Abstract
Sensitization to Hymenoptera venom in patients without a history of systemic allergic reactions to Hymenoptera stings is frequently found and can be due to the presence of specific IgE to cross-reactive carbohydrate determinants (CCD). This study investigates 105 pollen allergic subjects for the presence of specific IgE to honeybee or wasp venom, pollen, the MUXF3 carbohydrate epitope from bromelain and recombinant Hymenoptera venom components. In addition, in a subgroup of patients (n = 10) a basophil activation test (BAT) using bee and wasp venom was performed. Specific IgE to Hymenoptera venom was detected in 45.7% of the pollen allergic subjects and in 26.7% of the non-atopic controls, both without a history of systemic allergic reactions to Hymenoptera stings. The high sensitization rate in atopic patients could partially be explained by cross-sensitization between pollen and Hymenoptera venom due to specific IgE to CCDs. In our study population, only 20% showed a sensitization to CCDs. Primary sensitization due to sting exposure, high total IgE values or unspecific binding and detection of low affinity antibodies in the test procedure could be reasons. Thus, determination of specific IgE to Hymenoptera venom in patients without a history of systemic allergic reactions as screening test is not recommended.
Highlights
About 9.8% of the Swiss population shows specific IgE to honeybee or wasp venom without reporting systemic symptoms after Hymenoptera stings [1]
Since specific IgE (sIgE) values are related to total IgE (t-IgE) we examined the corresponding ratio: With one exception the ratio was below 0.1 (Fig 2)
In our study almost half (45.7%) of the symptomatic pollen allergic patients and 26.7% of the non-atopic controls without history of a systemic reaction after a Hymenoptera sting had sIgE
Summary
About 9.8% of the Swiss population shows specific IgE (sIgE) to honeybee or wasp venom without reporting systemic symptoms after Hymenoptera stings [1]. In European epidemiological studies the sensitization rate to honeybee or wasp venom in the general population varies between 27.1–44.1% [2, 3]. Despite this high sensitization rate only 3.5% develop a systemic. Sensitization to Hymenoptera venom in pollen allergic patients publish, or preparation of the manuscript. The laboratory ADR-AC GmBH, a specialized laboratory offering basophil activation tests for routine diagnostics in Switzerland, performed all basophil activation tests in this study
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