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Markus Ollert - One of the best experts on this subject based on the ideXlab platform.

  • Marker allergens in Hymenoptera Venom allergy — Characteristics and potential use in precision medicine
    Allergo Journal International, 2020
    Co-Authors: Simon Blank, Maria Beatrice Bilò, Carsten B. Schmidt-weber, Markus Ollert, Johannes Grosch, Thilo Jakob
    Abstract:

    Abstract Background A comprehensive diagnostic work-up is essential to ensure adequate patient management for the potentially life-threatening condition of Hymenoptera Venom allergy (HVA). This includes an unambiguous identification of the allergy-relevant Venom as prerequisite for successful Venom-specific immunotherapy (VIT). If the clinical history does not allow the identification of the culprit insect, diagnosis is often hampered by positive test results to various Venoms. Modern component-resolved diagnostics (CRD) applying marker allergens of Hymenoptera Venoms has created new opportunities which facilitate therapeutic decisions and may allow personalized risk stratification for individual patients. Methods Comprehensive literature search and critical analysis of recently published studies on Hymenoptera Venom allergens and CRD. Results and discussion Changing the research focus from whole Venom extracts to individual allergenic molecules led to the development of CRD in HVA. The currently available CRD is a valuable tool to resolve cross-reactivity and primary sensitization, particularly in honeybee and vespid Venom allergy. Hence, CRD has simplified therapeutic decisions in case of multiple positive test results, especially in patients who were not able to identify the culprit insect or in cases of discrepancies between clinical history and classical diagnostic results. Moreover, there is first evidence that sensitization to particular allergens might serve as biomarkers to predict risk for severe side-effects during VIT or even for VIT failure. To date, a clear limitation of CRD is the currently available allergen panel which does not allow a definite resolution of allergy to different vespid species such as yellow jackets and European paper wasps.

  • Marker allergens in Hymenoptera Venom allergy — Characteristics and potential use in precision medicine
    Allergo Journal International, 2020
    Co-Authors: Simon Blank, Maria Beatrice Bilò, Carsten B. Schmidt-weber, Markus Ollert, Johannes Grosch, Thilo Jakob
    Abstract:

    Background A comprehensive diagnostic work-up is essential to ensure adequate patient management for the potentially life-threatening condition of Hymenoptera Venom allergy (HVA). This includes an unambiguous identification of the allergy-relevant Venom as prerequisite for successful Venom-specific immunotherapy (VIT). If the clinical history does not allow the identification of the culprit insect, diagnosis is often hampered by positive test results to various Venoms. Modern component-resolved diagnostics (CRD) applying marker allergens of Hymenoptera Venoms has created new opportunities which facilitate therapeutic decisions and may allow personalized risk stratification for individual patients. Methods Comprehensive literature search and critical analysis of recently published studies on Hymenoptera Venom allergens and CRD. Results and discussion Changing the research focus from whole Venom extracts to individual allergenic molecules led to the development of CRD in HVA. The currently available CRD is a valuable tool to resolve cross-reactivity and primary sensitization, particularly in honeybee and vespid Venom allergy. Hence, CRD has simplified therapeutic decisions in case of multiple positive test results, especially in patients who were not able to identify the culprit insect or in cases of discrepancies between clinical history and classical diagnostic results. Moreover, there is first evidence that sensitization to particular allergens might serve as biomarkers to predict risk for severe side-effects during VIT or even for VIT failure. To date, a clear limitation of CRD is the currently available allergen panel which does not allow a definite resolution of allergy to different vespid species such as yellow jackets and European paper wasps.

  • the role of component resolved diagnosis in Hymenoptera Venom allergy
    Current Opinion in Allergy and Clinical Immunology, 2019
    Co-Authors: Maria Beatrice Bilò, Markus Ollert, Simon Blank
    Abstract:

    Purpose of review Component-resolved diagnostics (CRD) is a new tool aiming at detecting IgE-mediated sensitizations against individual, relevant allergens. Here, we discuss recent literature on molecular diagnosis in the field of Hymenoptera Venom allergy (HVA) as well as CRD strengths and weaknesses. Recent findings CRD, using single molecules or panels of allergens, may discriminate between primary sensitization and cross-reactivity in patients with double/multiple positivity in diagnostic tests with whole extracts, allowing the specialist to choose the most suitable Venom for specific immunotherapy (VIT), avoiding unnecessary VIT and reducing the risk of side effects. Future availability of the cross-reactive recombinant pairs of allergens of different species may further increase the diagnostic performance. CRD may be useful in patients with negative allergy tests and a proven history of a previous systemic reaction, including those with mast cell disorders, who could benefit from VIT. In honeybee Venom allergy, different sensitization profiles have been identified, which could be associated with a greater risk of VIT failure or treatment side effects. Summary CRD is undoubtedly an innovative diagnostic method that leads to a more precise definition of the sensitization profile of the HVA patient. Together with a better knowledge of the molecular composition of different Venom extracts, CRD may contribute to optimize patient-tailored therapy.

  • Prevalence of Hymenoptera Venom allergy and sensitization in the population-representative German KORA cohort
    Allergo Journal International, 2019
    Co-Authors: Simon Blank, Johannes Ring, Carsten B. Schmidt-weber, Stephanie Haemmerle, Teresa Jaeger, Dennis Russkamp, Markus Ollert
    Abstract:

    Purpose Allergic reactions to Hymenoptera Venoms represent potentially life-threatening conditions. However, studies on their prevalence in Germany and their relation to specific IgE sensitization are rare. The aim of this study was to evaluate the prevalence of Hymenoptera Venom allergy as well as the frequency of Venom-specific IgE sensitization in a large population-based adult German cohort.

  • added sensitivity of component resolved diagnosis in Hymenoptera Venom allergic patients with elevated serum tryptase and or mastocytosis
    Allergy, 2016
    Co-Authors: J B Michel, Knut Brockow, Ulf Darsow, J. Ring, Thomas Grunwald, Simon Blank, Carsten B Schmidtweber, Markus Ollert
    Abstract:

    Background Anaphylaxis caused by Hymenoptera Venom allergy is associated with elevation of baseline serum tryptase (sBT) and/or mastocytosis in about 5% of patients. Up to now, no information has become available on single Venom allergen sIgE reactivity and the usefulness of component-resolved approaches to diagnose this high-risk patient group. To address the component-resolved sIgE sensitization pattern and diagnostic sensitivity in Hymenoptera Venom-allergic patients with elevated sBT levels and/or mastocytosis, a panel of yellow jacket and honeybee Venom allergens was applied on a widely used IgE immunoassay platform. Methods Fifty-three patients with mastocytosis and/or elevated sBT tryptase level and systemic reactions to Hymenoptera Venoms were analyzed for their IgE reactivity to recombinant yellow jacket and honeybee Venom allergens by Immulite3 g. Results sIgE reactivity to Ves v 1, Ves v 5, Api m 1 to Api m 4 and Api m 10 was found at a similar frequency in Hymenoptera Venom-allergic patients with and without elevated sBT levels and/or mastocytosis. However, the use of the recombinant allergens and a diagnostic cutoff of 0.1 kUA/L allowed the diagnosis of patients with otherwise undetectable IgE to Venom extract. The diagnostic sensitivity of yellow jacket Venom allergy using the combination of Ves v 1 and Ves v 5 was 100%. Conclusions In high-risk patients with elevated sBT levels and/or mastocytosis, the use of molecular components and decreasing the threshold sIgE level to 0.1 kUA/L may be needed to avoid otherwise undetectable IgE to Hymenoptera Venom extracts in about 8% of such patients.

Simon Blank - One of the best experts on this subject based on the ideXlab platform.

  • Marker allergens in Hymenoptera Venom allergy — Characteristics and potential use in precision medicine
    Allergo Journal International, 2020
    Co-Authors: Simon Blank, Maria Beatrice Bilò, Carsten B. Schmidt-weber, Markus Ollert, Johannes Grosch, Thilo Jakob
    Abstract:

    Abstract Background A comprehensive diagnostic work-up is essential to ensure adequate patient management for the potentially life-threatening condition of Hymenoptera Venom allergy (HVA). This includes an unambiguous identification of the allergy-relevant Venom as prerequisite for successful Venom-specific immunotherapy (VIT). If the clinical history does not allow the identification of the culprit insect, diagnosis is often hampered by positive test results to various Venoms. Modern component-resolved diagnostics (CRD) applying marker allergens of Hymenoptera Venoms has created new opportunities which facilitate therapeutic decisions and may allow personalized risk stratification for individual patients. Methods Comprehensive literature search and critical analysis of recently published studies on Hymenoptera Venom allergens and CRD. Results and discussion Changing the research focus from whole Venom extracts to individual allergenic molecules led to the development of CRD in HVA. The currently available CRD is a valuable tool to resolve cross-reactivity and primary sensitization, particularly in honeybee and vespid Venom allergy. Hence, CRD has simplified therapeutic decisions in case of multiple positive test results, especially in patients who were not able to identify the culprit insect or in cases of discrepancies between clinical history and classical diagnostic results. Moreover, there is first evidence that sensitization to particular allergens might serve as biomarkers to predict risk for severe side-effects during VIT or even for VIT failure. To date, a clear limitation of CRD is the currently available allergen panel which does not allow a definite resolution of allergy to different vespid species such as yellow jackets and European paper wasps.

  • Marker allergens in Hymenoptera Venom allergy — Characteristics and potential use in precision medicine
    Allergo Journal International, 2020
    Co-Authors: Simon Blank, Maria Beatrice Bilò, Carsten B. Schmidt-weber, Markus Ollert, Johannes Grosch, Thilo Jakob
    Abstract:

    Background A comprehensive diagnostic work-up is essential to ensure adequate patient management for the potentially life-threatening condition of Hymenoptera Venom allergy (HVA). This includes an unambiguous identification of the allergy-relevant Venom as prerequisite for successful Venom-specific immunotherapy (VIT). If the clinical history does not allow the identification of the culprit insect, diagnosis is often hampered by positive test results to various Venoms. Modern component-resolved diagnostics (CRD) applying marker allergens of Hymenoptera Venoms has created new opportunities which facilitate therapeutic decisions and may allow personalized risk stratification for individual patients. Methods Comprehensive literature search and critical analysis of recently published studies on Hymenoptera Venom allergens and CRD. Results and discussion Changing the research focus from whole Venom extracts to individual allergenic molecules led to the development of CRD in HVA. The currently available CRD is a valuable tool to resolve cross-reactivity and primary sensitization, particularly in honeybee and vespid Venom allergy. Hence, CRD has simplified therapeutic decisions in case of multiple positive test results, especially in patients who were not able to identify the culprit insect or in cases of discrepancies between clinical history and classical diagnostic results. Moreover, there is first evidence that sensitization to particular allergens might serve as biomarkers to predict risk for severe side-effects during VIT or even for VIT failure. To date, a clear limitation of CRD is the currently available allergen panel which does not allow a definite resolution of allergy to different vespid species such as yellow jackets and European paper wasps.

  • the role of component resolved diagnosis in Hymenoptera Venom allergy
    Current Opinion in Allergy and Clinical Immunology, 2019
    Co-Authors: Maria Beatrice Bilò, Markus Ollert, Simon Blank
    Abstract:

    Purpose of review Component-resolved diagnostics (CRD) is a new tool aiming at detecting IgE-mediated sensitizations against individual, relevant allergens. Here, we discuss recent literature on molecular diagnosis in the field of Hymenoptera Venom allergy (HVA) as well as CRD strengths and weaknesses. Recent findings CRD, using single molecules or panels of allergens, may discriminate between primary sensitization and cross-reactivity in patients with double/multiple positivity in diagnostic tests with whole extracts, allowing the specialist to choose the most suitable Venom for specific immunotherapy (VIT), avoiding unnecessary VIT and reducing the risk of side effects. Future availability of the cross-reactive recombinant pairs of allergens of different species may further increase the diagnostic performance. CRD may be useful in patients with negative allergy tests and a proven history of a previous systemic reaction, including those with mast cell disorders, who could benefit from VIT. In honeybee Venom allergy, different sensitization profiles have been identified, which could be associated with a greater risk of VIT failure or treatment side effects. Summary CRD is undoubtedly an innovative diagnostic method that leads to a more precise definition of the sensitization profile of the HVA patient. Together with a better knowledge of the molecular composition of different Venom extracts, CRD may contribute to optimize patient-tailored therapy.

  • Prevalence of Hymenoptera Venom allergy and sensitization in the population-representative German KORA cohort
    Allergo Journal International, 2019
    Co-Authors: Simon Blank, Johannes Ring, Carsten B. Schmidt-weber, Stephanie Haemmerle, Teresa Jaeger, Dennis Russkamp, Markus Ollert
    Abstract:

    Purpose Allergic reactions to Hymenoptera Venoms represent potentially life-threatening conditions. However, studies on their prevalence in Germany and their relation to specific IgE sensitization are rare. The aim of this study was to evaluate the prevalence of Hymenoptera Venom allergy as well as the frequency of Venom-specific IgE sensitization in a large population-based adult German cohort.

  • added sensitivity of component resolved diagnosis in Hymenoptera Venom allergic patients with elevated serum tryptase and or mastocytosis
    Allergy, 2016
    Co-Authors: J B Michel, Knut Brockow, Ulf Darsow, J. Ring, Thomas Grunwald, Simon Blank, Carsten B Schmidtweber, Markus Ollert
    Abstract:

    Background Anaphylaxis caused by Hymenoptera Venom allergy is associated with elevation of baseline serum tryptase (sBT) and/or mastocytosis in about 5% of patients. Up to now, no information has become available on single Venom allergen sIgE reactivity and the usefulness of component-resolved approaches to diagnose this high-risk patient group. To address the component-resolved sIgE sensitization pattern and diagnostic sensitivity in Hymenoptera Venom-allergic patients with elevated sBT levels and/or mastocytosis, a panel of yellow jacket and honeybee Venom allergens was applied on a widely used IgE immunoassay platform. Methods Fifty-three patients with mastocytosis and/or elevated sBT tryptase level and systemic reactions to Hymenoptera Venoms were analyzed for their IgE reactivity to recombinant yellow jacket and honeybee Venom allergens by Immulite3 g. Results sIgE reactivity to Ves v 1, Ves v 5, Api m 1 to Api m 4 and Api m 10 was found at a similar frequency in Hymenoptera Venom-allergic patients with and without elevated sBT levels and/or mastocytosis. However, the use of the recombinant allergens and a diagnostic cutoff of 0.1 kUA/L allowed the diagnosis of patients with otherwise undetectable IgE to Venom extract. The diagnostic sensitivity of yellow jacket Venom allergy using the combination of Ves v 1 and Ves v 5 was 100%. Conclusions In high-risk patients with elevated sBT levels and/or mastocytosis, the use of molecular components and decreasing the threshold sIgE level to 0.1 kUA/L may be needed to avoid otherwise undetectable IgE to Hymenoptera Venom extracts in about 8% of such patients.

Edzard Spillner - One of the best experts on this subject based on the ideXlab platform.

  • component resolved diagnostics for Hymenoptera Venom allergy
    Current Opinion in Allergy and Clinical Immunology, 2017
    Co-Authors: Thilo Jakob, U Muller, A Helbling, Edzard Spillner
    Abstract:

    PURPOSE OF REVIEW Component-resolved diagnostics makes use of defined allergen molecules to analyse IgE-mediated sensitizations at a molecular level. Here, we review recent studies on the use of component-resolved diagnostics in the field of Hymenoptera Venom allergy (HVA) and discuss its benefits and limitations. RECENT FINDINGS Component resolution in HVA has moved from single molecules to panels of allergens. Detection of specific immunoglobulin E (sIgE) to marker and cross-reactive Venom allergens has been reported to facilitate the discrimination between primary sensitization and cross-reactivity and thus, to provide a better rationale for prescribing Venom immunotherapy (VIT), particularly in patients sensitized to both honeybee and vespid Venom. Characterization of IgE reactivity to a broad panel of Venom allergens has allowed the identification of different sensitization profiles that in honeybee Venom allergy were associated with increased risks for side effects or treatment failure of VIT. In contrast, component resolution so far has failed to provide reliable markers for the discrimination of sensitizations to Venoms of different members of Vespidae. SUMMARY Component-resolved diagnostics allows a better understanding of the complexity of sensitization and cross-reactivities in HVA. In addition, the enhanced resolution and precision may allow identification of biomarkers, which can be used for risk stratification in VIT. Knowledge about the molecular composition of different therapeutic preparations may enable the selection of appropriate preparations for VIT according to individual sensitization profiles, an approach consistent with the goals of personalized medicine.

  • Diagnostics in Hymenoptera Venom allergy: current concepts and developments with special focus on molecular allergy diagnostics
    Allergo Journal International, 2017
    Co-Authors: Thilo Jakob, David Rafei-shamsabadi, Edzard Spillner, Sabine Müller
    Abstract:

    Background The high rate of asymptomatic sensitization to Hymenoptera Venom, difficulty in correctly identifying Hymenoptera and loss of sensitization over time make an accurate diagnosis of Hymenoptera Venom allergy challenging. Although routine diagnostic tests encompassing skin tests and the detection of Venom-specific IgE antibodies with whole Venom preparations are reliable, they offer insufficient precision in the case of double sensitized patients or in those with a history of sting anaphylaxis, in whom sensitization cannot be proven or only to the presumably wrong Venom. Methods Systematic literature research and review of current concepts of diagnostic testing in Hymenoptera Venom allergy. Results and discussion Improvements in diagnostic accuracy over recent years have mainly been due to the increasing use of molecular allergy diagnostics. Detection of specific IgE antibodies to marker and cross-reactive Venom allergens improves the discrimination between genuine sensitization and cross-reactivity, and this provides a better rationale for prescribing Venom immunotherapy. The basophil activation test has also increased diagnostic accuracy by reducing the number of Hymenoptera Venom sensitizations overlooked with routine tests. This paper reviews current concepts of diagnostic testing in Hymenoptera Venom allergy and suggests fields for further development.

  • Diagnostics in Hymenoptera Venom allergy: current concepts and developments with special focus on molecular allergy diagnostics.
    Allergo journal international, 2017
    Co-Authors: Thilo Jakob, David Rafei-shamsabadi, Edzard Spillner, Sabine Müller
    Abstract:

    Background The high rate of asymptomatic sensitization to Hymenoptera Venom, difficulty in correctly identifying Hymenoptera and loss of sensitization over time make an accurate diagnosis of Hymenoptera Venom allergy challenging. Although routine diagnostic tests encompassing skin tests and the detection of Venom-specific IgE antibodies with whole Venom preparations are reliable, they offer insufficient precision in the case of double sensitized patients or in those with a history of sting anaphylaxis, in whom sensitization cannot be proven or only to the presumably wrong Venom.

  • Recombinant phospholipase A1 (Ves v 1) from yellow jacket Venom for improved diagnosis of Hymenoptera Venom hypersensitivity.
    Clinical and molecular allergy : CMA, 2010
    Co-Authors: Henning Seismann, Thomas Grunwald, Simon Blank, Markus Ollert, Liliana Cifuentes, Ingke Braren, Reinhard Bredehorst, Edzard Spillner
    Abstract:

    Background Hymenoptera Venoms are known to cause life-threatening IgE-mediated anaphylactic reactions in allergic individuals. Proper diagnosis of Hymenoptera Venom allergy using Venom extracts is severely affected by molecular cross-reactivities. Although non-glycosylated marker allergens would facilitate the identification of the culprit Venom, the major allergen phospholipase A1 (Ves v 1) from yellow jacket Venom (YJV) remained unavailable so far.

  • yellow jacket Venom for improved diagnosis of Hymenoptera Venom hypersensitivity
    2010
    Co-Authors: Henning Seismann, Thomas Grunwald, Simon Blank, Markus Ollert, Liliana Cifuentes, Ingke Braren, Reinhard Bredehorst, Edzard Spillner
    Abstract:

    Background: Hymenoptera Venoms are known to cause life-threatening IgE-mediated anaphylactic reactions in allergic individuals. Proper diagnosis of Hymenoptera Venom allergy using Venom extracts is severely affected by molecular cross-reactivities. Although non-glycosylated marker allergens would facilitate the identification of the culprit Venom, the major allergen phospholipase A1 (Ves v 1) from yellow jacket Venom (YJV) remained unavailable so far. Methods: Expression of Ves v 1 as wild type and enzymatically inactivated mutant and Ves v 5 in insect cells yielded soluble proteins that were purified via affinity chromatography. Functionality of the recombinant allergens was assessed by enzymatic and biophysical analyses as well as basophil activation tests. Diagnostic relevance was addressed by ELISA-based analyses of sera of YJV-sensitized patients. Results: Both major allergens Ves v 1 and Ves v 5 could be produced in insect cells in secreted soluble form. The recombinant proteins exhibited their particular biochemical and functional characteristics and were capable for activation of human basophils. Assessment of IgE reactivity of sera of YJV-sensitized and double-sensitized patients emphasised the relevance of Ves v 1 in Hymenoptera Venom allergy. In contrast to the use of singular molecules the combined use of both molecules enabled a reliable assignment of sensitisation to YJV for more than 90% of doublesensitised patients.

U Muller - One of the best experts on this subject based on the ideXlab platform.

  • component resolved diagnostics for Hymenoptera Venom allergy
    Current Opinion in Allergy and Clinical Immunology, 2017
    Co-Authors: Thilo Jakob, U Muller, A Helbling, Edzard Spillner
    Abstract:

    PURPOSE OF REVIEW Component-resolved diagnostics makes use of defined allergen molecules to analyse IgE-mediated sensitizations at a molecular level. Here, we review recent studies on the use of component-resolved diagnostics in the field of Hymenoptera Venom allergy (HVA) and discuss its benefits and limitations. RECENT FINDINGS Component resolution in HVA has moved from single molecules to panels of allergens. Detection of specific immunoglobulin E (sIgE) to marker and cross-reactive Venom allergens has been reported to facilitate the discrimination between primary sensitization and cross-reactivity and thus, to provide a better rationale for prescribing Venom immunotherapy (VIT), particularly in patients sensitized to both honeybee and vespid Venom. Characterization of IgE reactivity to a broad panel of Venom allergens has allowed the identification of different sensitization profiles that in honeybee Venom allergy were associated with increased risks for side effects or treatment failure of VIT. In contrast, component resolution so far has failed to provide reliable markers for the discrimination of sensitizations to Venoms of different members of Vespidae. SUMMARY Component-resolved diagnostics allows a better understanding of the complexity of sensitization and cross-reactivities in HVA. In addition, the enhanced resolution and precision may allow identification of biomarkers, which can be used for risk stratification in VIT. Knowledge about the molecular composition of different therapeutic preparations may enable the selection of appropriate preparations for VIT according to individual sensitization profiles, an approach consistent with the goals of personalized medicine.

  • use of β blockers during immunotherapy for Hymenoptera Venom allergy
    The Journal of Allergy and Clinical Immunology, 2005
    Co-Authors: U Muller, Gabrielle Haeberli
    Abstract:

    Background B-Blockers may aggravate anaphylactic reactions and interfere with treatment. There is therefore concern about their use in patients who have a history of anaphylaxis or are on allergen immunotherapy. Immunotherapy is the best available treatment for prevention of life-threatening anaphylaxis to Hymenoptera stings, which is often observed in elderly patients who have cardiovascular disease and therefore are on β-blocker treatment. Objective To analyze the risk of β-blocker treatment during Venom immunotherapy. Methods We screened all 1682 patients with Hymenoptera Venom allergy seen during a period of 34 months for immunotherapy, cardiovascular disease, and treatment with β-blockers. Results Of the 1389 patients in whom immunotherapy was recommended, 11.2% had cardiovascular disease, and 44 of these were on β-blockers before immunotherapy. In 31 of those, the drug was replaced before starting treatment. In 3 with coronary heart disease and 1 with severe ventricular arrhythmia, the drug was continued throughout immunotherapy. In 9, it was reintroduced after reaching the maintenance dose. In an additional 12 patients, β-blockers were newly started during immunotherapy. Of 25 patients on β-blockers during immunotherapy, 3 (12%) developed allergic side effects, compared with 23 (16.7%) of 117 with cardiovascular disease but without β-blockers. Systemic allergic symptoms after re-exposure by sting challenge or field sting were observed in 1 of 7 (14.3%) with and 4 of 29 (13.8%) without β-blockade. No severe reactions to treatment or sting reexposure were observed in patients with β-blockade. Conclusion Combination of β-blockers with Venom immunotherapy may be indicated in heavily exposed patients with severe cardiovascular disease.

  • elevated basal serum tryptase and Hymenoptera Venom allergy relation to severity of sting reactions and to safety and efficacy of Venom immunotherapy
    Clinical & Experimental Allergy, 2003
    Co-Authors: G Haeberli, M Bronnimann, T Hunziker, U Muller
    Abstract:

    Summary Background Mastocytosis and/or elevated basal serum tryptase may be associated with severe anaphylaxis. Objective To analyse Hymenoptera Venom-allergic patients with regard to basal tryptase in relation to the severity of sting reactions and the safety and efficacy of Venom immunotherapy. Methods Basal serum tryptase was measured in 259 Hymenoptera Venom-allergic patients (158 honey bee, 101 Vespula). In 161 of these (104 honey bee, 57 Vespula), a sting challenge was performed during Venom immunotherapy. Results Nineteen of the 259 patients had an elevated basal serum tryptase. Evidence of cutaneous mastocytosis as documented by skin biopsy was present in 3 of 16 patients (18.8%). There was a clear correlation of basal serum tryptase to the grade of the initial allergic reaction (P<0.0005). Forty-one of the 161 sting challenged patients reacted to the challenge, 34 to a bee sting and 7 to a Vespula sting. Thereof, 10 had an elevated basal serum tryptase, i.e. 1 (2.9%) of the reacting and 2 (2.9%) of the non-reacting bee Venom (BV) allergic individuals, as compared to 3 (42.9%) of the reacting and 4 (8%) of the non-reacting Vespula Venom-allergic patients. Thus, there was a significant association between a reaction to the sting challenge and an elevated basal serum tryptase in Vespula (χ2=6.926, P<0.01), but not in BV-allergic patients. Systemic allergic side-effects to Venom immunotherapy were observed in 13.9% of patients with normal and in 10% of those with elevated basal serum tryptase. Conclusions An elevated basal serum tryptase as well as mastocytosis are risk factors for severe or even fatal shock reactions to Hymenoptera stings. Although the efficacy of Venom immunotherapy in these patients is slightly reduced, most of them can be treated successfully. Based on currently available data, lifelong treatment has to be discussed in this situation.

  • the sting challenge test in Hymenoptera Venom allergy position paper of the subcommittee on insect Venom allergy of the european academy of allergology and clinical immunology
    Allergy, 1996
    Co-Authors: Franziska Rueff, Bernhard Przybilla, U Muller, Holger Mosbech
    Abstract:

    Rueff F, Przybilla B, Muller U, Mosbech H. The sting challenge test in Hymenoptera Venom allergy. Position paper of the Subcommittee on Insect Venom Allergy of the European Academy of Allergology and Clinical Immunology. Allergy 1996: 51: 216–225. © Munksgaard 1996.

Maria Beatrice Bilò - One of the best experts on this subject based on the ideXlab platform.

  • Marker allergens in Hymenoptera Venom allergy — Characteristics and potential use in precision medicine
    Allergo Journal International, 2020
    Co-Authors: Simon Blank, Maria Beatrice Bilò, Carsten B. Schmidt-weber, Markus Ollert, Johannes Grosch, Thilo Jakob
    Abstract:

    Background A comprehensive diagnostic work-up is essential to ensure adequate patient management for the potentially life-threatening condition of Hymenoptera Venom allergy (HVA). This includes an unambiguous identification of the allergy-relevant Venom as prerequisite for successful Venom-specific immunotherapy (VIT). If the clinical history does not allow the identification of the culprit insect, diagnosis is often hampered by positive test results to various Venoms. Modern component-resolved diagnostics (CRD) applying marker allergens of Hymenoptera Venoms has created new opportunities which facilitate therapeutic decisions and may allow personalized risk stratification for individual patients. Methods Comprehensive literature search and critical analysis of recently published studies on Hymenoptera Venom allergens and CRD. Results and discussion Changing the research focus from whole Venom extracts to individual allergenic molecules led to the development of CRD in HVA. The currently available CRD is a valuable tool to resolve cross-reactivity and primary sensitization, particularly in honeybee and vespid Venom allergy. Hence, CRD has simplified therapeutic decisions in case of multiple positive test results, especially in patients who were not able to identify the culprit insect or in cases of discrepancies between clinical history and classical diagnostic results. Moreover, there is first evidence that sensitization to particular allergens might serve as biomarkers to predict risk for severe side-effects during VIT or even for VIT failure. To date, a clear limitation of CRD is the currently available allergen panel which does not allow a definite resolution of allergy to different vespid species such as yellow jackets and European paper wasps.

  • Marker allergens in Hymenoptera Venom allergy — Characteristics and potential use in precision medicine
    Allergo Journal International, 2020
    Co-Authors: Simon Blank, Maria Beatrice Bilò, Carsten B. Schmidt-weber, Markus Ollert, Johannes Grosch, Thilo Jakob
    Abstract:

    Abstract Background A comprehensive diagnostic work-up is essential to ensure adequate patient management for the potentially life-threatening condition of Hymenoptera Venom allergy (HVA). This includes an unambiguous identification of the allergy-relevant Venom as prerequisite for successful Venom-specific immunotherapy (VIT). If the clinical history does not allow the identification of the culprit insect, diagnosis is often hampered by positive test results to various Venoms. Modern component-resolved diagnostics (CRD) applying marker allergens of Hymenoptera Venoms has created new opportunities which facilitate therapeutic decisions and may allow personalized risk stratification for individual patients. Methods Comprehensive literature search and critical analysis of recently published studies on Hymenoptera Venom allergens and CRD. Results and discussion Changing the research focus from whole Venom extracts to individual allergenic molecules led to the development of CRD in HVA. The currently available CRD is a valuable tool to resolve cross-reactivity and primary sensitization, particularly in honeybee and vespid Venom allergy. Hence, CRD has simplified therapeutic decisions in case of multiple positive test results, especially in patients who were not able to identify the culprit insect or in cases of discrepancies between clinical history and classical diagnostic results. Moreover, there is first evidence that sensitization to particular allergens might serve as biomarkers to predict risk for severe side-effects during VIT or even for VIT failure. To date, a clear limitation of CRD is the currently available allergen panel which does not allow a definite resolution of allergy to different vespid species such as yellow jackets and European paper wasps.

  • the role of component resolved diagnosis in Hymenoptera Venom allergy
    Current Opinion in Allergy and Clinical Immunology, 2019
    Co-Authors: Maria Beatrice Bilò, Markus Ollert, Simon Blank
    Abstract:

    Purpose of review Component-resolved diagnostics (CRD) is a new tool aiming at detecting IgE-mediated sensitizations against individual, relevant allergens. Here, we discuss recent literature on molecular diagnosis in the field of Hymenoptera Venom allergy (HVA) as well as CRD strengths and weaknesses. Recent findings CRD, using single molecules or panels of allergens, may discriminate between primary sensitization and cross-reactivity in patients with double/multiple positivity in diagnostic tests with whole extracts, allowing the specialist to choose the most suitable Venom for specific immunotherapy (VIT), avoiding unnecessary VIT and reducing the risk of side effects. Future availability of the cross-reactive recombinant pairs of allergens of different species may further increase the diagnostic performance. CRD may be useful in patients with negative allergy tests and a proven history of a previous systemic reaction, including those with mast cell disorders, who could benefit from VIT. In honeybee Venom allergy, different sensitization profiles have been identified, which could be associated with a greater risk of VIT failure or treatment side effects. Summary CRD is undoubtedly an innovative diagnostic method that leads to a more precise definition of the sensitization profile of the HVA patient. Together with a better knowledge of the molecular composition of different Venom extracts, CRD may contribute to optimize patient-tailored therapy.

  • Hymenoptera Venom Allergy: Management of Children and Adults in Clinical Practice.
    Journal of investigational allergology & clinical immunology, 2019
    Co-Authors: Maria Beatrice Bilò, O. Quercia, V. Pravettoni, D. Bignardi, Patrizia Bonadonna, Marina Mauro, Elio Novembre, Marcello Cilia, Gabriele Cortellini, Maria Teresa Costantino
    Abstract:

    Hymenoptera Venom allergy is an epidemiologically underestimated condition and a major cause of morbidity worldwide. Preventing future allergic reactions in patients who experience a systemic reaction is based on the correct management of the emergency followed by an accurate diagnosis, prescription of adrenaline autoinjectors, and, where indicated, specific Venom immunotherapy. Some epidemiological studies highlight our poor knowledge of this disease and the frequent inadequacy of its management. Moreover, they emphasize the importance of such a life-saving treatment as specific immunotherapy. The availability of high-quality Hymenoptera Venom extracts for diagnostic and therapeutic use has dramatically improved the prognosis and quality of life of allergic patients. Subcutaneous Venom immunotherapy is currently the most effective form of allergen-based immunotherapy, with a carry-over effect lasting up to several years after its interruption. This report on the management of Hymenoptera Venom-allergic children and adults was prepared by a panel of Italian experts. The main objective of this consensus document is to review the scientific evidence related to diagnosis, therapy, and management of patients allergic to Hymenoptera Venom. Thus, we can improve our knowledge of the disease and promote good clinical practices. The present document provides practical suggestions for correct diagnosis, prescription of emergency therapy and immunotherapy, and strategies for patient care.

  • Hymenoptera Venom Allergy: Management of children and adults in clinical practice
    'Esmon Publicidad SA', 2019
    Co-Authors: Maria Beatrice Bilò, Bignardi D, Bonadonna P, Mauro M, Novembre E, Quercia O, Cilia M, Cortellini G, Mt Costantino
    Abstract:

    Hymenoptera Venom allergy is an epidemiologically underestimated condition representing an important cause of morbidity worldwide. Preventing future allergic reactions in patients who have developed a systemic reaction is based on the correct management of emergency followed by a correct diagnosis, prescription of adrenaline autoinjectors and, where indicated, specific Venom immunotherapy (VIT). Some epidemiological studies highlight the poor knowledge of this disease and the frequent inadequacy of its management. Moreover, they emphasize the importance of such a life-saving treatment as specific immunotherapy. The availability of high quality Hymenoptera Venom extracts for diagnostic and therapeutic use has dramatically improved the prognosis and the quality of life of allergic patients. The subcutaneous VIT represents the most effective form of immunotherapy with allergen presently available, with a carry-over effect lasting up to several years after its interruption. This report on the management of children and adults allergic to Hymenoptera Venom was drawn up by a panel of Italian experts. The main objective of this consensus is to review the scientific evidences related to diagnosis, therapy and management of patients allergic to Hymenoptera Venom and is aimed to improve the knowledge about this disease and promote good clinical practices. Practical suggestions for a correct diagnosis, prescription of emergency therapy and immunotherapy, as well as strategies for taking care of patients´ management are included