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Cross-reactions between Polistes dominula and Vespula species are common in southern Europe. Currently, only CAP-inhibition demonstrates high accuracy in identifying genuine sensitizations, but this method is time-consuming and expensive, so a new approach is required. This study investigates skin tests, molecular diagnostics, total IgE (tIgE), and the Ves v 5/Pol d 5 (or vice versa) ratio. The ratio generated low-accuracy results and poor agreement with CAP-inhibition, and we did not find any agreement between CAP-inhibition test and double values of Ves v 5/Pol d 5. Nevertheless, a slight diagnostic improvement was obtained when Ves v 5/tIgE and Pol d 5/tIgE were measured., (© 2018 S. Karger AG, Basel.)

Purpose of Review: Knowledge of the different stinging vespids found in various parts of Europe and their venom cross-reactivity is important in order to improve the venoms available for diagnostic and therapeutic purposes., Recent Findings: In recent years the amino acid sequences of different vespid venom allergens have been determined. Comparison of these sequences has led to an improved taxonomical classification of vespids compared with that based on morphological differences. However, the distribution of vespids in Europe is still based on a very good but somewhat old study carried out in the 1970s. Most recent epidemiological studies focus on the type of reaction produced rather than the insect responsible., Summary: The genera Vespula, Dolichovespula and Vespa are found all over Europe, but the genus Polistes, although present in central Europe, is not found in the UK and only represents a specific clinical problem in areas around the Mediterranean sea. Although there are significant differences in the distribution of stings, the genus Vespula predominates over Polistes and Vespa throughout Europe, except in Mediterranean areas. The different species of Polistes in Europe show a great similarity in the sequences of their venom allergens, but the similarity to their American counterparts is less marked. Vespula allergens show up to 95% sequence identity and almost complete cross-reactivity. There is also great cross-reactivity among the genera Vespula, Vespa and Dolichovespula. This identity of amino acid sequences confirms the latest morphological taxonomy of Hymenoptera and opens the way for the use of recombinant hybrids of different species in venom immunotherapy.