Recombinant allergen-based IgE testing to distinguish bee and wasp allergy - 07/08/11
Reprint requests: Rudolf Valenta, MD, Division of Immunopathology, Department of Pathophysiology, Center for Physiology and Pathophysiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.Abstract |
Background |
The identification of the disease-causing insect in venom allergy is often difficult.
Objective |
To establish recombinant allergen-based IgE tests to diagnose bee and yellow jacket wasp allergy.
Methods |
Sera from patients with bee and/or wasp allergy (n = 43) and patients with pollen allergy with false-positive IgE serology to venom extracts were tested for IgE reactivity in allergen extract-based tests or with purified allergens, including nonglycosylated Escherichia coli–expressed recombinant (r) Api m 1, rApi m 2, rVes v 5, and insect cell–expressed, glycosylated rApi m 2 as well as 2 natural plant glycoproteins (Phl p 4, bromelain).
Results |
The patients with venom allergy could be diagnosed with a combination of E coli–expressed rApi m 1, rApi m 2, and rVes v 5 whereas patients with pollen allergy remained negative. For a group of 29 patients for whom the sensitizing venom could not be identified with natural allergen extracts, testing with nonglycosylated allergens allowed identification of the sensitizing venom. Recombinant nonglycosylated allergens also allowed definition of the sensitizing venom for those 14 patients who had reacted either with bee or wasp venom extracts. By IgE inhibition studies, it is shown that glycosylated Api m 2 contains carbohydrate epitopes that cross-react with natural Api m 1, Ves v 2, natural Phl p 4, and bromelain, thus identifying cross-reactive structures responsible for serologic false-positive test results or double-positivity to bee and wasp extracts.
Conclusion |
Nonglycosylated recombinant bee and wasp venom allergens allow the identification of patients with bee and wasp allergy and should facilitate accurate prescription of venom immunotherapy.
Le texte complet de cet article est disponible en PDF.Key words : Venom allergy, recombinant allergen, in vitro diagnosis, glycosylation
Abbreviations used : n, r, VIT
Plan
| Supported by the Christian Doppler Research Association, Phadia, Uppsala, Sweden and Biomay, Vienna, Austria. |
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| Disclosure of potential conflict of interest: R. Valenta receives research support from the Austrian Science Fund, the Christian Doppler Research Association, Phadia, and Biomay. The rest of the authors have declared that they have no conflict of interest. |
Vol 125 - N° 6
P. 1300 - juin 2010 Retour au numéro
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