Wasp venom is appropriate for immunotherapy of patients with allergic reaction to the European hornet sting.

AIM To identify whether it is the yellow jacket (Vespula germanica) or European hornet (Vespa crabro) venom that induces sensitization in patients with IgE-mediated allergic reaction to the venom from the sting of a European hornet. Since these patients usually have positive skin tests and specific IgE to all vespid venoms, it would be useful to distinguish cross-reactors from non-cross-reactors to perform immunotherapy with the venom that induced the sensitization. METHODS We performed inhibition tests in 24 patients who had experienced anaphylactic reaction after being stung by a European hornet. RESULTS Of 24 patients with allergic reaction after Vespa crabro sting, 17 were sensitized only to epitopes of Vespula germanica venom. Only 4 out of 24 patients were sensitized to epitopes completely cross-reactive with Dolichovespula arenaria venom. CONCLUSION In Slovenia, the vast majority of patients with anaphylactic reaction to Vespa crabro sting seem to be sensitized to Vespula germanica venom. We consider wasp venom an appropriate immunotherapeutic agent for such patients, except for those with proven primary sensitization to specific epitopes of Vespa crabro venom. Fluorescence enzyme immunoassay inhibition should be considered a convenient tool for the identification of primary sensitization in patients allergic to vespid venoms.