Cellular in vitro assays in the diagnosis of Hymenoptera venom allergy

International Archives of Allergy and Immunology
Kathrin SchererAndreas J Bircher

Abstract

The current diagnostic procedures of anaphylactic reactions to hymenoptera stings include intradermal tests, venom-specific IgE (sIgE) and possibly sting challenge tests. Sometimes, the culprit insect remains unidentified. The usefulness of the cellular assays CAST-ELISA and Flow-CAST in the management of hymenoptera venom allergy was investigated. 134 patients with systemic reactions after a yellow jacket wasp and/or honey bee sting and 44 healthy controls underwent skin tests, as well as determination of sIgE (CAP-FEIA), leukocyte sulfidoleukotriene release (CAST-ELISA) and basophil CD63 expression (Flow-CAST) upon insect venom stimulation. The clinical diagnosis based on the history alone served as reference. Sensitivity, specificity, and positive and negative predictive value of all methods were compared. Concordance and correlations among methods were calculated. Sensitivity and specificity of all in vitro tests were consistently high. The combination of all tests (skin tests, sIgE, combined cellular assays) yielded a positive predictive value of 100% for both venoms, if all 3 were positive, and a negative predictive value of 100%, if at least 1 test was positive. Relative specificities were considerably higher for the cel...Continue Reading

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Citations

Sep 28, 2010·Archivum Immunologiae Et Therapiae Experimentalis·Anna Wolanczyk-MedralaWojciech Medrala
Sep 30, 2010·Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete·B Wedi, A Kapp
Feb 13, 2008·International Archives of Allergy and Immunology·A L de WeckJ Sainte-Laudy
Feb 17, 2011·Immunotherapy·Beatrice M Bilò, Floriano Bonifazi
Apr 7, 2009·Journal of Proteomics·Dirk C de GraafBart Devreese
Nov 30, 2011·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·Tyson C Brown, Michael S Tankersley
Jan 22, 2013·Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology·D G EboL S De Clerck
Jun 19, 2009·Current Opinion in Allergy and Clinical Immunology·Kathrin SchererIngmar Afm Heijnen
Jun 27, 2013·Current Opinion in Allergy and Clinical Immunology·Tyson C Brown
Feb 5, 2014·Expert Review of Clinical Immunology·Didier G EboVito Sabato
Sep 17, 2014·Expert Review of Clinical Immunology·Astrid P UyttebroekDidier G Ebo
Jul 2, 2009·Current Opinion in Allergy and Clinical Immunology

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