Diagnosis of Apis dorsata venom allergy: use of recombinant allergens of Apis mellifera and a passive basophil activation test.

Q2 Medicine

Clinical and Molecular Allergy Pub Date : 2022-09-14 DOI:10.1186/s12948-022-00178-9

Peshala Gunasekara, S M Handunnetti, Sunil Premawansa, E W R A Witharana, Indra P Ratnayake, Pradeep Kaluarachchi, Chandima Karunatilake, R K S Dias, G A S Premakumara, W M D K Dasanayake, Suranjith L Seneviratne, Rajiva de Silva

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引用次数: 1

Abstract

Background: Allergy to Apis dorsata (Giant Asian Honeybee) venom is the commonest insect allergy in Sri Lanka and South East Asia. However, laboratory diagnosis is difficult as the pure venom and diagnostic reagents are not commercially available.

Objective: This study assessed the use of four recombinant allergens of A. mellifera venom and the passive basophil activation test in the diagnosis of A. dorsata venom anaphylaxis.

Methods: Serum IgE levels to four recombinant allergens of A. mellifera, rApi m 1, 2, 5 and 10 were assessed and compared with serum IgE to the crude venom of A. mellifera or V. vulgaris by Phadia ImmunoCAP, in patients who developed anaphylaxis to A. dorsata stings. Basophil activation in response to venom of A. dorsata or V. affinis was assessed using a passive basophil activation test. Association of the severity of the reaction with basophil activation was compared.

Results: rApi m 1 and 10 combinedly had significant correlation (r = 0.722; p < 0.001) with the crude venom of A. mellifera (Western honeybee) and a higher positivity rate of 90% (27/30). Whereas, IgE reactivity to rApi m 2 or 5 had significant correlation (p = 0.02 and p = 0.005 respectively) with V. vulgaris crude venom. All 30 (100%) were positive to A. dorsata venom in passive BAT; 70% (21/30) had over 80% activation, 96.7% (29/30) had over 60% activation and 100% had over 50% activation. Percentage activation of basophils in patients who had mild or moderate reactions (n = 20) was significantly low (p = 0.02) from that of patients who had severe reactions (n = 10).

Conclusions: rApi m 1 and 10 when combined was sensitive for the diagnosis of A. dorsata allergy. This combination had the lowest cross-reactivity rate with Vespula vulgaris. The passive BAT is highly sensitive in A. dorsata allergy. The basophil reactivity was significantly higher in severe anaphylaxis compared to mild/moderate anaphylaxis. This finding should be further explored in further studies.

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蜜蜂毒液过敏的诊断:应用蜜蜂重组过敏原和被动嗜碱性细胞激活试验。

背景:对亚洲巨型蜜蜂(Apis dorsata)毒液过敏是斯里兰卡和东南亚最常见的昆虫过敏。然而，实验室诊断是困难的，因为纯毒液和诊断试剂没有市售。目的:探讨四种蜜蜂毒液重组变应原及被动嗜碱性粒细胞激活试验在蜜蜂毒液过敏反应诊断中的应用价值。方法:采用Phadia ImmunoCAP检测对背蚜蜂蜇伤发生过敏反应的患者血清中4种重组变应原蜜蜂、rApi 1、2、5和10的IgE水平，并与蜜蜂粗毒液和寻常弧菌粗毒液的IgE水平进行比较。采用被动嗜碱性细胞激活试验评估了嗜碱性细胞对背背刺和附角刺毒的反应。比较了反应的严重程度与嗜碱性粒细胞活化的关系。结果:rApi m1与10合并有显著相关性(r = 0.722;结论:rApi m1和rApi 10联合检测对麻豆过敏有较高的诊断敏感性。该组合与凡草的交叉反应率最低。被动式BAT对柞蚕过敏高度敏感。与轻度/中度过敏反应相比，重度过敏反应中嗜碱性粒细胞的反应性明显更高。这一发现应在进一步的研究中进一步探讨。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Molecular Allergy Medicine-Immunology and Allergy

CiteScore

8.20

自引率

0.00%

发文量

审稿时长

13 weeks

期刊介绍： Clinical and Molecular Allergy is an open access, peer-reviewed, online journal that publishes research on human allergic and immunodeficient disease (immune deficiency not related to HIV infection/AIDS). The scope of the journal encompasses all aspects of the clinical, genetic, molecular and inflammatory aspects of allergic-respiratory (Type 1 hypersensitivity) and non-AIDS immunodeficiency disorders. However, studies of allergic/hypersensitive aspects of HIV infection/AIDS or drug desensitization protocols in AIDS are acceptable. At the basic science level, this includes original work and reviews on the genetic and molecular mechanisms underlying the inflammatory response.