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Objective: To define the sensitization pattern of patients with anaphylaxis to Vespa velutina nigrithorax (VVN). Methods: One-hundred consecutive Spanish patients with Hymenoptera anaphylaxis were studied. We systematically determined specific IgE (sIgE) to whole venoms (Vespula spp., Polistes dominula, Apis mellífera, Vespa crabro, Dolichovespula maculata) and their molecular components (rApi m 1, rApi m 5, rApi m 10, rVes v 1, rVes v 5, rPol d 5, cross-reactive carbohydrates). Specific IgE to VVN venom and its antigen-5 (nVesp v 5) were measured in a subsample. Results: Seventy-seven patients had VVN anaphylaxis. Of these, only 16 (20.8%) reported previous VVN stings but were stung by other Hymenoptera. Positive (>0.35 kU A /L) sIgE to each of the whole venoms was detected in >70% of patients (Vespula spp. in 100%). Components showing >50% positivity were rApi m 5 (51.4%), rPol d 5 (80.0%), and rVes v 5 (98.7%). This pattern was similar to that of patients with Vespula spp. anaphylaxis (n=11) but different from that of Apis mellifera anaphylaxis (n=10). Specific IgE to nVesp v 5 was positive in all studied patients (n=15) with VVN anaphylaxis and was correlated with sIgE to both rVes v 5 (R=0.931) and rPol d 5 (R=0.887). Conclusions: VVN has become the commonest cause of Hymenoptera anaphylaxis in our area. Most cases report no previous VVN stings. Their sensitization pattern is similar to that of patients with anaphylaxis to other Vespidae. Specific IgE to antigen-5 from VVN, Vespula spp., and Polistes dominula are strongly correlated in patients with VVN anaphylaxis.

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Background: Immunoglobulin E (IgE) to N-glycans from plant and invertebrate glycoproteins induces extensive in vitro cross-reactivity. This study investigates the prevalence and diagnostic relevance of IgE to these N-glycans [cross-reactive carbohydrate determinants (CCDs)] in patients with suspicion of respiratory allergy. Methods: A total of 1,025 adult subjects with symptoms of rhinitis and/or asthma from a reference allergy clinic were studied. Determinations included a structured questionnaire, skin prick tests (SPT), total IgE, a multiallergen IgE test and specific IgE (sIgE) to bromelain, MUXF (the bromelain-type N-glycan) and honeybee phospholipase-A2. Inhibition studies with CCDs were performed in selected cases. Results: The prevalence of CCD sensitization (MUXF sIgE and/or bromelain-sIgE ≧0.1 kU_A/l) was 18.0%. Male sex and atopy (SPT positivity) were associated with CCD sensitization. Sensitization was more frequent in patients sensitized to pollens than in those sensitized to mites, the most common inhalant allergens in the area. A history of Hymenoptera stings was associated with CCD sensitization and multiallergen IgE test positivity. CCD sensitization was not significantly associated with age, rural residence, alcohol consumption or smoking. Only 58 patients (5.6%) showed CCD-sIgE levels ≧0.35 kU_A/l. CCD-induced inhibition of pollen-sIgE or mite-sIgE in patients with respective positive SPT was minimal or absent in most cases. Conclusions: In this population of predominantly mite-allergic patients, CCD sensitization is relatively rare and CCD-sIgE levels are low. Thus, CCDs do not represent a major obstacle for the diagnosis of respiratory allergy in a specialized setting. Hymenoptera stings are associated with CCD sensitization.

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