Mast cell activation test in chlorhexidine allergy: a proof of concept

Elst, Jessy; Poorten, Marie-Line M. van der; Faber, Margaretha A.; Gasse, Athina L. Van; Garvey, Lene Heise; Bridts, Chris H.; Puysseleyr, Leander P. De; Mertens, Christel; Hagendorens, Margo M.; Sabato, Vito; Ebo, Didier G.

doi:10.1016/j.bja.2020.06.024

Cited by 26 publications

(34 citation statements)

References 38 publications

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“…These changes are detectable and quantifiable using specific fluorescent-labelled monoclonal antibodies. In most studies, MCs have been identified by positive staining for surface markers such as CD117/CD203c 15,16,[54][55][56] or as CD117/FcεRI. 10,19,20,22,40,44 Subsequently, after activation, the up-regulation of specific markers, such as CD63 and CD107a or CD203c is measured.…”

Section: Key Messagesmentioning

confidence: 99%

“…10,19,20,22,40,44 Subsequently, after activation, the up-regulation of specific markers, such as CD63 and CD107a or CD203c is measured. 10,11,15,16,21,22,44,[54][55][56][57][58] CD63 and CD107a are membrane proteins of the lysosome-associated molecular protein (LAMP) tetraspanin family that are barely expressed by resting MCs. Up-regulation of CD63 is closely associated with mediator release during degranulation.…”

Section: Key Messagesmentioning

confidence: 99%

“…[7][8][9] To circumvent the limitations encountered with BAT and tissue MCs, different groups have adopted passive sensitization techniques using specific basophil and MC cell lines, [10][11][12] stripped basophils 13,14 or primary human MCs cultured from donor progenitor cells. 10,[15][16][17][18] This article reviews the status on flow cytometric pMAT using both MC lines and cultured cells in the diagnosis of IgEdependent allergies. Table 1 summarizes the main differences between traditional flow cytometry (FCM)-assisted BAT and pMAT in their application to explore the effector cell activating potential of IgE antibodies and diagnosis of IgE-dependent allergies.…”

Section: Introductionmentioning

confidence: 99%

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Mast cell activation tests by flow cytometry: A new diagnostic asset?

Elst

Poorten

Gasse

et al. 2021

Clin Experimental Allergy

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Since the late nineties, evidence has accumulated that flow-assisted basophil activation test (BAT) might be an accessible and reliable method to explore the mechanisms governing basophil degranulation and diagnostic allowing correct prediction of the clinical outcome following exposure to the offending allergen(s) and cross-reactive structures for different IgE-dependent allergies and particular forms of autoimmune urticaria. Although the BAT offers many advantages over mediator release tests, it is left with some weaknesses that hinder a wider application. It is preferable to perform the BAT analysis within 4 h of collection, and the technique does not advance diagnosis in patients with non-responsive cells. Besides, the BAT is difficult to standardize mainly because of the difficulty to perform large batch analyses that might span over several days. This article reviews the status of flow cytometric mast cell activation test (MAT) using passively sensitized mast cells (MCs) with patients' sera or plasma (henceforth indicated as passive MAT; pMAT) using both MC lines and cultured MCs in the diagnosis of IgE-dependent allergies. In addition, this paper provides guidance for generating human MCs from peripheral blood CD34 + progenitor cells (PBCMCs) and correct interpretation of flow cytometric analyses of activated and/or degranulating cells. With the recent recognition of the mas-related G protein-coupled receptor X2 (MRGPRX2) occupation as a putative mechanism of immediate drug hypersensitivity reactions (IDHRs), we also speculate how direct activation of MCs (dMAT)-that

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Section: Key Messagesmentioning

confidence: 99%

Section: Key Messagesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mast cell activation tests by flow cytometry: A new diagnostic asset?

Elst

Poorten

Gasse

et al. 2021

Clin Experimental Allergy

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“…In case of delayed reactions patch tests are recommended. Additionally, BAT, histamine release test and more recent MAT are being developed as supplementary tests, though they have not yet entered routine application [65][66][67].…”

Section: General Anestheticsmentioning

confidence: 99%

“…Test and methods used in hypersensitivity diagnosis in patients with mast cell disorders. SPT-Skin Prick Test; IDT-Intradermal Test; BAT-Basophil Activation Test; MAT-Mast cell Activation Test; NSAIDs-Non steroid anti-inflammatory drugs; AIT-Allergen Immunotherapy[7,23,[30][31][32][44][45][46]53,63,64,66,67,[79][80][81][82]90,91,108,109].…”

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confidence: 99%

A Challenge for Allergologist: Application of Allergy Diagnostic Methods in Mast Cell Disorders

Romantowski

Górska

Niedoszytko

et al. 2021

IJMS

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Primary and secondary mast cell activation syndromes (MCAS) can occur in patients with mastocytosis. During the past few years our knowledge about the pathogenesis and disease-triggering mechanisms in MCAS and mastocytosis have increased substantially. Whereas mastocytosis is characterized by an accumulation of neoplastic (clonal) mast cells (MC) in various organ systems, MCAS is defined by a massive and systemic activation of these cells. Mast cells are crucial effector cells in allergic diseases, thus their elevated number and activation can cause severe anaphylactic reactions and MCAS in patients with mastocytosis. However, these cells may also degranulate spontaneously or degranulate in response to non-allergic triggers leading to clinical symptoms. In mastocytosis patients, such symptoms may lead to the diagnosis of a primary MCAS. The diagnosis of a concomitant allergy in mastocytosis patients is challenging. In these patients, a mixed form (primary and secondary) of MCAS may be diagnosed. These patients may also suffer from life-threatening anaphylactic reactions when exposed to allergens. In these cases, the possibility of severe side effects of in vivo provocations can sometimes also limit diagnostic evaluations. In the current article, we discuss the diagnosis and management of patients suffering from mastocytosis and concomitant MCAS, with special emphasis on novel diagnostic tests and management, including allergen microarrays, recombinant allergen analysis, basophil activation tests, optimal prophylaxis, and specific therapies.

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