Recombinant Allergen Components Secure Optimal Immunotherapy Treating Venom Allergy

UPPSALA, Sweden, June 14, 2011 -

Precise assessment of patients with allergy to bee and wasp
venoms helps allergists to identify the optimal venom immunotherapy
(VIT) in each case. Molecular Allergology with recombinant allergen
components facilitate the process by making it easier to
differentiate between “true“ allergies
and cross reactivity.

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This information was disclosed at the European Academy of Allergy
and Clinical Immunology (EAACI) held in Istanbul 11 - 15 June,
2011.    

- Making the right decision can be crucial and life saving in
cases of insect venom allergy, says professor, dr Thilo Jakob,
allergist at the University Medical Center in Freiburg,
Germany.

Stings from insects of the Hymenoptera order, such as bees and
wasps, can cause severe distress to individuals with venom allergy.
Studies have shown that optimal venom immunotherapy (VIT) improves
the safety and well-being of patients by providing effective
protection against future anaphylactic reactions. Indications for
VIT are based on documented true sensitization and allergic
reactions to venoms from the respective offending insect. The
correct venom(s) to be used in treatment are selected in each case
in accordance with the patient’s reaction to true venom
allergens.

In traditional clinical tests using complete natural venom
extracts for the detection of bee or wasp venom sensitization, many
patients with allergy to bee and wasp result positive for venom
from both insects, although they show clinical reactions only to
one type of substance. In most cases, such double positivity is due
to specific IgE antibodies directed towards Cross-reactive
Carbohydrate Determinants (CCDs). The reason for this
cross-reaction is that CCDs with identical structures are present
on several venom allergens from bee as well as from wasp. The IgE
reaction to CCDs is detected in the traditional test as double
positivity for both venoms, but these findings have rarely clinical
relevance.

It is possible to eliminate the problem of double positivity by
testing with CCD-free recombinant allergen components. Tests using
such components provide more detailed information than usual tests
but they can also discriminate whether double positivity is caused
by true sensitization or is merely the result of CCD-dependent
cross-reactivity between venoms.  

The test can thus discriminate between bee and wasp venom
sensitization also in cases of double-positivity to the complete
venom extracts

Molecular diagnostics with ImmunoCAP allergen components, for
instance, include testing with components such as rApi m 1 (marker
for honey bee), rVes v 1, rVes v 5/rPol d 5 (markers for wasps) and
CCD, the marker of cross-reactivity between several venom allergen
components.

Speakers at the EAACI meeting concluded that both complete venom
extracts and recombinant components are necessary for a precise
patient assessment in venom allergy.

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