Zastosowanie Testu Aktywacji Bazofilów w Diagnostyce Nadwrażliwości na Kwas Acetylosalicylowy

Abstract

In the face of increasing prevalence of hypersensitivity reactions, introduction of effective, reliable and safe methods plays a crucial role in their diagnosing. Among the currently available laboratory (in vitro) methods is basophil activation test (BAT). It is a flow- cytometry based assay that allows to identificate in the blood sample basophils and additionally to asses the degree of cell activation after exposure to an antigen. The most common superficial identification markers are CD63 and CD203c, which increase in number after activation. Basophil actvation test can be applied to confirm diagnosis of allergy to Hymenoptera venoms, food, pollens and hypersensitivity to drugs. The aim of present paper is to present theoretical methods of this test as well as its pros and cons. We focus also on presentation of clinical case where BAT seemed to be a necessary addition to a routine diagnostic pathway. We present a case of identification of the culprit drug which caused an anaphylactic reaction.

Diagnostics of peanut allergy – part II

“…Aktualnie coraz częściej rozważa się uzupełnienie standardowej diagnostyki o wykonanie BAT, szczególnie w przypadku alergii na leki i jad owadów [1]. Wartość diagnostyczna BAT w alergii na pokarmy jest alergenowo swoista i większość badań potwierdza dużą czułość i swoistość tej metody.…”

Basophil Activation Tests (BAT): Wheat and Chaff

“…BAT potentially may discriminate between IgE-mediated and IgE-non mediated allergy, although, as suggested by the Authors [1], non IgE-mediated allergy seems to be more frequently reported for drug hypersensitivity, for which sensitivity evaluation should be highly influenced. Interestingly, the Authors described a case report, a 52-years old patient, in whom hypersensitivity to NSAIDs was reported, in the absence of other allergologic signs, based on the CD63% FC expression in BAT (≥ 22%, c.o.…”

“…The recent article by Gawinowska et al, on the latest issue of "Polish Pneumology and Allergology" addressed the issue of the application of basophil activation test (BAT) in the diagnosis of drug hypersensitivity [1]. The Authors stressed on the commonly recognized role exerted by CD63 and CD203c markers in BAT, while existing further suggestions [2,3] but they never addressed the critical issue of basophil electronic capture in flow cytometry (FC), i.e.…”

“…Advantages of BAT in allergy diagnosis are closely related to the simple fact that this assay is a cell based investigation procedure [6] and therefore, while its major value is the ability in diagnosing either an IgE-or non IgE-mediated allergy, immunotherapy and anaphylaxis and to prevent the ethical issue associated to skin tests [1], a main concern is represented by the interpretation of activation markers in a good phenotyping FC approach [7]. The Authors reported, particularly in Table 1 of their paper, that BAT false negatives might be due mainly to the existence of non releaser subjects [1]. Non releaser individuals have usually reduced expression of basophil membrane FceRI, besides to a decrease in released molecules such as histamine and serum IgEs [8].…”

“…Interestingly, the Authors described a case report, a 52-years old patient, in whom hypersensitivity to NSAIDs was reported, in the absence of other allergologic signs, based on the CD63% FC expression in BAT (≥ 22%, c.o. 10%) [1]. The use of BAT in diagnosing NSAIDs allergy, including acetylsalycilic acid (ASA) or aspirin ® , is a major www.pneumonologia.viamedica.pl concern in the diagnosis of drug hypersensitivity but any analytical evaluation, which should include the calculation of parameters such as sensitivity, specificity and predictive values, fundamentally through ROC curves, have to be fitted to a defined FC protocol, properly suited to investigate basophils in vitro.…”