Stings of Hymenoptera can induce
IgE-mediated systemic and even fatal
allergic reactions.
Venom-specific
immunotherapy (VIT) is the only disease-modifying and curative treatment of
venom allergy. However, choosing the correct
venom for VIT represents a necessary prerequisite for efficient protection against further anaphylactic
sting reactions after VIT. In the past, therapeutic decisions based on the measurement of specific
IgE (sIgE) levels to whole
venom extracts were not always straightforward, especially when the patient was not able to identify the culprit insect. In the last years, the increasing knowledge about the molecular structure and relevance of important
venom allergens and their availability as recombinant
allergens, devoid of cross-reactive
carbohydrate determinants, resulted in the development of an advanced component-resolved diagnostics (CRD) approach in
venom allergy. Already to date, CRD has increased the sensitivity of sIgE detection and enabled the discrimination between primary sensitization and cross-reactivity, particularly in patients with sensitization to both honeybee and
vespid venom. Hence, CRD in many patients improves the selection of the appropriate immunotherapeutic intervention. Moreover, the detailed knowledge about sensitization profiles on a molecular level might open new options to identify patients who are at increased risk of side-effects or not to respond to
immunotherapy. Therefore, increasing potential of CRD becomes evident, to direct therapeutic decisions in a personalized and patient-tailored manner. Reviewed here are the state of the art options, recent developments and future perspectives of CRD of
Hymenoptera venom allergy.