Predominant Api m 10 sensitization as risk factor for treatment failure in honey bee venom immunotherapy

Frick, Marcel; Fischer, Jörg; Helbling, Arthur; Ruëff, Franziska; Wieczorek, Dorothea; Ollert, Markus; Pfützner, Wolfgang; Müller, Sabine; Huss-Marp, Johannes; Dorn, Britta; Biedermann, Tilo; Lidholm, Jonas; Ruecker, Gerta; Bantleon, Frank; Miehe, Michaela; Spillner, Edzard; Jakob, Thilo (2016). Predominant Api m 10 sensitization as risk factor for treatment failure in honey bee venom immunotherapy. Journal of allergy and clinical immunology, 138(6), 1663-1671.e9. Elsevier 10.1016/j.jaci.2016.04.024

[img]
Preview
Text
1-s2.0-S0091674916303542-main.pdf - Published Version
Available under License Creative Commons: Attribution-Noncommercial-No Derivative Works (CC-BY-NC-ND).

Download (1MB) | Preview

BACKGROUND

Component resolution recently identified distinct sensitization profiles in honey bee venom (HBV) allergy, some of which were dominated by specific IgE to Api m 3 and/or Api m 10, which have been reported to be underrepresented in therapeutic HBV preparations.

OBJECTIVE

We performed a retrospective analysis of component-resolved sensitization profiles in HBV-allergic patients and association with treatment outcome.

METHODS

HBV-allergic patients who had undergone controlled honey bee sting challenge after at least 6 months of HBV immunotherapy (n = 115) were included and classified as responder (n = 79) or treatment failure (n = 36) on the basis of absence or presence of systemic allergic reactions upon sting challenge. IgE reactivity to a panel of HBV allergens was analyzed in sera obtained before immunotherapy and before sting challenge.

RESULTS

No differences were observed between responders and nonresponders regarding levels of IgE sensitization to Api m 1, Api m 2, Api m 3, and Api m 5. In contrast, Api m 10 specific IgE was moderately but significantly increased in nonresponders. Predominant Api m 10 sensitization (>50% of specific IgE to HBV) was the best discriminator (specificity, 95%; sensitivity, 25%) with an odds ratio of 8.444 (2.127-33.53; P = .0013) for treatment failure. Some but not all therapeutic HBV preparations displayed a lack of Api m 10, whereas Api m 1 and Api m 3 immunoreactivity was comparable to that of crude HBV. In line with this, significant Api m 10 sIgG4 induction was observed only in those patients who were treated with HBV in which Api m 10 was detectable.

CONCLUSIONS

Component-resolved sensitization profiles in HBV allergy suggest predominant IgE sensitization to Api m 10 as a risk factor for treatment failure in HBV immunotherapy.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology and Immunology

UniBE Contributor:

Helbling, Arthur

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0091-6749

Publisher:

Elsevier

Language:

English

Submitter:

Stefan Kuchen

Date Deposited:

14 Mar 2017 11:18

Last Modified:

05 Dec 2022 15:02

Publisher DOI:

10.1016/j.jaci.2016.04.024

PubMed ID:

27372568

Uncontrolled Keywords:

Apis mellifera; HBV allergy; Hymenoptera venom allergy; allergen-specific immunotherapy; recombinant allergen; treatment failure

BORIS DOI:

10.7892/boris.95682

URI:

https://boris.unibe.ch/id/eprint/95682

Actions (login required)

Edit item Edit item
Provide Feedback