Comparable IgE reactivity to natural and recombinant Api m 1 in cross-reactive carbohydrate determinant–negative patients with bee venom allergy

Diagnostics in Hymenoptera venom allergy: current concepts and developments with special focus on molecular allergy diagnostics

“…It was speculated that IgE binding capacity of the recombinant Api m 1 used in the ImmunoCAP system may be diminished due to altered protein folding [49, 50]. However, this seems rather unlikely, since direct comparison of IgE reactivity to natural Api m 1 and to the recombinant Api m 1 on the ImmunoCAP system has been shown to be identical in CCD-negative sera [51]. Another suggested cause is possible variance in the interpolation calibration algorithm between the assays [49].…”

Insect Sting Allergy

“…16 The clinical relevance of CCD-reactive IgE antibodies in the case of insect venom allergy appears to be low or nonexistent. 20 By using CCD-free, correctly folded Ves v 2.0101 and Ves v 2.0201, it could also be demonstrated that hyaluronidases -contrary to previous assumptions -do not play a significant role as major allergens of YJV. 19 Recombinant allergens lack CCDs, allowing for a more precise distinction between true double sensitization and cross-reactivity between different venoms.…”

“…20 No immunologic criterion, such as skin test reactivity or titers of serum venom-specific IgE or IgG, distinguishes or identifies sting reactors from nonreactors. The younger the child, the more often they are (re)stung; in contrast, prevalence of systemic reactions to field stings was significantly lower in preschool (3.4%) and school-age children (4.3%) compared with adolescents (15.6%).…”

Key Issues in Hymenoptera Venom Allergy: An Update

“…In the case of wasps, it is necessary to use the allergens of the 2 insects to guarantee a good differential diagnosis [17]. The sensitivity of Api m 1 for the diagnosis with bee venom is highly variable and depends on the selection criteria for the population, the technique applied, and the type of molecule used [23][24][25][26]. In a recent study, the incorporation of new specific recombinant allergens from bee venom (Api m 2, Api m 3, Api m 4, Api m 5, and Api m 10) increased sensitivity to 95% and demonstrated that these allergens (with the exception of Api m 4) may also sensitize more than 50% of the population [8].…”