Specific allergen concentration of WHO and FDA reference preparations measured using a multiple allergen standard.

of diagnostic tests based on recombinant yellow jacket venom allergens. Nevertheless, rVes v 5 and rVes v 1 had missed 8% of subjects with established allergy. Testing for rVes v 2b added only a minor contribution to diagnostic sensitivity. Primarily, 3 allergens were recognized as responsible for Vespula venom allergy, beyond Ves v 5 and Ves v 1, also Ves v 2, which occurs in isoforms. Recently, a novel 100-kDa glycosylated protein with homology to dipeptidyl peptidases with allergenic potential, namely, Ves v 3, was reported as a yellow jacket allergen. rVes v 3 showed IgE reactivity in approximately 50% of Vespula allergic subjects (in overall 54 tested) andmight be useful to diagnose the few patients who are not identified with rVes v 5, 1, and 2. Clinically, we cannot afford to miss a patient who is sensitive to insect venom; thus, the whole venom (that contains all the venom allergens as a single test) needs to be the first line of laboratory evaluation. However, the identification of the disease-causing insect venom in venom allergy is often difficult. In such cases, commercially available CAP-FEIA tests based on recombinant rVes v 5 and rVes v 1 allergens should be helpful for the serological dissection of Vespula venom allergy.