Importance of wasp and honey bee recombinant allergens in the diagnosis of hymenoptera venom anaphylaxis

Abstract

Background: Hymenoptera venom-allergic patients frequently present multiple sensitisations. Objectives: To define the allergic profile by components in Hymenoptera venom allergic patients. To study the usefulness of specific IgE to components in cases of negative results of sIgE to the venoms. Patients (n = 86) with a diagnosis of allergic systemic reaction following honey bee or wasp stings were included in the study. Skin prick tests (SPT) and intradermal reaction were performed. sIgE to complete extracts of honey bee (Apis mellifera), Vespula (Vespula spp.), venom and recombinant allergens rApi m1, rApi m 5; rVes v5 and rVes v1 5 were analysed by ImmunoCAP (Phadia). sIgE concentration higher than 0.35 kU/l were considered positive. Results: 86 patients (40 male, 46 female) were included. No sIgE to Honey bee/Vespula was detected in 15 patients. In 7 of them only component diagnosis (Api m1 and Ves v5) confirmed hymenoptera allergy. Positive correlation between severity of anaphylactic reaction and sIgE to rVes v1 concentration was observed (r = 0,85; p < 0.05) and sIgE to rApi m1 (r = 0.87; p < 0.05). None such correlation was observed with specific IgE to other venom components. Conclusions: Components analysis can be useful to make diagnosis more accurate. Determination of sIgE towards phospholipase A2 (Apis mellifera) and phospholipase A1 (Vespula spp.) may reflects severity of allergic reaction after hymenoptera sting.