Gunasekara Peshala, Handunnetti S M, Premawansa Sunil, Witharana E W R A, Ratnayake Indra P, Kaluarachchi Pradeep, Karunatilake Chandima, Dias R K S, Premakumara G A S, Dasanayake W M D K, Seneviratne Suranjith L, de Silva Rajiva
Institute of Biochemistry, Molecular Biology and Biotechnology, University of Colombo, Colombo 3, Sri Lanka.
Department of Zoology and Environment Sciences, Faculty of Science, University of Colombo, Colombo 3, Sri Lanka.
Clin Mol Allergy. 2022 Sep 14;20(1):11. doi: 10.1186/s12948-022-00178-9.
Allergy to Apis dorsata (Giant Asian Honeybee) venom is the commonest insect allergy in Sri Lanka and South East Asia. However, laboratory diagnosis is difficult as the pure venom and diagnostic reagents are not commercially available.
This study assessed the use of four recombinant allergens of A. mellifera venom and the passive basophil activation test in the diagnosis of A. dorsata venom anaphylaxis.
Serum IgE levels to four recombinant allergens of A. mellifera, rApi m 1, 2, 5 and 10 were assessed and compared with serum IgE to the crude venom of A. mellifera or V. vulgaris by Phadia ImmunoCAP, in patients who developed anaphylaxis to A. dorsata stings. Basophil activation in response to venom of A. dorsata or V. affinis was assessed using a passive basophil activation test. Association of the severity of the reaction with basophil activation was compared.
rApi m 1 and 10 combinedly had significant correlation (r = 0.722; p < 0.001) with the crude venom of A. mellifera (Western honeybee) and a higher positivity rate of 90% (27/30). Whereas, IgE reactivity to rApi m 2 or 5 had significant correlation (p = 0.02 and p = 0.005 respectively) with V. vulgaris crude venom. All 30 (100%) were positive to A. dorsata venom in passive BAT; 70% (21/30) had over 80% activation, 96.7% (29/30) had over 60% activation and 100% had over 50% activation. Percentage activation of basophils in patients who had mild or moderate reactions (n = 20) was significantly low (p = 0.02) from that of patients who had severe reactions (n = 10).
rApi m 1 and 10 when combined was sensitive for the diagnosis of A. dorsata allergy. This combination had the lowest cross-reactivity rate with Vespula vulgaris. The passive BAT is highly sensitive in A. dorsata allergy. The basophil reactivity was significantly higher in severe anaphylaxis compared to mild/moderate anaphylaxis. This finding should be further explored in further studies.
对大蜜蜂（亚洲巨型蜜蜂）毒液过敏是斯里兰卡和东南亚最常见的昆虫过敏。然而，由于纯毒液和诊断试剂没有商业供应，实验室诊断很困难。
本研究评估了意大利蜜蜂毒液的四种重组变应原和被动嗜碱性粒细胞活化试验在诊断大蜜蜂毒液过敏反应中的应用。
通过Phadia ImmunoCAP检测对意大利蜜蜂的四种重组变应原rApi m 1、2、5和10的血清IgE水平，并与对意大利蜜蜂或普通黄蜂粗毒液的血清IgE进行比较，这些患者对大蜜蜂蜇刺发生了过敏反应。使用被动嗜碱性粒细胞活化试验评估对大蜜蜂或近缘黄蜂毒液的嗜碱性粒细胞活化。比较反应严重程度与嗜碱性粒细胞活化的相关性。
rApi m 1和10与意大利蜜蜂（西方蜜蜂）的粗毒液联合有显著相关性（r = 0.722；p < 0.001），阳性率较高，为90%（27/30）。而对rApi m 2或5的IgE反应性与普通黄蜂粗毒液有显著相关性（分别为p = 0.02和p = 0.005）。在被动嗜碱性粒细胞活化试验中，所有30例（100%）对大蜜蜂毒液呈阳性；70%（21/30）活化超过80%，96.7%（29/30）活化超过60%，100%活化超过50%。轻度或中度反应患者（n = 20）的嗜碱性粒细胞活化百分比显著低于重度反应患者（n = 10）（p = 0.02）。
rApi m 1和10联合对诊断大蜜蜂过敏敏感。这种组合与普通黄蜂的交叉反应率最低。被动嗜碱性粒细胞活化试验对大蜜蜂过敏高度敏感。重度过敏反应中的嗜碱性粒细胞反应性明显高于轻度/中度过敏反应。这一发现应在进一步研究中进一步探索。
