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Allergo Journal

, Volume 28, Issue 6, pp 42–51 | Cite as

Prevalence of Hymenoptera venom allergy and sensitization in the population-representative German KORA cohort

  • Simon BlankEmail author
  • Stephanie Haemmerle
  • Teresa Jaeger
  • Dennis Russkamp
  • Johannes Ring
  • Carsten B. Schmidt-Weber
  • Markus Ollert
Original

Abstract

Purpose

Allergic reactions to Hymenoptera venoms represent potentially life-threatening conditions. However, studies on their prevalence in Germany and their relation to specific IgE sensitization are rare. The aim of this study was to evaluate the prevalence of Hymenoptera venom allergy as well as the frequency of venom-specific IgE sensitization in a large population-based adult German cohort.

Methods

Questionnaire data were collected from the participants of the German population-based KORA (Cooperative Health Research in the Region of Augsburg) S4 baseline study population (n = 4,261) and the follow-up F4 study population (n = 3,074), which was conducted seven years later. Moreover, sIgE antibodies to honeybee (HBV) and yellow jacket venom (HJV) as well as to common aeroallergens were measured in the S4 study population.

Results

The prevalence of systemic sting reactions ranged between 2.3 % and 2.6 %. sIgE sensitization (≥ 0.35 kUA/L) to HBV and YJV was demonstrated in 23.1 % and 31.7 % of the population, respectively (41.6 % to HBV and/or YJV). Double-sensitization to both venoms occurred in 13.2 % of the individuals. Approximately 53 % and 77 % of the individuals who reported shock symptoms after honeybee and yellow jacket stings, respectively, exhibited sIgE ≥ 0.35 kUA/L to the culprit venom. In contrast, only 2.8 % of the venom-sensitized individuals reported symptoms exceeding local reactions. Local reactions were reported by 4.4 to 4.8 % of the population.

Conclusions

Self-reported Hymenoptera sting reactions and venom sensitization are frequent in the general German population. In many cases, sensitization and clinically relevant allergy are not observed in the same individual, indicating that comprehensive diagnostic approaches are a prerequisite for the identification of patients at risk for severe reactions.

Keywords

anaphylaxis honeybee venom insect venom allergy specific IgE systemic reaction venom sensitization yellow jacket venom 

Abbreviations

BMBF

German ministry of education and research

CCD

Cross-reactive carbohydrate determinant

CI

Confidence interval

DZL

German Center of Lung Research

HB

Honeybee

HBV

Honeybee venom

KORA

Cooperative Health Research in the Region of Augsburg

LIH

Luxembourg institute of health

LLRs

Large local reactions

NGFN

German national genome research network

OR

Odds ratio

RAST

Radioallergosorbent test

sIgE

Specific immunoglobulin E

tIgE

Total immunoglobulin E

VIT

Venom-specific immunotherapy

YJ

Yellow jacket

YJV

Yellow jacket venom

ZAUM

Center of allergy and environment

Notes

Acknowledgements

We are extremely grateful to all the individuals and families who took part in this study, the professionals who helped in recruiting them, and the KORA team, which includes interviewers, computer and laboratory technicians, research scientists, volunteers, managers, receptionists and nurses. Moreover, we gratefully acknowledge the KORA study group for providing us with all the sera and information of the surveys. We also gratefully acknowledge the technical contributions by Birgit Halter and Johanna Grosch.

Funding

The study was partially funded by grant 01GC0104 from the German Ministry of Education and Research (BMBF; to MO) and by grant UW-S15T03 from the German National Genome Research Network (NGFN) of the BMBF (to MO and JR). The IgE assays for the Immulite 2000® platform were kindly provided through an unrestricted grant by Siemens Healthcare Diagnostics.

Supplementary material

References

  1. 1.
    Antonicelli L, Bilo MB, Bonifazi F. Epidemiology of hymenoptera allergy. Curr Opin Allergy Clin Immunol. 2002;2:341–6CrossRefGoogle Scholar
  2. 2.
    Bilo BM, Bonifazi F. Epidemiologyofinsect-venom anaphylaxis. CurrOpinAllergyClin Immunol. 2008;8:330–7Google Scholar
  3. 3.
    Hoffman DR. Fatal reactions tohymenoptera stings. Allergy AsthmaProc. 2003;24:123–7Google Scholar
  4. 4.
    Worm M, Moneret-Vautrin A, Scherer K, Lang R, Fernandez Rivas M, Cardona V, et al. First European data from the network of severe allergic reactions (NORA). Arerugi. 2014;69:1397–404Google Scholar
  5. 5.
    Bilo BM, Rueff F, Mosbech H, Bonifazi F, Oude-Elberink JN, Hypersensitivity EIGoIV. Diagnosis of hymenoptera venom allergy. Arerugi. 2005;60:1339–49Google Scholar
  6. 6.
    Sturm GJ, Varga EM, Roberts G, Mosbech H, Bilo MB, Akdis CA, et al. EAACI guidelines on allergen immunotherapy: hymenoptera venom allergy. Arerugi. 2017;73:744–64Google Scholar
  7. 7.
    Blank S, Bilo MB, Ollert M. Component-resolved diagnostics todirectinvenomimmunotherapy: importantsteps towardsprecisionmedicine. ClinExpAllergy. 2018;48:354–64Google Scholar
  8. 8.
    Boyle RJ, Elremeli M, Hockenhull J, Cherry MG, Bulsara MK, Daniels M, et al. Venom immunotherapy for preventing allergic reactions to insect stings. Cochrane Database Syst Rev. 2012Google Scholar
  9. 9.
    Schiener M, Graessel A, Ollert M, Schmidt-Weber CB, Blank S. Allergen-specificimmunotherapy of hymenoptera venom allergy — also a matter of diagnosis. Hum Vaccin Immunother 2017;13:2467–81CrossRefGoogle Scholar
  10. 10.
    Przybilla B, Kapp A. Anaphylaxie auf Insektenstiche. Hautarzt 2014;65:768CrossRefGoogle Scholar
  11. 11.
    Worm M, Eckermann O, Dolle S, Aberer W, Beyer K, Hawranek T, et al. Triggers and treatment of anaphylaxis: an analysis of 4,000 cases from Germany, Austria and Switzerland. DtschArztebl Int 2014;111:367–75Google Scholar
  12. 12.
    Holle R, Happich M, Lowel H, Wichmann HE, Group MKS. KORA — a research platform for population based health research. Gesundheitswesen 2005;67(Suppl 1):S19–S25CrossRefGoogle Scholar
  13. 13.
    Ollert M, Weissenbacher S, Rakoski J, Ring J. Allergenspecific IgE measured by a continuous random-access immunoanalyzer: interassay comparison and agreement with skin testing. ClinChem 2005;51:1241–9Google Scholar
  14. 14.
    Bjornsson E, Janson C, Plaschke P, Norrman E, Sjoberg O. Venom allergyin adult Swedes: a population study. Arerugi 1995;50:800–5Google Scholar
  15. 15.
    Bokanovic D, Aberer W, Griesbacher A, Sturm GJ. Prevalence of hymenoptera venom allergy and poor adherence to immunotherapy in Austria. Arerugi 2011;66:1395–6Google Scholar
  16. 16.
    Charpin D, Birnbaum J, Lanteaume A, Vervloet D. Prevalence of allergy to hymenoptera stings in different samples of the general population. J Allergy Clin Immunol 1992;90:331–4CrossRefGoogle Scholar
  17. 17.
    Mosbech H, Tang L, Linneberg A. Insect sting reactions and specific IgE to venom and major allergens in a general population. IntArchAllergy Immunol 2016; 170:194–200CrossRefGoogle Scholar
  18. 18.
    Nittner-Marszalska M, Liebhart J, Liebhart E, Dor A, Dobek R, Obojski A, et al. Prevalence of hymenoptera venom allergy and its immunological markers current in adults in Poland. MedSciMonit 2004;10:CR324–9Google Scholar
  19. 19.
    Onbasi K, Onbasi O, Eminbeyli L, Kaynak C. Prevalence and alternativetherapymethods forbeeandwaspallergyinVan. Arerugi 2008;63:246–7Google Scholar
  20. 20.
    Incorvaia C, Mauro M, Pastorello EA. Hymenoptera stings inconscripts. Arerugi 1997;52:680–1Google Scholar
  21. 21.
    Navarro LA, Pelaez A, dela Torre F, TeniasBurillo JM, Megias J, Martinez I. Epidemiological factors on hymenoptera venom allergy in a Spanish adult population. J Investig Allergol Clin Immunol 2004;14:134–41PubMedGoogle Scholar
  22. 22.
    Langen U, Schmitz R, Steppuhn H. Häufigkeit allergischer Erkrankungen in Deutschland. Robert Koch-Institut, Epidemiologie und Gesundheitsberichterstattung 2013CrossRefGoogle Scholar
  23. 23.
    Schäfer T, Przybilla B. IgE antibodies to hymenoptera venoms in the serum are common in the general population and are related to indications of atopy. Arerugi 1996;51:372–7Google Scholar
  24. 24.
    Cifuentes L, Blank S, Pennino D, Michel J, Darsow U, Ring J, et al. Reply: to PMID 24290287. J Allergy Clin Immunol 2014;134:494–5CrossRefGoogle Scholar
  25. 25.
    Jakob T, Spillner E. Comparing sensitivity of hymenoptera allergen components on different diagnostic assay systems: comparing apples and oranges? J Allergy Clin Immunol 2017;139:1066–7CrossRefGoogle Scholar
  26. 26.
    Szecsi PB, Stender S. Comparison of immunoglobulin E measurementson IMMULITEand ImmunoCAPinsamples consisting of allergen-specific mouse-human chimeric monoclonal antibodies towards allergen extracts and four recombinant allergens. Int Arch Allergy Immunol 2013;162:131–4CrossRefGoogle Scholar
  27. 27.
    Wood RA, Segall N, Ahlstedt S, Williams PB. Accuracy of IgE antibody laboratory results. Ann Allergy Asthma Immunol 2007;99:34–41CrossRefGoogle Scholar
  28. 28.
    Schrautzer C, Bokanovic D, Hemmer W, Lang R, Hawranek T, Schwarz I, et al. Sensitivity and specificity of hymenoptera allergen components depend on the diagnostic assay employed. J Allergy Clin Immunol 2016;137:1603–5CrossRefGoogle Scholar
  29. 29.
    Pastorello EA, Incorvaia C, Sarassi A, Qualizza R, Bigi A, Farioli L. Epidemiological and clinical study on bee venom allergy among beekeepers. Boll Ist Sieroter Milan 1988;67:386–92PubMedGoogle Scholar
  30. 30.
    Settipane GA, Newstead GJ, Boyd GK. Frequency of hymenoptera allergy in an atopic and normal population. J Allergy Clin Immunol 1972;50:146–50CrossRefGoogle Scholar
  31. 31.
    Jakob T, Muller U, Helbling A, Spillner E. Component resolved diagnostics for hymenoptera venom allergy. Curr Opin Allergy Clin Immunol 2017;17:363–72CrossRefGoogle Scholar
  32. 32.
    Jakob T, Rafei-Shamsabadi D, Spillner E, Müller S. Diagnostics in hymenoptera venom allergy: current concepts and developments with special focus on molecular allergy diagnostics. Allergo J Int 2017; 26:93–105CrossRefGoogle Scholar

Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  • Simon Blank
    • 1
    Email author
  • Stephanie Haemmerle
    • 2
    • 3
  • Teresa Jaeger
    • 2
  • Dennis Russkamp
    • 1
  • Johannes Ring
    • 2
  • Carsten B. Schmidt-Weber
    • 1
  • Markus Ollert
    • 2
    • 4
    • 5
  1. 1.Center of Allergy and Environment (ZAUM)Technical University of Munich and Helmholtz Center Munich, Member of the German Center of Lung Research (DZL)MunichGermany
  2. 2.Department of Dermatology and AllergyBiederstein Technical University of MunichMunichGermany
  3. 3.Department of Child and Adolescent Psychiatry, Psychosomatics and PsychotherapyUniversity Hospital MunichMunichGermany
  4. 4.Department of Infection and ImmunityLuxembourg Institute of Health (LIH)Esch-sur-AlzetteLuxembourg
  5. 5.Department of Dermatology and Allergy Center, Odense Research Center for AnaphylaxisUniversity of Southern Denmark, OdenseOdenseDenmark

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