Antibody binding to venom carbohydrates is a frequent cause for double positivity to honeybee and yellow jacket venom in patients with stinging-insect allergy

Structure of recombinant Ves v 2 at 2.0 Å resolution: structural analysis of an allergenic hyaluronidase from wasp venom

“…Previous studies have shown that venom-allergic individuals can develop IgE antibodies against specific carbohydrate structures. The N-glycan structures containing -1,3-linked fucose residues at the glycan core have been suggested to be involved in this type of IgE-mediated cross-reactivity and thus are considered to be a major cause of in vitro double positivity in honeybee and vespid-allergic individuals (Hemmer et al, 2001(Hemmer et al, , 2004. Interestingly, in the present study only one site at Asn99 was found to carry this type of N-glycan.…”

“…Here, we report the cloning, expression, biochemical characterization and crystal structure determination of recombinant Ves v 2 (rVes v 2). In addition, the glycosylation sites of natural Ves v 2 (nVes v 2) were investigated, since cross-reactivity between venom allergens owing to carbohydrate-specific IgE has been demonstrated (Hemmer et al, 2001). …”

Coping with cross-reactive carbohydrate determinants in allergy diagnosis

“…A particular problem is the assignment of the culprit insect in the case of apparent double sensitization against bee and wasp venom, which o en is solely based on CCD cross-reactivity and only rarely a true double sensitization [22]. Nine years later, the idea of the innocence of CCDs consolidated further and Hemmer wrote "For the time being, we appreciate judging these antibodies as clinically insigni cant as a useful hypothesis, ..." [23].…”

Measurement of Hymenoptera Venom Specific IgE by the Immulite 3gAllergy in Subjects with Negative or Positive Results by Immunocap

“…One patient sample that was CAP-negative yielded a low positiveresult according to IMMULITE. This single IMMULITE low positiveresult could represent a false positive resulting from cross-reactivity to an antigen similar to Hymenoptera venom, possibly as a result of involvement of cross-reactive carbohydrate determinants (CCD) as described by Hemmer et al [17]. Alternatively, it may actually reflect a true positive-result in a participant who had sustained a previous sting or stings, but had no recollection or record of it.…”