Component-resolved diagnostics (CRD) is a new method for detecting IgE-mediated sensitizations to specific allergens. This paper reviews new work on molecular diagnostics in the realm of Hymenoptera venom allergy (HVA), as well as the strengths and shortcomings of CRD. In patients with dual/multiple positive characteristics, a CRD, with single molecules, or panels of allergens, may distinguish between primary sensitisation and cross-reactivity, allowing the specialist to select the best poison for specific immunotherapy (VIT), preventing unnecessary VIT, or reducing the risk of side effects. Further diagnostic performance can be increased if cross reactive reactive pairs of allergens of different species are available. CRD may be effective for individuals with negative allergy testing and a confirmed history of an earlier systemic reaction, including those who potentially benefit from VIT with mast cell diseases. Various sensitivity profiles that can be related with an increased risk of vitreous failure or adverse effects have been observed in honeybee venom allergy.

CRD is a novel approach which leads to a more accurate description of the HVA patient’s sensitization profile. CRD can contribute to optimising the patient-specific therapy together with increased understanding about the molecular composition of various venom extracts.