Improved recombinant Api m 1‐ and Ves v 5‐based IgE testing to dissect bee and yellow jacket allergy and their correlation with the severity of the sting reaction. Issue 4 (April 2016)

• Record Type: Journal Article
• Authors: Šelb, J.; Kogovšek, R.; Šilar, M.; Košnik, M.; Korošec, P.
• Is Part Of: Clinical & experimental allergy. Volume 46:Issue 4(2016:Apr.)
• Page Start: 621
• Page End: 630
• Publication Date: 2016-04
• Subjects: rApi m 1 -- rVes v 5 -- ImmunoCAP -- Immulite -- enhanced sensitivity -- comparison; Allergy -- Periodicals; Immunology -- Periodicals; 616.97
• DOI: 10.1111/cea.12639
• Languages: English
• ISSNs: 0954-7894

Abstract

Summary: Background: No study has assessed the diagnostic sensitivity of rApi m 1 and rVes v 5 on Immulite testing system. Objective: To compare the diagnostic sensitivity of commercially available venom recombinant allergens between the currently available immunoassays [ImmunoCAP (CAP) and Immulite (LITE)] and establish their correlation with the severity of the sting reaction. Methods: This study evaluated 95 bee venom and 110 yellow jacket venom‐allergic subjects. We measured the levels of sIgE to rApi m 1, rVes v 5 (LITE and CAP), rApi m 2 (LITE), rVes v 1 (CAP) and total IgE (CAP). Forty‐nine healthy subjects served as controls. Results: The diagnostic sensitivity of rApi m 1 and rVes v 5 was significantly higher with the LITE than with the CAP system (71% vs. 88% and 82% vs. 93%). The specificity of both assays for both allergens was between 94% and 98%. Twenty‐nine patients that tested negative for rApi m 1 or rVes v 5 with CAP were positive with LITE, but none of the patients that tested negative with LITE were positive with CAP. The positive values of rApi m 1 and rVes v 5 were on average 2.7 and 2.3 times higher, with the LITE than with the CAP system. The combination of rApi m 1 and rApi m 2 (LITE) and the combination of rVes v 5 (LITE) and rVes v 1 (CAP) almost matched the sensitivity of native venoms (95% and 97%, respectively), whereas the diagnostic sensitivity of the combination of rVes v 5 and rVes v 1 (CAP) did not reach the sensitivity of rVes v 5 (LITE) alone (90% vs. 93%). IgE levels to venom recombinants and total IgE did not correlate with the severity of sting reaction. Conclusions & Clinical Relevance: The use of rApi m 1 and rVes v 5 with the LITE system significantly enhanced diagnostic utility of venom recombinants and should improve the dissection of bee and yellow jacket venom allergy.