IgE-Api m 4 Is Useful for Identifying a Particular Phenotype of Bee Venom Allergy

Ruiz, Berta; Serrano, Pilar; Moreno‐Aguilar, Carmen

doi:10.18176/jiaci.0053

Cited by 29 publications

(26 citation statements)

References 22 publications

(37 reference statements)

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“…260 Interestingly, treatment with one allergen resulted in a reduction of IgE to the second in cases of double sensitization. Api m 4 was found to be a useful marker to identify bee venom allergy, 50,261 and sensitization to Api m 10 poses a risk for failure of bee venom AIT. Consistent with this, Api m 10 was underrepresented in 3 of 5 therapeutic HBV commercial preparations.…”

Section: Hymenoptera and Insectsmentioning

confidence: 99%

A WAO — ARIA — GA2LEN consensus document on molecular-based allergy diagnosis (PAMD@): Update 2020

Ansotegui¹,

Melioli²,

Canonica³

et al. 2020

World Allergy Organization Journal

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Precision allergy molecular diagnostic applications (PAMD@) is increasingly entering routine care. Currently, more than 130 allergenic molecules from more than 50 allergy sources are commercially available for in vitro specific immunoglobulin E (sIgE) testing. Since the last publication of this consensus document, a great deal of new information has become available regarding this topic, with over 100 publications in the last year alone. It thus seems quite reasonable to publish an update. It is imperative that clinicians and immunologists specifically trained in allergology keep abreast of the new and rapidly evolving evidence available for PAMD@. PAMD@ may initially appear complex to interpret; however, with increasing experience, the information gained provides relevant information for the allergist. This is especially true for food allergy, Hymenoptera allergy, and for the selection of allergen immunotherapy. Nevertheless, all sIgE tests, including PAMD@, should be evaluated within the framework of a patient's clinical history, because allergen sensitization does not necessarily imply clinical relevant allergies.

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Section: Hymenoptera and Insectsmentioning

confidence: 99%

A WAO — ARIA — GA2LEN consensus document on molecular-based allergy diagnosis (PAMD@): Update 2020

Ansotegui¹,

Melioli²,

Canonica³

et al. 2020

World Allergy Organization Journal

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“…Total or specific IgE levels including specific IgE to recombinant venom marker allergens, however, were not confirmed as independent indicators of severe sting‐induced anaphylaxis . Predominant Api m 4‐specific sensitization was proposed to be an indicator of more severe sting reactions by one group . Skin test negativity despite a convincing history of a systemic sting reaction is considered a common finding in coexisting mastocytosis, but has not been characterized as an independent predictor of severe sting‐induced anaphylaxis.…”

Section: Diagnostic Testsmentioning

confidence: 95%

Risk factors and indicators of severe systemic insect sting reactions

Stoevesandt

Sturm

Bonadonna

et al. 2019

Allergy

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Hymenoptera venom allergy ranks among the top three causes of anaphylaxis worldwide, and approximately one‐quarter of sting‐induced reactions are classified as severe. Fatal sting reactions are exceedingly rare, but certain factors may entail a considerably higher risk. Delayed administration of epinephrine and upright posture are situational risk factors which may determine an unfavorable outcome of the acute anaphylactic episode and should be addressed during individual patient education. Systemic mastocytosis and senior age are major, unmodifiable long‐term risk factors and thus reinforce the indication for venom immunotherapy. Vespid venom allergy and male sex likewise augment the risk of severe or even fatal reactions. Further studies are required to assess the impact of specific cardiovascular comorbidities. Available data regarding potential effects of beta‐blockers and/or ACE inhibitors in coexisting venom allergy are inconclusive and do not justify recommendations to discontinue guideline‐directed antihypertensive treatment. The absence of urticaria/angioedema during sting‐induced anaphylaxis is indicative of a severe reaction, serum tryptase elevation, and mast cell clonality. Determination of basal serum tryptase levels is an established diagnostic tool for risk assessment in Hymenoptera venom‐allergic patients. Measurement of platelet‐activating factor acetylhydrolase activity represents a complementary approach but is not available for routine diagnostic use.

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“…Interestingly, recent studies have shown that Api m 4 sensitization might be a useful marker to identify a particular phenotype of HBV allergy that is associated with a higher risk of systemic reactions during the up-dosing phase of VIT [85,86]. However, it has to be taken into account that in these studies the number of patients was very small and that no other known risk factors for side effects were considered.…”

Section: Accepted Articlementioning

confidence: 99%

Component‐resolved diagnostics to direct in venom immunotherapy: Important steps towards precision medicine

Blank

Bilò

Ollert

2018

Clin Experimental Allergy

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Stings of Hymenoptera can induce IgE-mediated systemic and even fatal allergic reactions. Venom-specific immunotherapy (VIT) is the only disease-modifying and curative treatment of venom allergy. However, choosing the correct venom for VIT represents a necessary prerequisite for efficient protection against further anaphylactic sting reactions after VIT. In the past, therapeutic decisions based on the measurement of specific IgE (sIgE) levels to whole venom extracts were not always straightforward, especially when the patient was not able to identify the culprit insect. In the last years, the increasing knowledge about the molecular structure and relevance of important venom allergens and their availability as recombinant allergens, devoid of cross-reactive carbohydrate determinants, resulted in the development of an advanced component-resolved diagnostics (CRD) approach in venom allergy. Already to date, CRD has increased the sensitivity of sIgE detection and enabled the discrimination between primary sensitization and cross-reactivity, particularly in patients with sensitization to both honeybee and vespid venom. Hence, CRD in many patients improves the selection of the appropriate immunotherapeutic intervention. Moreover, the detailed knowledge about sensitization profiles on a molecular level might open new options to identify patients who are at increased risk of side-effects or not to respond to immunotherapy. Therefore, increasing potential of CRD becomes evident, to direct therapeutic decisions in a personalized and patient-tailored manner. Reviewed here are the state of the art options, recent developments and future perspectives of CRD of Hymenoptera venom allergy.

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IgE-Api m 4 Is Useful for Identifying a Particular Phenotype of Bee Venom Allergy

Cited by 29 publications

References 22 publications

A WAO — ARIA — GA2LEN consensus document on molecular-based allergy diagnosis (PAMD@): Update 2020

A WAO — ARIA — GA2LEN consensus document on molecular-based allergy diagnosis (PAMD@): Update 2020

Risk factors and indicators of severe systemic insect sting reactions

Component‐resolved diagnostics to direct in venom immunotherapy: Important steps towards precision medicine

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