Antibody binding to venom carbohydrates is a frequent cause for double positivity to honeybee and yellow jacket venom in patients with stinging-insect.

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23. Clinical laboratory assessment of IgE-dependent hypersensitivity

Presentation transcript:

Antibody binding to venom carbohydrates is a frequent cause for double positivity to honeybee and yellow jacket venom in patients with stinging-insect allergy Wolfgang Hemmer, PhD, Margarete Focke, PhD, Daniel Kolarich, PhD, Iain B.H. Wilson, PhD, Friedrich Altmann, PhD, Stefan Wöhrl, MD, Manfred Götz, MD, Reinhart Jarisch, MD Journal of Allergy and Clinical Immunology Volume 108, Issue 6, Pages 1045-1052 (December 2001) DOI: 10.1067/mai.2001.120013 Copyright © 2001 Mosby, Inc. Terms and Conditions

Fig. 1 Structure of N-linked glycans displayed by the neoglycoproteins MM-BSA (top) and MUXF-BSA (middle) . MMF oligosaccharides (bottom) are typical for honeybee phospholipase A and hyaluronidase. Man , Mannose; GlcNAc , N-acetylglucosamine; Fuc , fucose; Xyl , xylose. Journal of Allergy and Clinical Immunology 2001 108, 1045-1052DOI: (10.1067/mai.2001.120013) Copyright © 2001 Mosby, Inc. Terms and Conditions

Fig. 2 IgE binding to OSR pollen extracts in patients with stinging-insect allergy. Fourteen patients with a single-positive CAP result to honeybee venom, 16 patients with a single-positive CAP result to YJ venom, and 41 patients with double-positive CAP results were randomly selected, and their reactivity with OSR pollen glycoproteins was assessed by means of CAP. Median CAP scores for each group are indicated. Journal of Allergy and Clinical Immunology 2001 108, 1045-1052DOI: (10.1067/mai.2001.120013) Copyright © 2001 Mosby, Inc. Terms and Conditions

Fig. 3 Dose-dependent inhibition of honeybee (HB) and YJ venom CAP results in 2 selected patients with double-positive results and a history of YJ venom allergy and positive CAP results to OSR pollen (patients 7 and 8). Patient sera were incubated overnight at 4°C with doses of 4, 20, or 100 μg/mL inhibitor protein, and nonbound IgE levels were measured by means of CAP. Inhibition by BSA (negative control) was done only with 100 μg/mL. IgE binding to honeybee venom was equivalently inhibited by OSR pollen extracts in both patients. MUXF-BSA was highly effective in patient 8 but not in patient 7, being inversely correlated with the inhibitory capacity of YJ venom. Filled circles , Honeybee venom; filled squares , YJ venom; open squares , OSR pollen; open triangles , MUXF-BSA; open diamonds , BSA. Journal of Allergy and Clinical Immunology 2001 108, 1045-1052DOI: (10.1067/mai.2001.120013) Copyright © 2001 Mosby, Inc. Terms and Conditions

Fig. 4 Inhibition of IgE binding to honeybee venom, YJ venom, and OSR pollen by Hymenoptera venoms, pollen allergens, and MUXF-BSA (all 100 μg/mL) in 4 patients with double-positive test results with anti-CCD IgE antibodies (patients 7, 9, 12, and 14). Bars represent the percentage of IgE binding in the inhibited serum in comparison with that in the noninhibited serum. IgE binding to honeybee venom was inhibited by OSR pollen proteins and was comparable with autologous inhibition in all patients. The efficacy of YJ venom in inhibiting honeybee and OSR CAP results was reciprocal to that of MUXF-BSA. HB , Honeybee venom; GR , timothy grass pollen; MUXF, MUXF-BSA , n.d. , not determined. Journal of Allergy and Clinical Immunology 2001 108, 1045-1052DOI: (10.1067/mai.2001.120013) Copyright © 2001 Mosby, Inc. Terms and Conditions

Fig. 5 Inhibition of IgE binding to honeybee and YJ venom in 7 patients with venom double-positive test results by different concentrations of a carbohydrate-specific rabbit antiserum (anti-Bra n). Open circles , Patients with YJ venom allergy cross-reacting with honeybee glycans (patients 7, 9, and 10); open triangles , patients reacting only with venom carbohydrates (patients 13 and 14); filled diamonds , truly double-sensitized patients without carbohydrate-specific IgE (patients 1 and 3). Journal of Allergy and Clinical Immunology 2001 108, 1045-1052DOI: (10.1067/mai.2001.120013) Copyright © 2001 Mosby, Inc. Terms and Conditions