Hymenoptera venom can induce severe IgE-mediated systemic and even fatal allergic reactions. Fortunately, venom-specific immunotherapy (VIT) is one of the most effective disease-modifying curative treatments in the field of clinical allergology, but choosing the correct venom for VIT represents a crucial prerequisite for effective protection. In the past, therapeutic decisions based on specific IgE (sIgE) levels to whole venom extracts were not always straightforward. The presence of cross-reactive allergens and cross-reactive carbohydrate determinants (CCDs) in the extracts complicated the discrimination between cross-reactivity and true allergy to more than one venom. In the last years, the increasing knowledge of the composition of relevant venom allergens and the availability of recombinant CCD-free marker allergens resulted in the development of an advanced component-resolved diagnostics (CRD) of venom allergy. CRD has increased the sensitivity of sIgE detection and enabled the discrimination between primary sensitization and cross-reactivity, particularly in patients double-sensitized to honeybee and vespid venom. This article is protected by copyright. All rights reserved.
