IgE-Api m 4 is useful for identifying a particular phenotype of bee venom allergy

Background and objective: different clinical behaviors have been identified in patients allergic to bee venom. compound-resolved diagnosis could be an appropriate tool for investigating these differences. the aims of this study were to analyze whether specific ige to api m 4 (sige-api m 4) can identify a particular kind of bee venom allergy and to describe response to bee venom immunotherapy (bvit). methods: prospective study of 31 patients allergic to bee venom who were assigned to phenotype group a (sige-api m 4 <0.98 ku/l),treated with native aqueous (na) extract,or phenotype group b (sige-api m 4 ≥0.98 ku/l),treated with purified aqueous (pa) extract. sex,age,cardiovascular risk,severity of preceding sting reaction,exposure to beekeeping,and immunological data (intradermal test,sige/sigg4-apis-napi m 1,and sige-rapi m 2-api m 4 were analyzed. systemic reactions (srs) during bvit build-up were analyzed. immunological and sting challenge outcomes were evaluated in each group after 1 and 2 years of bvit. results: phenotype b patients had more severe reactions (p=.049) and higher skin sensitivity (p=.011),baseline sige-apis (p=.0004),sige-napi m 1 (p=.0004),and sigg4-apis (p=.027) than phenotype a patients. furthermore,41% of patients in group b experienced srs during the build-up phase with na; the sting challenge success rate in this group was 82%. there were no significant reductions in serial intradermal test results,but an intense reduction in sige-napi m 1 (p=.013) and sige-api m 4 (p=.004) was observed after the first year of bvit. conclusion: use of ige-api m 4 as the only discrimination criterion demonstrated differences in bee venom allergy. further investigation with larger populations is necessary. © 2016 esmon publicidad.