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Component-resolved diagnosis of vespid venom-allergic individuals: phospholipases and antigen 5s are necessary to identify Vespula or Polistes sensitization

Authors

  • R. I. Monsalve,

    Corresponding author
    • R & D, ALK-Abelló, Madrid, Spain
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  • A. Vega,

    1. Hospital Universitario de Guadalajara, Guadalajara, Spain
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    • Member of the Hymenoptera Committee of the SEAIC (Spanish Society of Allergy and Clinical Immunology).
  • L. Marqués,

    1. Hospital Santa Maria – Universitari Arnau de Vilanova, Lleida, Spain
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    • Member of the Hymenoptera Committee of the SEAIC (Spanish Society of Allergy and Clinical Immunology).
  • A. Miranda,

    1. Hospital Carlos Haya, Málaga, Spain
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    • Member of the Hymenoptera Committee of the SEAIC (Spanish Society of Allergy and Clinical Immunology).
  • J. Fernández,

    1. Hospital General Universitario de Alicante, Alicante, Spain
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    • Member of the Hymenoptera Committee of the SEAIC (Spanish Society of Allergy and Clinical Immunology).
  • V. Soriano,

    1. Hospital General Universitario de Alicante, Alicante, Spain
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    • Member of the Hymenoptera Committee of the SEAIC (Spanish Society of Allergy and Clinical Immunology).
  • S. Cruz,

    1. Hospital Torrecardenas, Almería, Spain
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    • Member of the Hymenoptera Committee of the SEAIC (Spanish Society of Allergy and Clinical Immunology).
  • C. Domínguez-Noche,

    1. Hospital Virgen del Puerto, Plasencia, Spain
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    • Member of the Hymenoptera Committee of the SEAIC (Spanish Society of Allergy and Clinical Immunology).
  • L. Sánchez-Morillas,

    1. Hospital Central de la Cruz Roja, Madrid, Spain
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    • Member of the Hymenoptera Committee of the SEAIC (Spanish Society of Allergy and Clinical Immunology).
  • M. Armisen-Gil,

    1. Hospital Provincial de Santiago de Compostela, Santiago de Compostela, Spain
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    • Member of the Hymenoptera Committee of the SEAIC (Spanish Society of Allergy and Clinical Immunology).
  • R. Guspí,

    1. Hospital de Tortosa, Verge de la Cinta, Institut de Investigació Sanitaria Pere i Virgili (IISPV), Tortosa, Spain
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    • Member of the Hymenoptera Committee of the SEAIC (Spanish Society of Allergy and Clinical Immunology).
  • D. Barber

    1. R & D, ALK-Abelló, Madrid, Spain
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  • Edited by: Reto Crameri

Correspondence

Rafael I. Monsalve, Miguel Fleta 19, ALK-Abelló, 28037 Madrid, Spain.

Tel.: +34913276100

Fax: +34913276122

E-mail: rafael.monsalve@alk-abello.com

Abstract

Background

Cross-reactivity between hymenoptera species varies according to the different allergenic components of the venom. The true source of sensitization must therefore be established to ensure the efficacy of venom immunotherapy.

Objective

In the Mediterranean region, Polistes dominulus and Vespula spp. are clinically relevant cohabitating wasps. A panel of major vespid venom allergens was used to investigate whether serum-specific IgE (sIgE) could be used to distinguish sensitization to either vespid.

Methods

Fifty-nine individuals with allergic reactions to vespid stings and positive ImmunoCAP and/or intradermal tests to vespid venoms were studied. sIgE against recombinant and natural venom components from each wasp species was determined using the ADVIA Centaur® system.

Results

sIgE against recombinant antigen 5s sensitization to be detected in 52% of the patients tested (13/25). The sensitivity increased to 80% (20/25), when using natural antigen 5s, and to 100% with the complete panel of purified natural components, because the sIgE was positive to either the antigen 5s (Pol d 5/Ves v 5) or to the phospholipases (Pol d 1/Ves v 1) of the two vespids, or to both components at the same time. In 69% of cases, it was possible to define the most probable sensitizing insect, and in the rest, possible double sensitization could not be excluded. Vespula hyaluronidase was shown to have no additional value as regards the specificity of the assay.

Conclusions

The major allergens of P. dominulus’ and Vespula vulgaris’ venom, namely phoshpholipases and antigen 5s, are required to discriminate the probable sensitizing species in vespid-allergic patients.

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