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Sensitization to Hymenoptera venom marker allergens: Prevalence, predisposing factors, and clinical implications
Author(s) -
Stoevesandt Johanna,
Hosp Christine,
Kerstan Andreas,
Trautmann Axel
Publication year - 2018
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1111/cea.13237
Subject(s) - sensitization , hymenoptera , venom , medicine , immunology , biology , zoology , ecology
Summary Background The prevalence and predisposing factors of asymptomatic sensitization to Hymenoptera venom marker allergens are largely unknown. Objective To evaluate sensitization profiles in a group of 490 dermatologic patients without a history of sting‐induced anaphylaxis. Methods Clinical data were collected using a structured questionnaire; sera were tested for total IgE and specific IgE to venom preparations, recombinant venom marker allergens, inhalative allergens, and cross‐reactive carbohydrate determinants. Results The lifetime prevalence of Hymenoptera stings was 85.3%. IgE rates exceeding cut‐off values of 0.35 kU A /L were 17.3% for rVes v 1, 18.0% for rVes v 5, and 3.5% for rApi m 1. Median specific/total IgE ratios for the above mentioned marker allergens were 0.05%, 0.02%, and 0.00%, respectively. Marker allergen‐directed sensitization was detectable in 85.5% of 138 Vespula venom‐reactive sera. Of 68 bee venom‐reactive participants, 23.5% were sensitized to rApi m 1 and 64.7% to any one or several of five commercially available bee venom allergens. Although double reactivity to bee and Vespula venom was clearly associated with sensitization to cross‐reactive carbohydrate determinants ( P < 0.001), sensitization to marker allergens of both species was detectable in most double‐reactive sera (56.5%). Vespula venom marker allergen‐directed sensitization was associated with recent stings ( P = 0.010), large local reactions ( P = 0.009), total IgE elevation ( P < 0.001), and sensitization to cross‐reactive carbohydrate determinants ( P = 0.008). Conclusions and Clinical Relevance The high sensitization rates observed in individuals without a history of sting‐induced anaphylaxis as well as total IgE levels and cross‐reactive carbohydrate determinant‐directed reactivity as potential confounders need to be considered in any interpretation of positive test results for Hymenoptera venom marker allergens.