Predominant Api m 10 sensitization as risk factor for treatment failure in honey bee venom immunotherapy.
- Frick M Department of Dermatology and Allergology, University Medical Center Gießen-Marburg, Justus Liebig University, Gießen, Germany; Allergy Research Group, Department of Dermatology, Medical Center, University of Freiburg, Freiburg, Germany.
- Fischer J Department of Dermatology and Allergology, University Medical Center Tübingen, Tübingen, Germany.
- Helbling A Department of Internal Medicine, Spital Netz Bern, Allergy Unit Zieglerspital, Bern, Switzerland.
- Ruëff F Department of Dermatology and Allergology, Ludwig-Maximilian-University Munich, Munich, Germany.
- Wieczorek D Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany.
- Ollert M Department of Infection and Immunity, Luxembourg Institute of Health (LIH), Esch-sur-Alzette, Luxembourg; Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, University of Southern Denmark, Odense, Denmark.
- Pfützner W Department of Dermatology and Allergology, University Medical Center Gießen-Marburg, Philipps University, Marburg, Germany.
- Müller S Allergy Research Group, Department of Dermatology, Medical Center, University of Freiburg, Freiburg, Germany.
- Huss-Marp J Allergy Research Group, Department of Dermatology, Medical Center, University of Freiburg, Freiburg, Germany.
- Dorn B Department of Dermatology and Allergology, University Medical Center Gießen-Marburg, Justus Liebig University, Gießen, Germany; Allergy Research Group, Department of Dermatology, Medical Center, University of Freiburg, Freiburg, Germany.
- Biedermann T Department of Dermatology and Allergology, University Medical Center Tübingen, Tübingen, Germany; Department of Dermatology and Allergology, Technical University Munich, Munich, Germany.
- Lidholm J Thermo Fisher Scientific, Uppsala, Sweden.
- Ruecker G Institute for Medical Biometry and Statistics, Medical Center - University of Freiburg, Freiburg, Germany.
- Bantleon F Department of Engineering, Aarhus University, Immunological Engineering, Aarhus, Denmark.
- Miehe M Department of Engineering, Aarhus University, Immunological Engineering, Aarhus, Denmark.
- Spillner E Department of Engineering, Aarhus University, Immunological Engineering, Aarhus, Denmark.
- Jakob T Department of Dermatology and Allergology, University Medical Center Gießen-Marburg, Justus Liebig University, Gießen, Germany; Allergy Research Group, Department of Dermatology, Medical Center, University of Freiburg, Freiburg, Germany. Electronic address: thilo.jakob@derma.med.uni-giessen.de.
- 2016-07-04
Published in:
- The Journal of allergy and clinical immunology. - 2016
Apis mellifera
HBV allergy
Hymenoptera venom allergy
allergen-specific immunotherapy
recombinant allergen
treatment failure
Adolescent
Adult
Aged
Allergens
Bee Venoms
Child
Cross Reactions
Desensitization, Immunologic
Female
Humans
Hypersensitivity
Immunization
Immunoglobulin E
Male
Middle Aged
Retrospective Studies
Risk Factors
Treatment Failure
Young Adult
English
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 sIgG4 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.
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 sIgG4 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.
- Language
-
- English
- Open access status
- hybrid
- Identifiers
-
- DOI 10.1016/j.jaci.2016.04.024
- PMID 27372568
- Persistent URL
- https://folia.unifr.ch/global/documents/2239
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