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Blank, S. ; Korosec, P.* ; Slusarenko, B.O. ; Ollert, M.* ; Hamilton, R.G.*

Venom component allergen IgE measurement in the diagnosis and management of insect sting allergy.

J. Allergy Clin. Immunol. Pract., DOI: 10.1016/j.jaip.2024.07.023 (2024)
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Accurate identification of the allergy-eliciting stinging insect(s) is essential to insuring effective management of Hymenoptera venom-allergic individuals with venom-specific immunotherapy (VIT). Diagnostic testing using whole venom extracts with skin tests and serological-based analyses remains the first level of discrimination for honeybee versus vespid venom sensitization in clinical history-positive patients. As a second-level evaluation, serological testing using molecular venom allergens can further discriminate genuine sensitization (honeybee venom: Api m 1, 3, 4, and 10 versus yellow jacket venom/Polistes dominula venom Ves v 1/Pol d 1 and Ves v 5/Pol d 5) from inter-species cross-reactivity [hyaluronidases (Api m 2, Ves v 2, Pol d 2) and dipeptidyl peptidases IV (Api m 5, Ves v 3, Pol d 3)]. Clinical laboratories use a number of singleplex, oligoplex, and multiplex immunoassays that employ both extracted whole venom and molecular venom allergens (highlighted above) for confirmation of allergic venom sensitization. Established quantitative singleplex autoanalyzers have general governmental regulatory clearance worldwide for venom allergic patient testing with maximally achievable analytical sensitivity (0.1 kUA/L) and confirmed reproducibility (inter-assay CVs<10%). Emerging oligo- and multiplex (fixed panel) assays conserve on serum and are more cost-effective, but they need regulatory clearance in some countries and are prone to higher rates of detecting asymptomatic sensitization. Ultimately, the patient's clinical history, combined with the proof of sensitization, is the final arbiter in the diagnosis of Hymenoptera venom allergy.
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Publication type Article: Journal article
Document type Review
Keywords Hymenoptera Venom Allergy ; Ige ; Component-resolved Diagnosis ; Molecular Diagnostics ; Venom Allergens
Language english
Publication Year 2024
HGF-reported in Year 2024
ISSN (print) / ISBN 2213-2198
e-ISSN 2213-2201
Publisher Elsevier
Publishing Place Amsterdam [u.a.]
Reviewing status Peer reviewed
POF-Topic(s) 30202 - Environmental Health
Research field(s) Allergy
PSP Element(s) G-505400-001
Scopus ID 85201499913
PubMed ID 39097146
Erfassungsdatum 2024-09-25