Seyfarth Florian, Miguel Diana, Schliemann Sibylle, Hipler Uta-Christina
Department of Dermatology, Jena University Hospital, Jena, Germany.
Dermatology Practice PD Dr. med. habil. K. Jung, Uta Zell, Erfurt.
J Dtsch Dermatol Ges. 2017 May;15(5):507-515. doi: 10.1111/ddg.13240.
BACKGROUND: The measurement of specific IgE (sIgE) antibodies plays a key role in the diagnosis of honeybee and wasp venom allergy. In recent years, component-resolved diagnosis (CRD) has been introduced, which allows for the measurement of sIgE antibodies against Api m 1, Ves v 1, Ves v 5, and Pol d 5, as well as cross-reactive carbohydrate determinants (CCDs). These tests are intended to help determine the clinical relevance of any given sensitization, especially in patients with dual sensitization. PATIENTS AND METHODS: Specific IgE antibody levels were measured in 143 patients with bee and/or wasp venom allergy using the extract-based ImmunoCAP allergens i1 and i3 as well as the ImmunoCAP allergen components i208-211 and O214 (Api m 1, Ves v 1, Ves v 5, Pol d 5, CCDs). In patients with dual sensitization, inhibition testing was also performed. In a subgroup of the study population, sIgE to Api m 1, Api m 4, Pol d 5, and Ves v 5 were determined using the ISAC allergy microarray (n = 44). RESULTS: The sensitivity of Ves v 5 in patients with isolated wasp venom allergy was 78.5 %; in combination with Ves v 1, that figure increased to 92.3 %. The sensitivity of Api m 1 in individuals with isolated bee venom allergy was 25 %. CRD and inhibition testing in individuals with dual sensitization showed divergent results. CRD using the ISAC allergy microarray showed marked differences, especially with regard to Api m 1 and CCDs. CONCLUSION: Component-resolved tests are a valuable addition to the diagnostic spectrum as long as they are used in combination with established procedures. Apart from Ves v 5, measuring IgE antibodies to Ves v 1 should always be included in the diagnostic workup.
背景:特异性IgE(sIgE)抗体的检测在蜜蜂和黄蜂毒液过敏的诊断中起着关键作用。近年来,已引入成分分辨诊断(CRD),它能够检测针对Api m 1、Ves v 1、Ves v 5和Pol d 5以及交叉反应性碳水化合物决定簇(CCD)的sIgE抗体。这些检测旨在帮助确定任何给定致敏反应的临床相关性,尤其是在双重致敏的患者中。 患者与方法:使用基于提取物的ImmunoCAP过敏原i1和i3以及ImmunoCAP过敏原成分i208 - 211和O214(Api m 1、Ves v 1、Ves v 5、Pol d 5、CCD),对143例蜜蜂和/或黄蜂毒液过敏患者进行特异性IgE抗体水平检测。对双重致敏的患者还进行了抑制试验。在研究人群的一个亚组中,使用ISAC过敏微阵列测定了对Api m 1、Api m 4、Pol d 5和Ves v 5的sIgE(n = 44)。 结果:孤立性黄蜂毒液过敏患者中Ves v 5的敏感性为78.5%;与Ves v 1联合时,该数字增至92.3%。孤立性蜜蜂毒液过敏个体中Api m 1的敏感性为25%。双重致敏个体的CRD和抑制试验结果存在差异。使用ISAC过敏微阵列的CRD显示出明显差异,尤其是在Api m 1和CCD方面。 结论:只要将成分分辨检测与既定程序结合使用,它们就是诊断方法的有价值补充。除了Ves v 5外,诊断检查中始终应包括检测针对Ves v 1的IgE抗体。
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