Scholarlink

Background <p>A&#xa0;reliable diagnosis of hymenoptera venom allergy is based on medical history, skin tests, and serological immunoglobulin&#xa0;E (IgE) determination. Over the past 10&#xa0;years, component-resolved diagnostics (CRD) have gained in importance, and new strategies for interpreting serological double sensitization have been introduced with the bee/vespula venom-specific IgE ratio.</p> Objectives <p>The aim was to examine whether the bee/vespula venom-specific IgE ratio supplemented by CRD can be a&#xa0;reliable alternative to skin testing.</p> Methods <p>In a&#xa0;student project, the guideline algorithm for serological diagnostics was supplemented with the sIgE ratio (≥ 5:1) and tested in a&#xa0;simulation using anonymized data from a&#xa0;retrospective study (Fischer et&#xa0;al.). A&#xa0;partial data set of 375 cases with complete CRD and documented prick and intradermal test results was selected for the simulation. The performance of the algorithm was evaluated by a&#xa0;post&#xa0;hoc comparison of the algorithmic therapy recommendations with the allergen immunotherapies (AIT) actually implemented in the clinic.</p> Results <p>The simulation yielded 48.5% monosensitizations and 49.9% double sensitizations. In 56.3% of the double sensitizations, the ratio ≥ 5:1 indicated a&#xa0;dominant sensitization, which was classified as a&#xa0;mono-allergy. The therapies suggested by the algorithm corresponded to the clinically implemented AIT in 91% of cases; overall, the correspondence was 89.7%. While the algorithm predicted double AIT in 10% of cases, this was only clinically implemented in 2.7% of cases, with anamnestic details on sting circumstances and diagnostic certainty influencing the decision.</p> Conclusion <p>Standardized serological diagnostics with bee/vespula venom-specific IgE ratio and CRD provide high diagnostic precision and comprehensively demonstrate the progress made over the last 10&#xa0;years. Skin tests remain a&#xa0;medically useful and valuable part of diagnostics, especially in cases of double sensitization.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Is the serological bee/vespula venom-specific IgE ratio supplemented by component-resolved diagnostics a reliable alternative to skin testing for hymenoptera venom allergy?

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月4日

查看全文
  • Jörg Fischer,
  • Ralf Wenninger,
  • Lena Löffelad,
  • Sebastian Volc

摘要

Background

A reliable diagnosis of hymenoptera venom allergy is based on medical history, skin tests, and serological immunoglobulin E (IgE) determination. Over the past 10 years, component-resolved diagnostics (CRD) have gained in importance, and new strategies for interpreting serological double sensitization have been introduced with the bee/vespula venom-specific IgE ratio.

Objectives

The aim was to examine whether the bee/vespula venom-specific IgE ratio supplemented by CRD can be a reliable alternative to skin testing.

Methods

In a student project, the guideline algorithm for serological diagnostics was supplemented with the sIgE ratio (≥ 5:1) and tested in a simulation using anonymized data from a retrospective study (Fischer et al.). A partial data set of 375 cases with complete CRD and documented prick and intradermal test results was selected for the simulation. The performance of the algorithm was evaluated by a post hoc comparison of the algorithmic therapy recommendations with the allergen immunotherapies (AIT) actually implemented in the clinic.

Results

The simulation yielded 48.5% monosensitizations and 49.9% double sensitizations. In 56.3% of the double sensitizations, the ratio ≥ 5:1 indicated a dominant sensitization, which was classified as a mono-allergy. The therapies suggested by the algorithm corresponded to the clinically implemented AIT in 91% of cases; overall, the correspondence was 89.7%. While the algorithm predicted double AIT in 10% of cases, this was only clinically implemented in 2.7% of cases, with anamnestic details on sting circumstances and diagnostic certainty influencing the decision.

Conclusion

Standardized serological diagnostics with bee/vespula venom-specific IgE ratio and CRD provide high diagnostic precision and comprehensively demonstrate the progress made over the last 10 years. Skin tests remain a medically useful and valuable part of diagnostics, especially in cases of double sensitization.