Journal article

Publication year: 2016

Pages: 1663-166+

Journal: Journal of Allergy and Clinical Immunology

Volume number: 138

Issue number: 6

ISSN: 0091-6749

eISSN: 1097-6825

Open access status: Hybrid

DOI Link: https://doi.org/10.1016/j.jaci.2016.04.024

Publisher: Elsevier

Abstract: 

Background: Component resolution recently identified distinct sensitization profiles in honey bee venom (HBV) allergy, some of which were dominated by specific IgE to Api m 3 and/or Api m 10, which have been reported to be underrepresented in therapeutic HBV preparations.

Objective: We performed a retrospective analysis of component-resolved sensitization profiles in HBV-allergic patients and association with treatment outcome.

Methods: HBV-allergic patients who had undergone controlled honey bee sting challenge after at least 6 months of HBV immunotherapy (n = 115) were included and classified as responder (n = 79) or treatment failure (n = 36) on the basis of absence or presence of systemic allergic reactions upon sting challenge. IgE reactivity to a panel of HBV allergens was analyzed in sera obtained before immunotherapy and before sting challenge.

Results: No differences were observed between responders and nonresponders regarding levels of IgE sensitization to Api m 1, Api m 2, Api m 3, and Api m 5. In contrast, Api m 10 specific IgE was moderately but significantly increased in nonresponders. Predominant Api m 10 sensitization (>50% of specific IgE to HBV) was the best discriminator (specificity, 95%; sensitivity, 25%) with an odds ratio of 8.444 (2.127-33.53; P = .0013) for treatment failure. Some but not all therapeutic HBV preparations displayed a lack of Api m 10, whereas Api m 1 and Api m 3 immunoreactivity was comparable to that of crude HBV. In line with this, significant Api m 10 sIgG(4) induction was observed only in those patients who were treated with HBV in which Api m 10 was detectable.

Conclusions: Component-resolved sensitization profiles in HBV allergy suggest predominant IgE sensitization to Api m 10 as a risk factor for treatment failure in HBV immunotherapy.

Harvard Citation style: Frick, M., Fischer, J., Helbling, A., Rueff, F., Wieczorek, D., Ollert, M., et al. (2016) Predominant Api m 10 sensitization as risk factor for treatment failure in honey bee venom immunotherapy, Journal of Allergy and Clinical Immunology, 138(6), pp. 1663-166+. https://doi.org/10.1016/j.jaci.2016.04.024

APA Citation style: Frick, M., Fischer, J., Helbling, A., Rueff, F., Wieczorek, D., Ollert, M., Pfuetzner, W., Mueller, S., Huss-Marp, J., Dorn, B., Biedermann, T., Lidholm, J., Ruecker, G., Bantleon, F., Miehe, M., Spillner, E., & Jakob, T. (2016). Predominant Api m 10 sensitization as risk factor for treatment failure in honey bee venom immunotherapy. Journal of Allergy and Clinical Immunology. 138(6), 1663-166+. https://doi.org/10.1016/j.jaci.2016.04.024