific IgE levels permits to identify the culprit venom in double-sensitized patients; to evaluate whether independent sensitization to BV- and VV-specific components corresponds to an indication for double immunotherapy.

Methods: This single centre observational study evaluates 1069 consecutive patients; 490 non-allergic controls were available for statistical comparison. The diagnosis (BV allergy, VV allergy, double allergy) based on a comprehensive allergological work-up including patient history, IgE serology, intradermal skin test, and - if required - basophil activation testing. Quantitative allergen-specific IgE to BV, VV, rApi m 1, rVes v 5 was retrospectively compared with the final diagnosis; the ratio of BV/VV-specific IgE levels was considered in double-sensitized venom-allergic patients.

Results: Sensitization to whole venom preparations and components was frequent in patients and asymptomatic controls, with higher specific IgE levels in the patient group. An at least 5:1-dominance of the specific IgE to either BV or VV was documented in 239 (52.1 %) of 459 double-sensitized venom-allergic patients; 232 (97.1%) of these patients were diagnosed mono-allergic to only the venom they were dominantly sensitized to.

Conclusions: Five:1-dominant specific IgE indicates the culprit venom in double-sensitized allergic patients. Additional component-resolved diagnostic testing can be restricted to cases with double sensitization to whole venoms at a ratio less than 5:1. Double sensitization to rApi m 1 and rVes v 5 per se does not justify double venom immunotherapy.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
蜜蜂/蛛毒特异性 IgE 比率≥5:1 表示双重过敏患者的罪魁祸首是昆虫。
背景:毒液过敏患者经常对蜜蜂毒液(BV)和蝰蛇毒液(VV)双重过敏;真正的双重过敏并不常见:评估 BV 和 VV 特异性 IgE 水平的定量比较是否允许确定双重过敏患者的罪魁祸首毒液;评估对 BV 和 VV 特异性成分的独立过敏是否与双重免疫疗法的适应症相对应:这项单中心观察性研究对 1069 名连续患者进行了评估;490 名非过敏对照者可用于统计比较。诊断(BV 过敏、VV 过敏、双重过敏)基于全面的过敏学检查,包括患者病史、IgE 血清学检查、皮内皮肤测试,必要时还包括嗜碱性粒细胞活化测试。对 BV、VV、rApi m 1、rVes v 5 的过敏原特异性 IgE 定量与最终诊断进行回顾性比较;对双重过敏的毒液过敏患者考虑 BV/VV 特异性 IgE 水平的比值:结果:在患者和无症状对照组中,经常出现对整个毒液制剂和成分过敏的情况,患者组的特异性 IgE 水平更高。在 459 名双重毒液过敏患者中,有 239 人(52.1%)对 BV 或 VV 的特异性 IgE 至少以 5:1 的比例占优势;其中 232 人(97.1%)被诊断为只对其主要过敏的毒液单一过敏:结论:5:1 主导特异性 IgE 显示了双重过敏患者的罪魁祸首毒液。额外的成分分辨诊断测试可仅限于对整个毒液双重过敏且比例小于 5:1 的病例。对 rApi m 1 和 rVes v 5 双重过敏本身并不能证明双重毒液免疫疗法是正确的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
11.10
自引率
9.60%
发文量
683
审稿时长
50 days
期刊介绍: JACI: In Practice is an official publication of the American Academy of Allergy, Asthma & Immunology (AAAAI). It is a companion title to The Journal of Allergy and Clinical Immunology, and it aims to provide timely clinical papers, case reports, and management recommendations to clinical allergists and other physicians dealing with allergic and immunologic diseases in their practice. The mission of JACI: In Practice is to offer valid and impactful information that supports evidence-based clinical decisions in the diagnosis and management of asthma, allergies, immunologic conditions, and related diseases. This journal publishes articles on various conditions treated by allergist-immunologists, including food allergy, respiratory disorders (such as asthma, rhinitis, nasal polyps, sinusitis, cough, ABPA, and hypersensitivity pneumonitis), drug allergy, insect sting allergy, anaphylaxis, dermatologic disorders (such as atopic dermatitis, contact dermatitis, urticaria, angioedema, and HAE), immunodeficiency, autoinflammatory syndromes, eosinophilic disorders, and mast cell disorders. The focus of the journal is on providing cutting-edge clinical information that practitioners can use in their everyday practice or to acquire new knowledge and skills for the benefit of their patients. However, mechanistic or translational studies without immediate or near future clinical relevance, as well as animal studies, are not within the scope of the journal.
期刊最新文献
Guidance for the Evaluation by Payors of Claims Submitted Using Current Procedural Terminology Codes 95165, 95115, and 95117. Bee/Vespula venom-specific IgE ratio ≥5:1 indicates culprit insect in double-sensitized patients. Class I HLA Alleles are associated with an increased risk of osimertinib-induced hypersensitivity. AAAAI Position Statement on Changing Electronic Health Record Allergy Documentation to "Alerts" to Lead to Easily Understood, Actionable Labels. An International Delphi Consensus on the Management of Pollen-Food-Allergy Syndrome: A Work Group Report of the AAAAI Adverse Reactions to Foods Committee.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1