Is there an <i>in vitro</i> test for type IV allergy discriminating between sensitization and allergic disease?

Traidl‐Hoffmann, Claudia; Ring, Johannes

doi:10.1111/j.1365-2222.2008.03065.x

Cited by 9 publications

(7 citation statements)

References 28 publications

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“…Although previous studies have suggested that the ACD response might be attenuated in patients with AD, 25,27 these studies focused on immune responses in peripheral blood, which might not be representative of skin, [43][44][45][46] or on clinically irrelevant sensitizers, such as DNCB. 27 Recently, Newell et al 26 demonstrated an attenuated hypersensitivity reaction and T H 2 skewing in nonlesional AD versus healthy skin by using a strong hapten (DNCB), suggesting that the characteristic immune phenotype of background AD skin contributes to the distinct T H 2 polarization on challenge.…”

Section: Discussionmentioning

confidence: 99%

Patients with atopic dermatitis have attenuated and distinct contact hypersensitivity responses to common allergens in skin

Rosa

Malajian

Shemer³

et al. 2015

Journal of Allergy and Clinical Immunology

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Section: Discussionmentioning

confidence: 99%

Patients with atopic dermatitis have attenuated and distinct contact hypersensitivity responses to common allergens in skin

Rosa

Malajian

Shemer³

et al. 2015

Journal of Allergy and Clinical Immunology

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“…For nearly 120 years [1] the largely unchanged patch test has remained the “gold standard” for detecting delayed hypersensitivity in diagnosing allergic contact dermatitis. In‐vitro tests have not yet been sufficiently evaluated for routine clinical use [87, 88].…”

Section: In‐vitro Testsmentioning

confidence: 99%

“New” techniques for more sensitive patch testing?

Altmeyer

Brasch

2011

J Deutsche Derma Gesell

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SummaryThe patch test is the mainstay of diagnosis in allergic contact dermatitis. In its nearly 120-year-long history, numerous efforts to standardize several methodical aspects proved successful. The aim was always to enhance the validity and reliability of patch testing. This article reviews modifications of the basic patch test technique for enhancing test sensitivity. We expand on the recently validated strip patch test, which is a modification that involves affixing tape strips to the skin and removing them prior to patch testing. Although it was first described in 1953, we proposed the first protocol for standardized performance of the "strip patch test." The protocol was then tested in studies. As a result, test sensitivity of standardized strip patch test versus patch test was increased. The protocol produced a uniform reduction in the thickness of the stratum corneum and a good inter-rater agreement. Additionally, there was evidence of a non-specific stimulation of the inflammatory epidermal system. With regard to patient history, the standardized strip patch test showed a vastly better sensitivity than the patch test with only marginally lower specificity. As a complementary measure to patch testing diagnostic accuracy could be improved significantly by performing the standardized strip patch test. Further studies are needed on the reproducibility of the standardized strip patch test.

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“…In consequence, the combination of clinical history and patch test results continues to be the basis for the diagnosis of ACD [17]. Further studies are needed in search of an innovative in vitro test method with sufficient discrimination between allergic and non-allergic patients [26].…”

Section: Resultsmentioning

confidence: 99%

“…However, we omitted staining with anti-CD45ROFITC due to a too high restriction resulting in a small number of analyzable T cells. Second, it is reported that nickel sulfate has in contrast to other metal salts non-specific stimulatory properties in vitro which still is a major problem [14,15,17]. In our study we obtained the raw material of nickel sulfate hexahydrate straight from the production process of the patch test substance and the highest concentration used for stimulation was 2.6 μg/ml [14].…”

Section: Discussionmentioning

confidence: 96%

“…Although a non-in vivo test would be desirable, to date, none of the established in vitro tests for the diagnosis of ACD (e.g., LTT, MELISA ® , ELISpot assay) fulfils the requirements of a practical test with sufficient validity and reliability [5,14-17]. An advanced approach is the flow cytometric analysis of CD69 up-regulation on T lymphocytes in vitro [18-21].…”

Section: Introductionmentioning

confidence: 99%

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Association of CD69 Up-Regulation on CD4+ CLA+ T cells versus patch test, strip patch test and clinical history in nickel sensitization

et al. 2010

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ObjectiveThe patch test (PT) with its modification - the strip patch test (SPT) - is the standard in vivo procedure to diagnose an allergic contact dermatitis (ACD). To date, none of the in vitro tests for the diagnosis of ACD fulfils the requirements of an easy, valid and reliable test. To investigate the prediction ability of a flow cytometric assay of CD69 up-regulation on CD4+ CLA+ T cells in nickel-sensitive and non-nickel-sensitive patients.MethodsIn a prospective, investigator-blinded, clinical study a total of 85 nickel-sensitive (n = 44; 51.8%) and non-nickel-sensitive patients (n = 41; 48.2%) were enrolled. The association between CD69 up-regulation on CD4+ CLA+ T cells on the one hand and PT, SPT, and clinical history on the other hand was measured. Association is expressed with c statistic values (receiver operating characteristic analysis) and corresponding 95% CIs.ResultsThe associations were c = 0.57 (95% CI: 0.42-0.72) between CD69 up-regulation and PT, c = 0.49 (95% CI: 0.36-0.62) between CD69 up-regulation and SPT, and c = 0.51 (95% CI: 0.37-0.64) between CD69 up-regulation and clinical history.ConclusionsCD69 up-regulation on CD4+ CLA+ T cells in vitro could not predict neither a positive PT or SPT result nor a positive clinical history to nickel sulfate. The combination of clinical history and patch testing still remains the basis for diagnosing ACD.

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Is there an in vitro test for type IV allergy discriminating between sensitization and allergic disease?

Cited by 9 publications

References 28 publications

Patients with atopic dermatitis have attenuated and distinct contact hypersensitivity responses to common allergens in skin

Patients with atopic dermatitis have attenuated and distinct contact hypersensitivity responses to common allergens in skin

“New” techniques for more sensitive patch testing?

Association of CD69 Up-Regulation on CD4+ CLA+ T cells versus patch test, strip patch test and clinical history in nickel sensitization

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