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.
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.
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).
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.
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.
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。
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）。
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。
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。
