Detection of IgE to recombinant Api m 1 and rVes v 5 is valuable but not sufficient to distinguish bee from wasp venom allergy.

摘要

Hofmann et al tackle an important problem in Hymenoptera venom allergy: the frequently observed (asymptomatic) double sensitization to bee and wasp venom, and the problem of identifying the relevant venom for immunotherapy. Component-resolved diagnosis is undoubtedly a major advancement in the diagnosis of Hymenoptera venom allergy. Nevertheless, the following aspects should be noted: Hofmann et al1 as well as Miiller et al2 enrolled patients on the basis of a positive skin test response. However, some patients with a venom allergy have negative skin tests. Golden et al3 frequently observed negative skin tests in patients with allergy to Hymenoptera venom, and a considerable number of these patients reacted to sting challenges. Particularly, a low total IgE level is linked to negative skin tests and nondetectable specific IgE (slgE)4 but is associated with more severe reactions.