Schäfer T, Przybilla B
Hautklinik am Universitätskrankenhaus Eppendorf, Hamburg, Germany.
Allergy. 1996 Jun;51(6):372-7.
Determination of Hymenoptera venom (HV)-specific serum IgE antibodies is a useful diagnostic method in patients with systemic anaphylactic reaction (SAR) to Hymenoptera stings. In a general population cohort, we determined the prevalence of SAR and HV-specific IgE antibodies and assessed parameters associated with the latter. A total of 277 voluntarily participating inhabitants of rural Bavaria (Germany) (232 adults, mean age 38.0 years; 45 children, mean age 8.4 years) were investigated for a history of atopic disease or SAR to insect stings; in 258 of these, total IgE and specific IgE antibodies to HV (Apis mellifera, Vespula vulgaris/germanica) and four common aeroallergens (birch pollen, grass pollen, house-dust mite, and cat dander) in the serum were determined. Nine (3.3%) subjects reported SAR to insect stings. In 27.1% of the sera, specific IgE antibodies to HV were found, to bee venom in 24.8%, and to wasp venom in 8.5% (P < 0.0001). Of those exhibiting HV-specific IgE, 7.1% reported SAR to insect stings. A personal history of atopic disease (hay fever, asthma, or atopic eczema) was present in 16.7%, specific IgE to common aeroallergens was found in 32.6%, and total IgE > 100 kU/l was found in 22.5%. Specific serum IgE to HV was significantly associated with male sex (female vs. male, OR = 0.47; CI 0.25-0.86), young age (children vs. adults, OR = 2.80; CI 1.25-6.28), a history of SAR to insect stings (OR = 4.16; CI 1.15-15.03), total sIgE > 100 kU/l (OR = 3.88; CI 1.98-7.60), and specific IgE antibodies to three of the four aeroallergens (grass pollen, OR = 7.24 CI 3.66-14.38; birch pollen, OR = 3.67 CI 1.54-8.81; and house-dust mite, OR = 4.61 CI 2.08-10.32). It is concluded that immunologic sensitization to HV is common in the general population and is associated with atopy-related humoral IgE hyperresponsiveness.
对于对膜翅目昆虫叮咬发生全身性过敏反应（SAR）的患者，检测膜翅目昆虫毒液（HV）特异性血清IgE抗体是一种有用的诊断方法。在一个普通人群队列中，我们确定了SAR和HV特异性IgE抗体的患病率，并评估了与后者相关的参数。对德国巴伐利亚农村地区277名自愿参与的居民（232名成年人，平均年龄38.0岁；45名儿童，平均年龄8.4岁）进行了特应性疾病史或昆虫叮咬所致SAR史的调查；其中258人的血清中检测了总IgE以及针对HV（意大利蜜蜂、普通黄胡蜂/德国黄胡蜂）和四种常见气传变应原（桦树花粉、草花粉、屋尘螨和猫皮屑）的特异性IgE抗体。9名（3.3%）受试者报告有昆虫叮咬所致SAR。在27.1%的血清中发现了针对HV的特异性IgE抗体，其中针对蜂毒的为24.8%，针对黄蜂毒液的为8.5%（P<0.0001）。在那些表现出HV特异性IgE的人中，7.1%报告有昆虫叮咬所致SAR。16.7%的人有特应性疾病（花粉症、哮喘或特应性皮炎）个人史，32.6%的人发现了针对常见气传变应原的特异性IgE，22.5%的人总IgE>100 kU/l。血清中针对HV的特异性IgE与男性性别（女性与男性相比，OR = 0.47；CI 0.25 - 0.86）、年轻年龄（儿童与成年人相比，OR = 2.80；CI 1.25 - 6.28）、昆虫叮咬所致SAR史（OR = 4.16；CI 1.15 - 15.03）、总sIgE>100 kU/l（OR = 3.88；CI 1.98 - 7.60）以及针对四种气传变应原中三种的特异性IgE抗体（草花粉，OR = 7.24 CI 3.66 - 14.38；桦树花粉，OR = 3.67 CI 1.54 - 8.81；屋尘螨，OR = 4.61 CI 2.08 - 10.32）显著相关。结论是，普通人群中对HV的免疫致敏很常见，且与特应性相关的体液IgE高反应性有关。
