This article is more than 5 years old. Information may no longer be current.

CAP-inhibition shows diagnostic importance in determining VIT

Research in this study found that CAP–inhibition shows some diagnostic importance over molecular allergy for patients with positive tests for both Vespula and Polistes spp., according to research.

“This suggests that in the choice of the venom to be used in immunotherapy CAP–inhibition remains a pivotal tool, because the significance of in vitro inhibition is definite and provides a diagnostic importance higher than molecular allergy in patients with positive tests to both Vespula and Polistes spp. who failed to recognize the culprit vespid,” Eleonora Savi, from the Allergy/Pulmonary Rehabilitation Department at ICP Hospital in Milan, Italy, and colleagues wrote in their study. “The availability of additional molecules, such as Pol d 1, will probably improve the ability of molecular allergy in vespid allergy, but this warrants to be demonstrated by further studies.”

Savi and colleagues evaluated 54 patients with anaphylactic reactions to Hymenoptera stings and positive reactions to both Vespula spp. and Polistes dominula demonstrated on skin tests and specific immunoglobulin E measurements, according to the abstract. Using CAP–inhibition (Thermo Fisher Scientific; Uppsala, Sweden) and diagnostics from molecular allergy, the researchers measured the sera of all patients with recombinant Ves v 1, Ves v 5 and Pol d 5 to determine which venom immunotherapy to prescribe for patients.

When using molecular allergy data, Savi and colleagues found 7 patients would be recommended Polistes VIT, 6 patients would be recommended Vespula VIT and 41 patients would be recommended both. They found CAP–inhibition data would recommend the Vespula VIT for 28 patients, the Polistes VIT for 15 patients and both VITs for 11 patients.

“The concordance between the results of molecular allergy with Ves v 1, Ves v 5, Pol d 5 and the results of CAP–inhibition was very poor, showing a value of k = 0.01,” Savi and colleagues wrote. “A good concordance was found only when the value in kU/l of Ves v 5 were about twice those of Pol d 5, and vice versa.” – by Jeff Craven

Disclosure: Savi received speaking fees from Thermofisher, Stallergenes and ALK; Peveri received speaking fees from Thermofisher; Pravettoni is a paid consultant for Alk-Abellò and Incorvaia is a paid consultant for Stallergenes.