Basophil Activation Test in Double-Sensitized Patients With Hymenoptera Venom Allergy: Additional Benefit of Component-Resolved Diagnostics.


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:
09 2023
Historique:
received: 22 02 2023
revised: 10 05 2023
accepted: 01 06 2023
medline: 11 9 2023
pubmed: 12 6 2023
entrez: 11 6 2023
Statut: ppublish

Résumé

In Hymenoptera venom allergy serologically double-sensitized patients, it is often difficult to identify the culprit insect for venom immunotherapy (VIT). To evaluate if basophil activation tests (BATs) performed not only with venom extracts but additionally with single component-resolved diagnostics could differentiate between sensitized and allergic individuals and how the test results influenced the physicians' decision regarding VIT. BATs were performed with bee and wasp venom extracts and with single components (Api m 1, Api m 10, Ves v 1, and Ves v 5) in 31 serologically double-sensitized patients. In 28 finally included individuals, 9 BATs were positive and 4 negative for both venoms. Fourteen of 28 BATs showed positive results for wasp venom alone. Two of 10 BATs positive for bee venom were only positive to Api m 1 and 1 of 28 BATs only to Api m 10, but not for whole bee venom extract. Five of 23 BATs positive for wasp venom were only positive for Ves v 5 but negative for wasp venom extract and Ves v 1. Finally, VIT with both insect venoms was recommended in 4 of 28 individuals, with wasp venom alone in 21 of 28 patients and with bee venom alone in 1 of 28. In 2 cases no VIT was recommended. BATs with Ves v 5, followed by Api m 1 and Api m 10, were helpful for the decision for VIT with the clinically relevant insect in 8 of 28 (28.6%) patients. A BAT with components should therefore be additionally carried out in cases with equivocal results.

Sections du résumé

BACKGROUND
In Hymenoptera venom allergy serologically double-sensitized patients, it is often difficult to identify the culprit insect for venom immunotherapy (VIT).
OBJECTIVES
To evaluate if basophil activation tests (BATs) performed not only with venom extracts but additionally with single component-resolved diagnostics could differentiate between sensitized and allergic individuals and how the test results influenced the physicians' decision regarding VIT.
METHODS
BATs were performed with bee and wasp venom extracts and with single components (Api m 1, Api m 10, Ves v 1, and Ves v 5) in 31 serologically double-sensitized patients.
RESULTS
In 28 finally included individuals, 9 BATs were positive and 4 negative for both venoms. Fourteen of 28 BATs showed positive results for wasp venom alone. Two of 10 BATs positive for bee venom were only positive to Api m 1 and 1 of 28 BATs only to Api m 10, but not for whole bee venom extract. Five of 23 BATs positive for wasp venom were only positive for Ves v 5 but negative for wasp venom extract and Ves v 1. Finally, VIT with both insect venoms was recommended in 4 of 28 individuals, with wasp venom alone in 21 of 28 patients and with bee venom alone in 1 of 28. In 2 cases no VIT was recommended.
CONCLUSIONS
BATs with Ves v 5, followed by Api m 1 and Api m 10, were helpful for the decision for VIT with the clinically relevant insect in 8 of 28 (28.6%) patients. A BAT with components should therefore be additionally carried out in cases with equivocal results.

Identifiants

pubmed: 37302791
pii: S2213-2198(23)00650-5
doi: 10.1016/j.jaip.2023.06.007
pii:
doi:

Substances chimiques

Arthropod Venoms 0
Allergens 0
Wasp Venoms 0
Immunoglobulin E 37341-29-0
Bee Venoms 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2890-2899.e2

Informations de copyright

Copyright © 2023 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Auteurs

Paul Schmidle (P)

Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University of Munich, Munich, Germany.

Simon Blank (S)

Center of Allergy and Environment (ZAUM), Technical University of Munich, School of Medicine and Helmholtz Center Munich, German Research Center for Environmental Health, Munich, Germany.

Sabine Altrichter (S)

Department of Dermatology and Venerology, Kepler University Hospital, Linz, Austria.

Wolfram Hoetzenecker (W)

Department of Dermatology and Venerology, Kepler University Hospital, Linz, Austria.

Knut Brockow (K)

Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University of Munich, Munich, Germany.

Ulf Darsow (U)

Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University of Munich, Munich, Germany.

Tilo Biedermann (T)

Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University of Munich, Munich, Germany.

Bernadette Eberlein (B)

Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University of Munich, Munich, Germany. Electronic address: bernadette.eberlein@tum.de.

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Classifications MeSH