Sensitization to Hymenoptera venom in pollen allergic patients: Frequency and involvement of cross-reacting carbohydrate determinants (CCD)

PLoS One. 2020 Sep 8;15(9):e0238740. doi: 10.1371/journal.pone.0238740. eCollection 2020.

Abstract

Sensitization to Hymenoptera venom in patients without a history of systemic allergic reactions to Hymenoptera stings is frequently found and can be due to the presence of specific IgE to cross-reactive carbohydrate determinants (CCD). This study investigates 105 pollen allergic subjects for the presence of specific IgE to honeybee or wasp venom, pollen, the MUXF3 carbohydrate epitope from bromelain and recombinant Hymenoptera venom components. In addition, in a subgroup of patients (n = 10) a basophil activation test (BAT) using bee and wasp venom was performed. Specific IgE to Hymenoptera venom was detected in 45.7% of the pollen allergic subjects and in 26.7% of the non-atopic controls, both without a history of systemic allergic reactions to Hymenoptera stings. The high sensitization rate in atopic patients could partially be explained by cross-sensitization between pollen and Hymenoptera venom due to specific IgE to CCDs. In our study population, only 20% showed a sensitization to CCDs. Primary sensitization due to sting exposure, high total IgE values or unspecific binding and detection of low affinity antibodies in the test procedure could be reasons. Thus, determination of specific IgE to Hymenoptera venom in patients without a history of systemic allergic reactions as screening test is not recommended.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Allergens / immunology
  • Animals
  • Bee Venoms / immunology*
  • Carbohydrates / immunology*
  • Cross Reactions*
  • Female
  • Humans
  • Hymenoptera / immunology*
  • Hypersensitivity / immunology*
  • Male
  • Middle Aged
  • Wasp Venoms / immunology*
  • Young Adult

Substances

  • Allergens
  • Bee Venoms
  • Carbohydrates
  • Wasp Venoms

Grants and funding

This study was funded by Ulrich Mueller Gierok Allergy Foundation Bern, Switzerland. The funding was granted to KB and AH. The funder provided only support for laboratory costs and material, but not for salaries for the authors. The funder did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. In 2019 this foundation was closed. The laboratory ADR-AC GmBH, a specialized laboratory offering basophil activation tests for routine diagnostics in Switzerland, performed all basophil activation tests in this study.