Prick and intradermal skin tests in patients with severe hymenoptera sting allergy using commercial versus in-house allergen extracts
1
Issued Date
2025-03-01
Resource Type
ISSN
0125877X
Scopus ID
2-s2.0-105001211581
Pubmed ID
34246210
Journal Title
Asian Pacific journal of allergy and immunology
Volume
43
Issue
1
Start Page
40
End Page
48
Rights Holder(s)
SCOPUS
Bibliographic Citation
Asian Pacific journal of allergy and immunology Vol.43 No.1 (2025) , 40-48
Suggested Citation
Visitsunthorn N., Visitsunthorn K., Sookrung N., Srisuwatchari W., Pacharn P., Jirapongsananuruk O. Prick and intradermal skin tests in patients with severe hymenoptera sting allergy using commercial versus in-house allergen extracts. Asian Pacific journal of allergy and immunology Vol.43 No.1 (2025) , 40-48. 48. doi:10.12932/AP-151120-0995 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/109316
Title
Prick and intradermal skin tests in patients with severe hymenoptera sting allergy using commercial versus in-house allergen extracts
Author's Affiliation
Corresponding Author(s)
Other Contributor(s)
Abstract
BACKGROUND: Fire ant, honey bee, and wasp allergen extracts are useful in the diagnosis and treatment of severe Hymenoptera allergic patients. OBJECTIVE: To evaluate the result of skin prick test (SPT) and intradermal test (ID) compared between local and commercial insect allergen extracts in patients with severe Hymenoptera sting allergy. METHODS: SPT and ID using local and commercial insect allergen extracts were performed. Specific IgE (sIgE) to honey bee, wasp, and fire ant; component-resolved diagnosis (CRD); (rApi m1, rApi m2, rApi m3, rApi m5, rApi m10, rVes v5, rPol d5, and rVes v1); and, cross-reactive carbohydrate determinant (CCD) were performed. RESULTS: Twenty-seven patients were included. Twenty-five had anaphylaxis, and 2 had severe systemic skin reaction. Positive skin test (SPT and/or ID) result from local and commercial allergen extracts was 74% vs. 67% for fire ant, 48% vs. 59% for honey bee, and 52% vs. 74% for yellowjacket. Local and commercial allergen extracts showed substantial agreement for fire ant (k = 0.647, p = 0.001) and honey bee (k = 0.632, p = 0.001), and moderate agreement for wasp (k = 0.547, p = 0.001). When compared with sIgE subtracted with CCD and/or CRD, skin test results of local fire ant allergen extract showed higher sensitivity (87% vs. 67%), specificity (42% vs. 33%), and accuracy (67% vs. 52%) than commercial extract. Commercial honey bee and wasp showed higher sensitivity (62% vs. 50%, 85% vs. 65%) and accuracy (63% vs. 52%, 78% vs. 70%), respectively. CONCLUSIONS: SPT and ID with local or commercial insect venoms could help in confirming and/or identifying the causative insects.