Component-resolved diagnostics to direct in venom immunotherapy: Important steps towards precision medicine

Area of Science:

• Allergy and Immunology
• Clinical Diagnostics
• Hymenoptera Venom Allergy

Background:

• Hymenoptera stings can cause severe allergic reactions, with venom-specific immunotherapy (VIT) being the only curative treatment.
• Accurate venom identification is crucial for effective VIT, but traditional methods using whole venom extracts can be ambiguous.
• Component-resolved diagnostics (CRD) has emerged as an advanced approach for diagnosing venom allergy.

Purpose of the Study:

• To review the current state, recent advancements, and future prospects of CRD in Hymenoptera venom allergy.
• To highlight how CRD improves the selection of appropriate venom for immunotherapy.
• To explore the potential of CRD in identifying patients at risk of side effects or non-response to VIT.

Main Methods:

• Utilizing recombinant allergens for enhanced sensitivity in specific IgE (sIgE) detection.
• Discriminating between primary sensitization and cross-reactivity using molecular allergen information.
• Analyzing sensitization profiles at a molecular level.

Main Results:

• CRD increases the sensitivity of sIgE detection in venom allergy diagnosis.
• CRD enables differentiation between primary sensitization and cross-reactivity, especially in complex cases (e.g., honeybee and vespid venom sensitization).
• CRD aids in selecting the most suitable venom for immunotherapy, improving patient outcomes.

Conclusions:

• CRD significantly enhances the precision of venom allergy diagnosis and the selection of personalized immunotherapy.
• Molecular-level insights from CRD offer potential for predicting treatment response and side effects.
• CRD represents a key advancement towards patient-tailored therapeutic decisions in Hymenoptera venom allergy.