Benefit of the basophil activation test in deciding when to reintroduce cow’s milk in allergic children

Rubio, Andres J.; Vivinus-Nébot, Mylène; Bourrier, T.; Saggio, B.; Albertini, M.; Bernard, A.

doi:10.1111/j.1398-9995.2010.02432.x

Cited by 114 publications

(93 citation statements)

References 40 publications

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“…BAT should be carried out as soon as possible after blood withdrawal [9,11,123], and its performance may depend on several factors, such as the type of vial used for specimen collection [109]. BATs have proved to be useful tools to diagnose early onset of allergy and anaphylactic adverse reactions, such as with drugs [124], but also in monitoring immunotherapy [125,126,127] and to reintroduce food to allergic children [128]. Multicenter and pilot studies have also been carried out in order to achieve a consensus agreement and to outline possible guidelines for BAT optimization and application [129,130,131].…”

Section: Resultsmentioning

confidence: 99%

Basophil Activation Test in Allergy: Time for an Update?

Chirumbolo

2012

Int Arch Allergy Immunol

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A wide range of reported evidence in the literature has shown that the quantification of basophil activation by flow cytometry (basophil activation test, BAT) has proven to be a useful tool for the assessment of immediate-type responses to allergens mediated by IgE or other mechanisms in allergic patients. The usefulness of BAT in anaphylactic adverse reactions, late-onset allergy and immunotherapy follow-up has also been demonstrated. To date, most BAT studies reported in the literature involved the capture of basophils only with a fluorochrome-labeled anti-IgE antibody and application of CD63 upregulation in order to evaluate the basophil response to allergens. Many issues need to be addressed, such as optimizing the analytical performance of the test, checking preanalytical conditions, the selection of the flow cytometry best gating protocol, the introduction of new algorithms and parameters, the search for new activation markers and the introduction of anti-IgE controls. BAT is certainly a useful technique, also for isolated cases of hypersensitivity to various other compounds and drugs, and an update of its application is certainly an interesting topic to expand the debate on allergy diagnosis.

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Section: Resultsmentioning

confidence: 99%

Basophil Activation Test in Allergy: Time for an Update?

Chirumbolo

2012

Int Arch Allergy Immunol

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“…This varied response has been described previously [22,23,24]. The consequence of this is that an oral challenge has to be performed on individuals who are low responders or nonresponders in the CD-sens test [22].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies comparing CD-sens and skin prick test titration [20], nasal allergen challenge [20] and food challenges also indicated a good agreement [22]. Basophil activation tests measuring cell reactivity have also been evaluated in milk, egg and wheat allergy [23,24,25,] and, recently, Chinuki et al [16] showed that basophil reactivity could be useful in differentiating between subtypes of WDEIA caused by wheat and/or by HWP.…”

Section: Introductionmentioning

confidence: 99%

Combining Analyses of Basophil Allergen Threshold Sensitivity, CD-sens, and IgE Antibodies to Hydrolyzed Wheat, ω-5 Gliadin and Timothy Grass Enhances the Prediction of Wheat Challenge Outcome

Nilsson

Hedlin

et al. 2013

Int Arch Allergy Immunol

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Background: Wheat is a common food causing allergy which has implications on the quality of life. The diagnosis of IgE-mediated wheat allergy is based on the clinical history and presence of IgE antibodies (IgE-Ab) in skin or blood, and the results of an oral food challenge which is time consuming and associated with risks. An improved diagnostic workup is needed for wheat allergy. The objective was to examine the relationship between wheat challenge, CD-sens and IgE-Ab to related allergens in wheat-allergic children and investigate if a combination of different markers could enhance the prediction of challenge outcome. Method: Twenty-four children (aged 1-15 years) with a wheat allergy diagnosis underwent an open wheat challenge. CD-sens and IgE-Ab to wheat, hydrolyzed wheat protein (HWP), ω-5 gliadin and timothy grass were analyzed and related to the challenge outcome. Results: A positive challenge was seen in 12/24 children. Children reacting to the challenge had higher IgE-Ab concentrations to wheat, ω-5 gliadin and HWP (p < 0.01) and a tendency to higher wheat CD-sens values (p = 0.08) than nonreacting children. Combining wheat CD-sens >150 and IgE-Ab to wheat >20 kU_A/l, or ω-5 gliadin >0.1 kU_A/l predicted the challenge outcome in 83% of the patients. Most children with IgE-Ab to wheat also had IgE-Ab to timothy. Seven of 9 challenge-positive children had a positive CD-sens to HWP and IgE-Ab to HWP >8 kU_A/l. Conclusion: Combining CD-sens and IgE-Ab to wheat or wheat components could be useful in the diagnosis and follow-up of wheat-allergic children.

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“…The basophil activation test (BAT) has recently also been described as the best method to assess clinical tolerance to peanuts (84). Good sensitivity and specificity have also been described for milk (85,86) and egg allergy (87). However, its usefulness to delineate whether patients can consume baked egg or milk is less clear (85,86).…”

Section: Oral and Sublingual Immunotherapy In Food Allergymentioning

confidence: 99%

“…Good sensitivity and specificity have also been described for milk (85,86) and egg allergy (87). However, its usefulness to delineate whether patients can consume baked egg or milk is less clear (85,86). In the context of OIT, reduced basophil activation corresponds to desensitization in OIT with peanut (80,88,89), egg (1,90), and milk (91).…”

Section: Oral and Sublingual Immunotherapy In Food Allergymentioning

confidence: 99%

Markers of tolerance development to food allergens

Ponce

Diesner

Szépfalusi

et al. 2016

Allergy

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IgE-mediated reactions to food allergens are the most common cause of anaphylaxis in childhood. Although allergies to cow's milk, egg, or soy proteins, in contrast to peanut and tree nut allergens, resolve within the first 6 years of life in up to 60% due to natural tolerance development, this process is not well understood. At present, there is no cure or treatment for food allergy that would result in an induction of tolerance to the symptom-eliciting food. Avoidance, providing an emergency plan and education, is the standard of treatment. Oral immunotherapeutic approaches have been proven reasonable efficacy; however, they are associated with high rates of side-effects and low numbers of patients achieving tolerance. Nevertheless, mechanisms that take place during oral immunotherapy may help to understand tolerance development. On the basis of these therapeutic interventions, events like loss of basophil activation and induction of regulatory lymphocyte subsets and of blocking antibodies have been described. Their functional importance at a clinical level, however, remains to be investigated in detail. Consequently, there is eminent need to understand the process of tolerance development to food allergens and define biomarkers to develop and monitor new treatment strategies for food allergy.IgE-mediated food allergy represents the most important cause of anaphylaxis in childhood. While milk and egg allergy are associated with a high rate of natural tolerance development within the first 6 years of life, this is less clear for other food allergies. Consequently, once it is communicated the diagnosis persists often lifelong severely impacting the quality of life of the patient and the environment despite the recommendation to reconsider clinical tolerance development from time to time.Currently, avoidance, providing an emergency plan and teaching, is the standard of treatment; however, there is no cure or treatment that has reached the level of recommendation to re-induce tolerance to the symptom-eliciting food. Tolerance assessment occurs either via oral food challenges or due to unintended exposure. Given the cost and time intensiveness of oral food challenges and its potential harmfulness, there is eminent need to understand the process of tolerance development and define markers thereof to develop and monitor new treatment strategies for food allergy. This review aimed to provide an overview on recent advances regarding markers and mechanisms of tolerance development to food allergens.Oral tolerance in the context of food allergy is considered to occur if the antigen/food can be ingested without problems despite prolonged periods of avoidance, while the status of desensitization is strictly dependent on regular ingestion of the respective food in order to confer protection from allergic reactions. Currently, there is no general consensus on the exact time frame of avoidance and re-exposure that would allow the usage of the terminus tolerance that is considered equivalent to cure in the context of or...

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Benefit of the basophil activation test in deciding when to reintroduce cow’s milk in allergic children

Abstract: The BAT could be a valuable tool in the management of paediatric CMA in addition to specific IgE quantification and SPT, by contributing in determining whether an oral challenge can safely be undertaken.

Cited by 114 publications

References 40 publications

Basophil Activation Test in Allergy: Time for an Update?

Basophil Activation Test in Allergy: Time for an Update?

Combining Analyses of Basophil Allergen Threshold Sensitivity, CD-sens, and IgE Antibodies to Hydrolyzed Wheat, ω-5 Gliadin and Timothy Grass Enhances the Prediction of Wheat Challenge Outcome

Markers of tolerance development to food allergens

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Benefit of the basophil activation test in deciding when to reintroduce cow’s milk in allergic children

Abstract: The BAT could be a valuable tool in the management of paediatric CMA in addition to specific IgE quantification and SPT, by contributing in determining whether an oral challenge can safely be undertaken.

Cited by 114 publications

References 40 publications

Basophil Activation Test in Allergy: Time for an Update?

Basophil Activation Test in Allergy: Time for an Update?

Combining Analyses of Basophil Allergen Threshold Sensitivity, CD-sens, and IgE Antibodies to Hydrolyzed Wheat, &#x03C9;-5 Gliadin and Timothy Grass Enhances the Prediction of Wheat Challenge Outcome

Markers of tolerance development to food allergens

Contact Info

Product

Resources

About

Combining Analyses of Basophil Allergen Threshold Sensitivity, CD-sens, and IgE Antibodies to Hydrolyzed Wheat, ω-5 Gliadin and Timothy Grass Enhances the Prediction of Wheat Challenge Outcome