Basophil responsiveness in patients with insect sting allergies and negative venom‐specific immunoglobulin E and skin prick test results

Korošec, Peter; Eržen, Renato; Šilar, Mira; Bajrović, Nissera; Kopač, Peter; Košnik, Mitja

doi:10.1111/j.1365-2222.2009.03347.x

Cited by 95 publications

(80 citation statements)

References 21 publications

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“…Previous reports have clearly described patients with a history of systemic reactionsafter Hymenoptera sting, but with negative venom-specific IgE and skin test results [1,2,3]. Moreover, Golden et al [1] showed that those patients could subsequently experience another severe reaction to sting because they demonstrated that after the sting challenge, the frequency of systemic reaction is comparable between patients with a positive (21%) and a negative (22%) skin test result.…”

Section: Introductionmentioning

confidence: 87%

“…An intradermal skin test was done with up to 1 μg/ml of wasp and honeybee venom allergen as previously described [3]. …”

Section: Methodsmentioning

confidence: 99%

“…It was previously demonstrated that in patients with a positive history of anaphylactic sting reaction and negative venom-specific IgE and skin testing, the CD63 basophil activation test (BAT) could be a very useful tool that can improve overall sensitivity of the diagnostic evaluation [3,4]. For this reason, a few years ago, we started using theBAT inroutine diagnostic testing of patients with negative venom-specific IgE antibodies, preferably in those with a severe clinical reaction.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, Golden et al [1] showed that those patients could subsequently experience another severe reaction to sting because they demonstrated that after the sting challenge, the frequency of systemic reaction is comparable between patients with a positive (21%) and a negative (22%) skin test result. Furthermore, in cases of fatal sting anaphylaxis, venom-specific IgEs are very low or even undetectable in more than 30% of patients [3]. …”

Section: Introductionmentioning

confidence: 99%

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Clinical Routine Utility of Basophil Activation Testing for Diagnosis of Hymenoptera-Allergic Patients with Emphasis on Individuals with Negative Venom-Specific IgE Antibodies

Korošec¹,

Šilar²,

Eržen³

et al. 2013

Int Arch Allergy Immunol

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Background: Previous reports suggest the usefulness of basophil activation testing (BAT) in Hymenoptera-allergic patients with negative venom-specific IgE antibodies. We sought to evaluate the diagnostic utility of this testing in a routine clinical laboratory setting. Materials and Methods: Twenty-one patients with anaphylactic reactions to Hymenoptera sting (median grade III) and negative venom-specific IgE were routinely and prospectively tested with BAT. Results: We were able to diagnose 81% (17 of 21) of patients with BAT and 57% (12 of 21) with intradermal skin testing. Three wasp venom-allergic patients showed IgE positivity to rVes v 5. Four patients (19%) were negative for all tests. In the case of double-positive BAT, the culprit insect correlated with the venom that induced a significantly higher basophil response. Conclusions: BAT allows the identification of severe Hymenoptera-allergic patients with negative specific IgE and skin tests. The routine use of this cellular test should facilitate prescription of venom immunotherapy in complex cases with inconclusive diagnostic results.

show abstract

Section: Introductionmentioning

confidence: 87%

“…An intradermal skin test was done with up to 1 μg/ml of wasp and honeybee venom allergen as previously described [3]. …”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Routine Utility of Basophil Activation Testing for Diagnosis of Hymenoptera-Allergic Patients with Emphasis on Individuals with Negative Venom-Specific IgE Antibodies

Korošec¹,

Šilar²,

Eržen³

et al. 2013

Int Arch Allergy Immunol

View full text Add to dashboard Cite

show abstract

“…This test has a diagnostic sensitivity of between 85% and 100%, with a specificity of 83% to 100%, depending on the study [27]. It has been reported that BAT is capable of diagnosing up to two-thirds of patients with SR due to stings and negative results with conventional tests [27,31].…”

Section: Systemic Reactions Due To Hymenoptera Stings With Negative Smentioning

confidence: 99%

Key Issues in Hymenoptera Venom Allergy: An Update

Alfaya

Soriano-Gomis

Mera

et al. 2017

J Investig Allergol Clin Immunol

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In this review, the Hymenoptera Allergy Committee of the SEAIC analyzes the most recent scientific literature addressing problems related to the diagnosis of hymenoptera allergy and to management of venom immunotherapy. Molecular diagnosis and molecular risk profiles are the key areas addressed. The appearance of new species of hymenoptera that are potentially allergenic in Spain and the associated diagnostic and therapeutic problems are also described. Finally, we analyze the issue of mast cell activation syndrome closely related to hymenoptera allergy, which has become a new diagnostic challenge for allergists given its high prevalence in patients with venom anaphylaxis.

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P38 mitogen‐activated protein kinase signal transduction in the diagnosis and follow up of immunotherapy of wasp venom allergy

Verweij

Knop

Bridts

et al. 2010

Cytometry Part B Clinical

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Background: P38 mitogen-activated protein kinase (MAPK) is known to govern IgE-mediated basophil activation. Intracellular phosphorylated p38 MAPK (Pp38 MAPK) in IgE-activated basophils can be quantified flow cytometrically.Objectives: To study whether Pp38 MAPK constitutes a potential novel read-out for flow-assisted diagnosis of hymenoptera venom allergy and to investigate whether this marker allows follow-up of successful venom immunotherapy (VIT).Methods: Fifty-two patients with documented wasp venom allergy and seven wasp-stung asymptomatic control individuals were enrolled. Wasp venom-induced basophil activation was analyzed flow cytometrically with anti-IgE, anti-CD63, and anti-Pp38 MAPK to assess their activation status before starting immunotherapy. To assess whether p38 MAPK constitutes a candidate marker for monitoring VIT, we repeated the basophil activation test (BAT) in 25 patients on the fifth day of a build-up immunotherapy. In addition, we investigated whether the Pp38 MAPK-based BAT could contribute in the decision of discontinuing VIT in a cross-sectional analysis in 13 patients receiving treatment for 3 years and 14 patients receiving treatment for 5 years.Results: Patients exhibited a dose-dependent basophil activation with phosphorylation of p38 MAPK and upregulation of downstream CD63. In contrast, stung controls demonstrated a dose-dependent but ''abrogated'' signal transduction in basophils with less and shorter duration of the phosphorylation of p38 MAPK and without subsequent upregulation of CD63. When repeated after 5 days of VIT and when investigated cross-sectionally after 3 years or 5 years of maintenance therapy, no effect of VIT on the phosphorylation of p38 MAPK was demonstrable.Conclusions: This study discloses that not only basophils from patients, but also from the stung control individuals, respond to wasp venom stimulation with phosphorylation of p38 MAPK, although to a lesser extend. No clear effect of VIT on the phosphorylation of p38 MAPK was shown. Thus, although p38 MAPK provides an additional tool in the diagnosis of wasp venom allergy, it does not contribute to the decision whether to stop successful VIT.

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Basophil responsiveness in patients with insect sting allergies and negative venom‐specific immunoglobulin E and skin prick test results

Abstract: Here we show that, in complex cases with inconclusive diagnostic results, the CD63 activation test could be particularly useful and more sensitive than intradermal skin testing.

Cited by 95 publications

References 21 publications

Clinical Routine Utility of Basophil Activation Testing for Diagnosis of Hymenoptera-Allergic Patients with Emphasis on Individuals with Negative Venom-Specific IgE Antibodies

Clinical Routine Utility of Basophil Activation Testing for Diagnosis of Hymenoptera-Allergic Patients with Emphasis on Individuals with Negative Venom-Specific IgE Antibodies

Key Issues in Hymenoptera Venom Allergy: An Update

P38 mitogen‐activated protein kinase signal transduction in the diagnosis and follow up of immunotherapy of wasp venom allergy

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