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- Title
Cross-reactive carbohydrate determinants strongly affect the results of the basophil activation test in hymenoptera-venom allergy.
- Authors
Mertens, M.; Amler, S.; Moerschbacher, B. M.; Brehler, R.
- Abstract
Background In hymenoptera-venom allergy, sera of up to 60% of patients show in vitro reactivity to honeybee venom (HBV) and yellow jacket venom (YJV). This phenomenon is mainly caused by specific IgE (sIgE) against cross-reactive carbohydrate determinants (CCD). Whether or not these antibodies can induce clinical symptoms is a longstanding debate. Objective The aim of this study was to investigate the biological activity of CCD-sIgE and the suitability of the basophil activation test (BAT) in hymenoptera venom-allergic patients having CCD-sIgE. Methods The biological activity of CCD-sIgE was analysed by application of native and CCD-depleted YJV and HBV in BAT with the blood of 62 hymenoptera venom-allergic patients and 16 non-allergic controls. According to results of intracutaneous skin tests (IC) with YJV and HBV and the existence of CCD-sIgE, patients were classified into six subgroups. Results In patients with mono-positive IC and CCD-sIgE, and thus double-positive sIgE, BAT with native venoms was also double positive in up to 67% of the patients. In contrast, BAT with CCD-depleted venoms was positive only with the IC-positive venom. However, activation of basophils with the IC-negative venom was significantly lower compared with the IC-positive one. In IC mono-positive patients without CCD-sIgE, BAT was mono-positive with the IC-positive venom in the native and in the CCD-depleted form. CCD-positive patients with double-positive IC were a heterogeneous group, with the majority of CCD-positive patients also being double positive with the native forms of both venoms but mono-positive with the CCD-depleted ones. Conclusions In vitro BAT clearly demonstrates biological activity of CCD-sIgE. However, because most of the patients showed a mono-positive IC and activation of basophils with the IC-negative venom was significantly lower compared with the IC-positive one, the present data suggest that CCD-sIgE is clinically irrelevant in these patients. Cite this as: M. Mertens, S. Amler, B. M. Moerschbacher and R. Brehler, Clinical & Experimental Allergy, 2010 (40) 1333–1345.
- Subjects
BASOPHILS; VENOM; INSECT allergy; CARBOHYDRATES; YELLOW jackets (Vespidae); IMMUNOGLOBULINS; SKIN tests
- Publication
Clinical & Experimental Allergy, 2010, Vol 40, Issue 9, p1333
- ISSN
0954-7894
- Publication type
Article
- DOI
10.1111/j.1365-2222.2010.03535.x