Antigen 5 Allergens of Hymenoptera Venoms and Their Role in Diagnosis and Therapy of Venom Allergy
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ALLERGENS (RK BUSH AND S VIETHS, SECTION EDITORS)
Antigen 5 Allergens of Hymenoptera Venoms and Their Role in Diagnosis and Therapy of Venom Allergy Simon Blank 1 & Murilo Luiz Bazon 1,2 & Johannes Grosch 1 & Carsten B. Schmidt-Weber 1 & Márcia Regina Brochetto-Braga 2 & Maria Beatrice Bilò 3 & Thilo Jakob 4
# The Author(s) 2020
Abstract Purpose of Review Stings of Hymenoptera of the superfamily Vespoidea such as yellow jackets, paper wasps or stinging ants are common triggers for severe and even fatal allergic reactions. Antigen 5 allergens are potent allergens in the majority of these venoms with major importance for diagnosis and therapy. Reviewed here are the characteristics of antigen 5 allergens, their role in component-resolved diagnostics as well as current limitations of the available diagnostics for proper therapeutic decisions. Recent Findings Antigens 5 are proteins of unknown function in Hymenoptera venoms with high allergenic potency. They represent key elements in component-resolved diagnosis to discriminate between honeybee and vespid venom allergy. However, due to their pronounced cross-reactivity, there are remaining diagnostic and therapeutic challenges that have to be addressed. Summary Antigens 5 are highly relevant venom allergens of the Vespoidea superfamily. Although their use in componentresolved diagnosis facilitates dissection of cross-reactivity and primary allergy in double sensitization to honeybee and vespid venom, new diagnostic concepts are needed to discriminate between allergies to different vespid species. Keywords Antigen 5 . Component-resolved diagnostics . Allergen cross-reactivity . Hymenoptera venom allergy . Polistes dominula venom . Yellow jacket venom
Introduction Stings of Hymenoptera are one of the most frequent triggers for severe IgE-mediated anaphylaxis in adults [1]. Systemic Simon Blank and Thilo Jakob contributed equally to this work. This article is part of the Topical Collection on Allergens. * Simon Blank [email protected] 1
Center of Allergy and Environment (ZAUM), School of Medicine and Helmholtz Center Munich, German Research Center for Environmental Health, Member of the German Center of Lung Research (DZL), Technical University of Munich, Ingolstädter Landstraße 1, 85764 Munich, Germany
2
Department of General and Applied Biology, Biosciences Institute, Sao Paulo State University, Rio Claro, São Paulo, Brazil
3
Department of Clinical and Molecular Sciences, Ancona and Allergy Unit, Department of Internal Medicine, University Hospital of Ancona, Polytechnic University of Marche, Ancona, Italy
4
Experimental Dermatology and Allergy Research Group, Department of Dermatology and Allergology, Justus-Liebig-University Gießen, Giessen, Germany
reactions to the venoms of stinging Hymenoptera may be restricted to generalized symptoms of the skin, but can also affect the respiratory and vascular system and lead to multiorgan failure. Fatal anaphylaxis after Hymenoptera stings is a rare but well-recognized cause of sudden death [2] and accounts for appro
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