Clinical features and the diagnostic value of component allergen-specific IgE in hymenoptera venom allergy

Yoo Seob Shin, Jing Nan Liu, Gyu Young Hur, Eui Kyung Hwang, Young Hee Nam, Hyun Jung Jin, Sang Min Lee, Young Min Ye, Dong Ho Nahm, Hae Sim Park

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose: Although patient history is vital for the diagnosis of hymenoptera venom allergy, specific IgE detection is also important to identify the culprit insect and monitor the effect of immunotherapy. We evaluated the diagnostic value of serum-specific IgE detection of hymenoptera venom component allergens and documented changes in allergen-specific IgE after immunotherapy. Methods: Fifty-six hymenoptera venom allergy patients receiving venom immunotherapy were recruited from Ajou University Hospital, Korea. The clinical manifestations of the patients were noted, and serum-specific IgE detection was performed, using conventional venom extracts as well as component allergens. Data were analyzed retrospectively. Results: A total of 35 (62.5%) patients were male, and 33 (73.3%) patients were atopic. The mean patient age was 44.9±13.8 years. Localized reactions occurred in 23.2% of patients, and systemic reactions occurred in 76.8%. The most common clinical manifestations included skin involvement, such as urticaria and angioedema, and respiratory involvement. Yellow jackets were the most frequent culprit insect, followed by yellow hornets, white-faced hornets, honeybees, and paper wasps, as determined at the time of diagnosis. Double sensitization to both Apidae and Vespidae species was detected in 70.9% of patients. The positive predictive values (PPV) of rVes v 5-specific and rPol d 5-specific IgE detection were85.7% and 87.5%, respectively, which correlated well with conventional venom extract-specific IgE detection (r=0.762 and r=0.757, respectively). In contrast, the PPV of rApi m 1-specific IgE detection at the time of diagnosis was 34.8%. Threeyears of venom immunotherapy resulted in decreased venom-specific IgE, particularly IgE specific for Vespidae venom components. Conclusions: Stings by yellow jackets and male sex may be risk factors for hymenoptera venom allergy in Korea. Vespidae component-specific IgE, but not Apidae component-specific IgE, had diagnostic and monitoring value in hymenopteravenom allergy comparable to that of conventional hymenoptera venom extract-specific IgE.

Original languageEnglish
Pages (from-to)284-289
Number of pages6
JournalAllergy, Asthma and Immunology Research
Volume4
Issue number5
DOIs
Publication statusPublished - 2012 Sep 1

Fingerprint

Hymenoptera
Venoms
Allergens
Immunoglobulin E
Hypersensitivity
Wasps
Immunotherapy
Bees
Korea
Insects
Skin Manifestations
Angioedema
Urticaria
Bites and Stings
Serum

Keywords

  • Component-resolved diagnosis
  • Hymenoptera venom
  • Immunotherapy

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Pulmonary and Respiratory Medicine

Cite this

Clinical features and the diagnostic value of component allergen-specific IgE in hymenoptera venom allergy. / Shin, Yoo Seob; Liu, Jing Nan; Hur, Gyu Young; Hwang, Eui Kyung; Nam, Young Hee; Jin, Hyun Jung; Lee, Sang Min; Ye, Young Min; Nahm, Dong Ho; Park, Hae Sim.

In: Allergy, Asthma and Immunology Research, Vol. 4, No. 5, 01.09.2012, p. 284-289.

Research output: Contribution to journalArticle

Shin, Yoo Seob ; Liu, Jing Nan ; Hur, Gyu Young ; Hwang, Eui Kyung ; Nam, Young Hee ; Jin, Hyun Jung ; Lee, Sang Min ; Ye, Young Min ; Nahm, Dong Ho ; Park, Hae Sim. / Clinical features and the diagnostic value of component allergen-specific IgE in hymenoptera venom allergy. In: Allergy, Asthma and Immunology Research. 2012 ; Vol. 4, No. 5. pp. 284-289.
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AU - Nam, Young Hee

AU - Jin, Hyun Jung

AU - Lee, Sang Min

AU - Ye, Young Min

AU - Nahm, Dong Ho

AU - Park, Hae Sim

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N2 - Purpose: Although patient history is vital for the diagnosis of hymenoptera venom allergy, specific IgE detection is also important to identify the culprit insect and monitor the effect of immunotherapy. We evaluated the diagnostic value of serum-specific IgE detection of hymenoptera venom component allergens and documented changes in allergen-specific IgE after immunotherapy. Methods: Fifty-six hymenoptera venom allergy patients receiving venom immunotherapy were recruited from Ajou University Hospital, Korea. The clinical manifestations of the patients were noted, and serum-specific IgE detection was performed, using conventional venom extracts as well as component allergens. Data were analyzed retrospectively. Results: A total of 35 (62.5%) patients were male, and 33 (73.3%) patients were atopic. The mean patient age was 44.9±13.8 years. Localized reactions occurred in 23.2% of patients, and systemic reactions occurred in 76.8%. The most common clinical manifestations included skin involvement, such as urticaria and angioedema, and respiratory involvement. Yellow jackets were the most frequent culprit insect, followed by yellow hornets, white-faced hornets, honeybees, and paper wasps, as determined at the time of diagnosis. Double sensitization to both Apidae and Vespidae species was detected in 70.9% of patients. The positive predictive values (PPV) of rVes v 5-specific and rPol d 5-specific IgE detection were85.7% and 87.5%, respectively, which correlated well with conventional venom extract-specific IgE detection (r=0.762 and r=0.757, respectively). In contrast, the PPV of rApi m 1-specific IgE detection at the time of diagnosis was 34.8%. Threeyears of venom immunotherapy resulted in decreased venom-specific IgE, particularly IgE specific for Vespidae venom components. Conclusions: Stings by yellow jackets and male sex may be risk factors for hymenoptera venom allergy in Korea. Vespidae component-specific IgE, but not Apidae component-specific IgE, had diagnostic and monitoring value in hymenopteravenom allergy comparable to that of conventional hymenoptera venom extract-specific IgE.

AB - Purpose: Although patient history is vital for the diagnosis of hymenoptera venom allergy, specific IgE detection is also important to identify the culprit insect and monitor the effect of immunotherapy. We evaluated the diagnostic value of serum-specific IgE detection of hymenoptera venom component allergens and documented changes in allergen-specific IgE after immunotherapy. Methods: Fifty-six hymenoptera venom allergy patients receiving venom immunotherapy were recruited from Ajou University Hospital, Korea. The clinical manifestations of the patients were noted, and serum-specific IgE detection was performed, using conventional venom extracts as well as component allergens. Data were analyzed retrospectively. Results: A total of 35 (62.5%) patients were male, and 33 (73.3%) patients were atopic. The mean patient age was 44.9±13.8 years. Localized reactions occurred in 23.2% of patients, and systemic reactions occurred in 76.8%. The most common clinical manifestations included skin involvement, such as urticaria and angioedema, and respiratory involvement. Yellow jackets were the most frequent culprit insect, followed by yellow hornets, white-faced hornets, honeybees, and paper wasps, as determined at the time of diagnosis. Double sensitization to both Apidae and Vespidae species was detected in 70.9% of patients. The positive predictive values (PPV) of rVes v 5-specific and rPol d 5-specific IgE detection were85.7% and 87.5%, respectively, which correlated well with conventional venom extract-specific IgE detection (r=0.762 and r=0.757, respectively). In contrast, the PPV of rApi m 1-specific IgE detection at the time of diagnosis was 34.8%. Threeyears of venom immunotherapy resulted in decreased venom-specific IgE, particularly IgE specific for Vespidae venom components. Conclusions: Stings by yellow jackets and male sex may be risk factors for hymenoptera venom allergy in Korea. Vespidae component-specific IgE, but not Apidae component-specific IgE, had diagnostic and monitoring value in hymenopteravenom allergy comparable to that of conventional hymenoptera venom extract-specific IgE.

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