Prevalence of Pol d 1 Sensitization in Polistes dominula Allergy and Its Diagnostic Role in Vespid Double-Positivity.
CAP-inhibition
Cross-reactivity
Double-sensitization
Hymenoptera allergy
Phospholipase A1
Pol d 1
Pol d 5
Polistes
Venom immunotherapy
Vespid
Journal
The journal of allergy and clinical immunology. In practice
ISSN: 2213-2201
Titre abrégé: J Allergy Clin Immunol Pract
Pays: United States
ID NLM: 101597220
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
received:
03
04
2021
revised:
22
05
2021
accepted:
25
05
2021
pubmed:
20
6
2021
medline:
29
10
2021
entrez:
19
6
2021
Statut:
ppublish
Résumé
Stings by Polistes species frequently cause allergic reactions. However, standard allergy diagnostics are often unable to differentiate between primary sensitization and cross-reactivity in case of Vespula/Polistes double-sensitization because antigen 5 is the only Polistes venom molecule currently available in diagnostics (Pol d 5). To evaluate the frequency of phospholipase A1 in Polistes venom allergy (Pol d 1) and its diagnostic role in vespid allergy. We performed component-resolved diagnostics in patients with vespid allergic reactions who were positive to Polistes venom. A prevalence analysis was performed and the diagnostic accuracy of Pol d 1 was evaluated to detect primary Polistes sensitization in double-sensitized patients. Blood samples were collected from 132 patients. Pol d 1 was present in 97% to 100% of 128 Polistes-positive patients. It was frequently involved in case of positivity to a single Polistes molecule (48% in double- and 80% in mono-sensitized patients). Furthermore, Pol d 1 was positive in 95% of Pol d 5-negative subjects. The diagnostic accuracy of Pol d 1 was good (folded type: area under the curve = 87%; 82% sensitivity and 77% specificity at the best cutoff of 5.773), and even better when used combined with the whole extract ratio (area under the curve = 99%; 91% sensitivity and 100% specificity). The study shows that Pol d 1 is the most frequent Polistes allergen in Italian patients. It can distinguish Polistes primary sensitizations with good diagnostic accuracy, which supports its use in clinical practice.
Sections du résumé
BACKGROUND
Stings by Polistes species frequently cause allergic reactions. However, standard allergy diagnostics are often unable to differentiate between primary sensitization and cross-reactivity in case of Vespula/Polistes double-sensitization because antigen 5 is the only Polistes venom molecule currently available in diagnostics (Pol d 5).
OBJECTIVE
To evaluate the frequency of phospholipase A1 in Polistes venom allergy (Pol d 1) and its diagnostic role in vespid allergy.
METHODS
We performed component-resolved diagnostics in patients with vespid allergic reactions who were positive to Polistes venom. A prevalence analysis was performed and the diagnostic accuracy of Pol d 1 was evaluated to detect primary Polistes sensitization in double-sensitized patients.
RESULTS
Blood samples were collected from 132 patients. Pol d 1 was present in 97% to 100% of 128 Polistes-positive patients. It was frequently involved in case of positivity to a single Polistes molecule (48% in double- and 80% in mono-sensitized patients). Furthermore, Pol d 1 was positive in 95% of Pol d 5-negative subjects. The diagnostic accuracy of Pol d 1 was good (folded type: area under the curve = 87%; 82% sensitivity and 77% specificity at the best cutoff of 5.773), and even better when used combined with the whole extract ratio (area under the curve = 99%; 91% sensitivity and 100% specificity).
CONCLUSIONS
The study shows that Pol d 1 is the most frequent Polistes allergen in Italian patients. It can distinguish Polistes primary sensitizations with good diagnostic accuracy, which supports its use in clinical practice.
Identifiants
pubmed: 34146747
pii: S2213-2198(21)00660-7
doi: 10.1016/j.jaip.2021.05.033
pii:
doi:
Substances chimiques
Allergens
0
Wasp Venoms
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
3781-3787Informations de copyright
Copyright © 2021. Published by Elsevier Inc.