Recognition of food-allergic patients and their allergens by the RAST technique and clinical investigation.
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Biomedical subjects
Publications and source records attributed to L Yman.
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Specific IgE antibodies against bee venom, phospholipase A, melittin and wasp venom have been examined in fifty patients with an unusually severe reaction after bee or wasp sting. Two thirds of the bee venom-sensitive patients also have detectable IgE antibodies to wasp venom. More than 50% of the wasp venom-sensitive patients are also allergic to bee venom. Phospholipase A and melittin IgE antibodies were found, respectively, in two thirds and one third of the bee venom-sensitive cases. Specific IgE antibody determinations by the Radioallergosorbent test play an essential role in the diagnostic work. After a reaction to hymenoptera stings both bee and wasp venom tests are necessary due to the high incidence of a false or incomplete identification of the stinging insect. Melittin, known for its potent pharmacological activity and possibly responsible for most of the side effects in bee venom immunotherapy, can probably not be excluded from therapeutic venom preparations since IgE antibodies to the melittin preparation were detected in one third of the cases.
Skin tests and estimation of specific IgE-antibodies by the RAST are evaluated as diagnostic procedures in bee sting hypersensitivity with the followiny extracts. (2) With bee venom results of skin tests and RAST correspond in 82%, with bee wholebody extracts in 68%. (3) Both with skin tests and the RAST with bee venom a good discrimination between patients with bee sting hypersensitivity and non-allergic controls is observed. Skin tests with bee venom are somewhat more sensitive than bee venom-RAST. (4) With the careful skin test procedure chosen, no adverse reactions were observed.
Clinical hypersensitivity to wasp stings was found to be fairly well correlated with the presence of serum IgE-antibodies against yellow jacket venom as detected by the RAST technique. Such antibodies were never found in a control group of non-allergic blood donors, but they were detected in a surprisingly large proportion of patients with bee sting allergy without known allergic reactions to wasps. Studies using RAST inhibition technique failed to prove cross-reactions between bee and wasp venoms. Considerably better results were obtained when venom antigens instead of whole body antigens were used in the RAST. RAST inhibition studies suggested that IgE-antibodies detected with RAST using whole body antigen are directed against bee venom constituents in the whole body extract.
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