Abstract
BackgroundSkin testing can expose allergic subjects to potential systemic reactions, sensitization against unrelated proteins, and increased risk of future sting reactions. Therefore the continuous improvement of in vitro diagnostic methods is desirable. Recombinant allergens have been shown to improve the sensitivity of specific IgE (sIgE) detection in vitro whilst no data is available regarding their application and reliability in basophil activation test (BAT). Here we aimed to compare the specificity and sensitivity of recombinant allergens Ves v 1, Ves v 2, Ves v 3 and Ves v 5 in both specific IgE (sIgE) detection in vitro and basophil activation test.MethodssIgE detection by ELISA or ImmunoCAP and BAT towards the panel of recombinant allergens Ves v 1, Ves v 2, Ves v 3 and Ves v 5 were performed in 43 wasp venom allergic patients with a history of anaphylactic reaction and sIgE seropositivity, as well as 17 controls defined as subjects with a history of repetitive wasp stings but absence of any allergic symptom.ResultsThe BAT performed with the recombinant allergens Ves v 1, Ves v 2, Ves v 3 and Ves v 5 markedly improved the specificity of diagnosis in wasp venom allergic subjects when compared to the respective sIgE detection in serum.ConclusionsBAT performed with the recombinant allergens Ves v 5, Ves v 3 and Ves v 1 provides an emerging highly specific in vitro method for the detection of wasp venom allergy, compared to the sIgE detection. Recombinant allergens applied to BAT represent a step forward in developing reliable in vitro tests for specific diagnosis of allergy.
Highlights
Up to 3% of the general population suffer from potentially lifethreatening systemic reactions after wasp stings [1]
Basophils were identified according to their dimension and IgE positivity (Figure 1a)
The stimulation of basophils with the positive control: monoclonal antibody recognizing the high affinity IgE binding receptor (IgE-FCeRI) as well as natural venom, indicated that basophils were in good conditions during the experiments and that natural venom activated basophils in allergic subjects (Figure 1b and 1c)
Summary
Up to 3% of the general population suffer from potentially lifethreatening systemic reactions after wasp stings [1]. Skin testing exposes allergic subjects to systemic reactions, sensitization against unrelated proteins, and increased risk of future sting reactions [4,5,6,7,8]. Skin conditions such as dermographism or severe skin diseases do not allow skin testing. Skin testing can expose allergic subjects to potential systemic reactions, sensitization against unrelated proteins, and increased risk of future sting reactions. Recombinant allergens have been shown to improve the sensitivity of specific IgE (sIgE) detection in vitro whilst no data is available regarding their application and reliability in basophil activation test (BAT). We aimed to compare the specificity and sensitivity of recombinant allergens Ves v 1, Ves v 2, Ves v 3 and Ves v 5 in both specific IgE (sIgE) detection in vitro and basophil activation test
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