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. 2024 Mar 23;20(1):22.
doi: 10.1186/s13223-024-00885-9.

The role of molecular diagnosis in anaphylactic patients with dual or triple-sensitization to Hymenoptera venoms

Mohammad Hassan Bemanian  1 , Raheleh Shokouhi Shoormasti  2   3 , Saba Arshi  1 , Mahsa Jafari  2   3 , Sima Shokri  1 , Morteza Fallahpour  1 , Mohammad Nabavi  1 , Fatemeh Zaremehrjardi  4   5
Affiliations

The role of molecular diagnosis in anaphylactic patients with dual or triple-sensitization to Hymenoptera venoms

Mohammad Hassan Bemanian et al. Allergy Asthma Clin Immunol. .

Abstract

Background: The poly-sensitization to Hymenoptera venom makes it difficult to select genuine allergens for immunotherapy and increases patients' costs. The objective of this study was to determine the culprit allergen in dual or triple-sensitized patients to three Hymenoptera venoms through molecular diagnosis and evaluating the results of incorporating the molecular diagnosis with skin tests.

Methods: Thirty-two patients with anaphylactic reactions and dual or triple-sensitization to Hymenoptera venoms in skin tests entered this study. IgE-sensitization to whole extracts and molecules of Apis mellifera (Api m), Vespula vulgaris (Ves v), and Polistes dominulus (Pol d) was evaluated utilizing ALEX or ImmunoCAP.

Results: Twenty-nine patients (90.6%) were male. IgE-sensitization to at least one of the allergenic molecules related to Apis mellifera, Vespula vulgaris, and Polistes dominulus was seen in 59.4, 53.1, and 21.9%, respectively. Among 32 patients, 14 (43.8) and 8 (25%), were mono-sensitized to Api m and Ves v components in ALEX, respectively. Double sensitization to Hymenoptera was identified in 18.8% of patients in ALEX. Api m 1+/Api m 2-/Api m 10- and Ves v 1+/Ves v 5+ demonstrated the most prevalent sensitizations patterns in our patients.

Conclusions: The molecular diagnosis of IgE-sensitization to Hymenoptera venoms can be valuable, especially in patients who show dual or triple-sensitization in skin tests, as the ALEX results revealed mono and double-sensitization to Hymenoptera venoms in 22 and 6 patients, respectively. Regarding the high cost and adverse reactions of venom immunotherapy, especially for two or three venoms, incorporating the molecular diagnosis alongside skin tests for accurate diagnosis of the culprit venom could help decrease costs for patients.

Keywords: Bee sting; Bee venom allergy; Honey bee; Hymenoptera; IgE; Molecular diagnosis; Paper wasp; Sensitization; Yellow jacket.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Venn diagram for the IgE-sensitization to whole extracts of Apis mellifera, Vespula vulgaris and Polistes dominulus in ALEX (A); Venn diagram for the IgE-sensitization to allergenic molecules of Apis mellifera in ALEX (B); Venn diagram for the IgE-sensitization to allergenic molecules of Vespula vulgaris with ALEX and ImmunoCAP (C). jvenn was used to draw Venn diagrams [17]
Fig. 2
Fig. 2
A Wheal diameter of intradermal test for Hymenoptera venoms according to anaphylaxis grades. B The specific IgE concentration to allergenic extracts and molecules of Hymenoptera venoms according to anaphylaxis grades
Fig. 3
Fig. 3
IgE-sensitization to allergenic extracts and molecules of different Hymenoptera venoms
See this image and copyright information in PMC

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