Clinical use of basophil activation test in drug, food and hymenoptera venom allergies

M. De Amici, F. Barocci, S. Caimmi, L. Nespoli, A. Licari, G. Giuliani, G. Marseglia

Research output: Contribution to journalArticle

Abstract

The basophil activation is emerging as a reliable and robust in vitro biomarker of in vivo allergy reactions. Basophil Activation Test (BAT), intended as in vitro stimulation of patient blood basophil with allergens, followed by flow cytometric detection and quantification of such activation, is nowadays a well-established assay in a growing number of routine diagnostic labs. The advancements in the standardization of BAT testing and first convincing clinical evidence are behind this spreading of the assay in clinical lab. BAT is essentially an assay with superior specificity compared to any other allergy testing and, if appropriately used, it can have a valuable clinical utility in different field of allergy diagnosis. In drug allergy, very few testing opportunities are available for the numbers of drugs actually in the market. Antibiotics and analgesics are just two of the categories of drugs were BAT testing can have an added value for the limited specificity of IgE testing or limited availability of other lab testing. In food allergy, BAT is emerging as the more accurate assay to predict an in vivo reaction to food, helping in the discrimination of patients that are only sensitized versus the patient really allergic to an allergen. Furthermore, BAT testing determining the basophil sensitivity can be useful for monitoring the natural resolution of allergies and clinical responses to immunomodulatory treatment for food allergies. For this characteristic, BAT has the potential to reduce the need of OFC. In the hymenoptera venom allergy, BAT is an effective tool in identifying primary sensitizing antigen and in the follow up of patient in venom immunotherapy. With this review, we want to present current state of BAT testing focusing on the clinical laboratory parameters and issue of this assay. A highlight on the standardization needs of BAT is provided, together with considerations on further developments and clinical evidences still to be achieved. © 2018 EDIZIONI MINERVA MEDICA.
Original languageEnglish
Pages (from-to)209-217
Number of pages9
JournalMinerva Pediatrica
Volume71
Issue number2
DOIs
Publication statusPublished - 2019

Fingerprint

Hymenoptera
Basophils
Venoms
Hypersensitivity
Food
Pharmaceutical Preparations
Food Hypersensitivity
Allergens
Drug Hypersensitivity
Immunotherapy
Immunoglobulin E
Analgesics

Keywords

  • Allergens
  • Food
  • Hymenoptera
  • Pharmaceutical preparations
  • allergen
  • analgesic agent
  • antibiotic agent
  • biological marker
  • cd203c antigen
  • CD63 antigen
  • chemokine receptor CCR3
  • cyclosporine
  • eotaxin
  • histamine
  • Hymenoptera venom
  • immunoglobulin E
  • immunoglobulin E receptor
  • interleukin 3
  • leukocyte antigen
  • leukotriene
  • mitogen activated protein kinase 14
  • protein kinase Syk
  • unclassified drug
  • allergic reaction
  • antigen specificity
  • basophil activation test
  • clinical outcome
  • clinical study
  • desensitization
  • drug hypersensitivity
  • drug purity
  • drug screening
  • drug stability
  • flow cytometry
  • fluorescence activated cell sorting
  • food allergy
  • health care availability
  • human
  • immunomodulation
  • immunotherapy
  • macrophage activation
  • personalized medicine
  • Review
  • sensitivity and specificity
  • serology
  • signal transduction
  • skin test
  • animal
  • basophil
  • immunology
  • insect bite
  • procedures
  • Animals
  • Basophils
  • Drug Hypersensitivity
  • Flow Cytometry
  • Food Hypersensitivity
  • Humans
  • Immunoglobulin E
  • Insect Bites and Stings
  • Sensitivity and Specificity

Cite this

Clinical use of basophil activation test in drug, food and hymenoptera venom allergies. / De Amici, M.; Barocci, F.; Caimmi, S.; Nespoli, L.; Licari, A.; Giuliani, G.; Marseglia, G.

In: Minerva Pediatrica, Vol. 71, No. 2, 2019, p. 209-217.

Research output: Contribution to journalArticle

@article{28541b7548de4e9ca609f2d11b1b127b,
title = "Clinical use of basophil activation test in drug, food and hymenoptera venom allergies",
abstract = "The basophil activation is emerging as a reliable and robust in vitro biomarker of in vivo allergy reactions. Basophil Activation Test (BAT), intended as in vitro stimulation of patient blood basophil with allergens, followed by flow cytometric detection and quantification of such activation, is nowadays a well-established assay in a growing number of routine diagnostic labs. The advancements in the standardization of BAT testing and first convincing clinical evidence are behind this spreading of the assay in clinical lab. BAT is essentially an assay with superior specificity compared to any other allergy testing and, if appropriately used, it can have a valuable clinical utility in different field of allergy diagnosis. In drug allergy, very few testing opportunities are available for the numbers of drugs actually in the market. Antibiotics and analgesics are just two of the categories of drugs were BAT testing can have an added value for the limited specificity of IgE testing or limited availability of other lab testing. In food allergy, BAT is emerging as the more accurate assay to predict an in vivo reaction to food, helping in the discrimination of patients that are only sensitized versus the patient really allergic to an allergen. Furthermore, BAT testing determining the basophil sensitivity can be useful for monitoring the natural resolution of allergies and clinical responses to immunomodulatory treatment for food allergies. For this characteristic, BAT has the potential to reduce the need of OFC. In the hymenoptera venom allergy, BAT is an effective tool in identifying primary sensitizing antigen and in the follow up of patient in venom immunotherapy. With this review, we want to present current state of BAT testing focusing on the clinical laboratory parameters and issue of this assay. A highlight on the standardization needs of BAT is provided, together with considerations on further developments and clinical evidences still to be achieved. {\circledC} 2018 EDIZIONI MINERVA MEDICA.",
keywords = "Allergens, Food, Hymenoptera, Pharmaceutical preparations, allergen, analgesic agent, antibiotic agent, biological marker, cd203c antigen, CD63 antigen, chemokine receptor CCR3, cyclosporine, eotaxin, histamine, Hymenoptera venom, immunoglobulin E, immunoglobulin E receptor, interleukin 3, leukocyte antigen, leukotriene, mitogen activated protein kinase 14, protein kinase Syk, unclassified drug, allergic reaction, antigen specificity, basophil activation test, clinical outcome, clinical study, desensitization, drug hypersensitivity, drug purity, drug screening, drug stability, flow cytometry, fluorescence activated cell sorting, food allergy, health care availability, human, immunomodulation, immunotherapy, macrophage activation, personalized medicine, Review, sensitivity and specificity, serology, signal transduction, skin test, animal, basophil, immunology, insect bite, procedures, Animals, Basophils, Drug Hypersensitivity, Flow Cytometry, Food Hypersensitivity, Humans, Immunoglobulin E, Insect Bites and Stings, Sensitivity and Specificity",
author = "{De Amici}, M. and F. Barocci and S. Caimmi and L. Nespoli and A. Licari and G. Giuliani and G. Marseglia",
note = "Cited By :1 Export Date: 10 October 2019 CODEN: MIPEA Correspondence Address: Barocci, F.; Laboratory Medicine Unit ASST Rhodense, Garbagnate MilaneseItaly; email: fiorellabarocci@yahoo.it Chemicals/CAS: cyclosporine, 59865-13-3, 63798-73-2, 79217-60-0; histamine, 51-45-6, 56-92-8, 93443-21-1; immunoglobulin E, 37341-29-0; protein kinase Syk, 138674-26-7; Allergens; Immunoglobulin E References: Cardona, V., Demoly, P., Dreborg, S., Kalpaklioglu, A.F., Klimek, L., Muraro, A., Current practice of allergy diagnosis and the potential impact of regulation in Europe (2018) Allergy, 73, pp. 323-327; Knol, E.F., Mul, F.P., Jansen, H., Calafat, J., Roos, D., Monitoring human basophil activation via CD63 monoclonal antibody 435 (1991) J Allergy Clin Immunol, 88, pp. 328-338; Sainte-Laudy, J., Vallon, C., Gu{\'e}rin, J.C., Analysis of membrane expression of the CD63 human basophil activation marker. Applications to allergologic diagnosis] (1994) Allerg Immunol (Paris), 26, pp. 211-214; Hoffmann, H.J., Santos, A.F., Mayorga, C., Nopp, A., Eberlein, B., Ferrer, M., The clinical utility of basophil activation testing in diagnosis and monitoring of allergic disease (2015) Allergy, 70, pp. 1393-1405; Hausmann, O.V., Gentinetta, T., Fux, M., Ducrest, S., Pi-chler, W.J., Dahinden, C.A., Robust expression of CCR3 as a single basophil selection marker in flow cytometry (2011) Allergy, 66, pp. 85-91; Eberlein, B., Le{\'o}n Su{\'a}rez, I., Darsow, U., Ru{\"e}ff, F., Behrendt, H., Ring, J., A new basophil activation test using CD63 and CCR3 in allergy to antibiotics (2010) Clin Exp Allergy, 40, pp. 411-418; Sturm, E.M., Kranzelbinder, B., Heinemann, A., Groselj-Strele, A., Aberer, W., Sturm, G.J., CD203c-based basophil activation test in allergy diagnosis: Characteristics and differences to CD63 upregulation (2010) Cytometry B Clin Cytom, 78, pp. 308-318; Santos, A.F., Douiri, A., B{\'e}cares, N., Wu, S.Y., Stephens, A., Radulovic, S., Basophil activation test discriminates between allergy and tolerance in peanut-sensitized children (2014) J Allergy Clin Immunol, 134, pp. 645-652; Mukai, K., Gaudenzio, N., Gupta, S., Vivanco, N., Bendall, S.C., Maecker, H.T., Assessing basophil activation by using flow cytometry and mass cytometry in blood stored 24 hours before analysis (2017) J Allergy Clin Immunol, 139, pp. 889–899. e11; Puan, K.J., Andiappan, A.K., Lee, B., Kumar, D., Lai, T.S., Yeo, G., Systematic characterization of basophil anergy (2017) Allergy, 72, pp. 373-384; DeWeck, A.L., Sanz, M.L., Flow cytometric cellular allergen stimulation Test (FAST/Flow-CAST): Technical and clinical evaluation of a new diagnostic test in allergy and pseudo-allergy (2002) ACI International, 14, pp. 204-215; Korošec, P., Šilar, M., Eržen, R., Čelesnik, N., Bajrović, N., Zi-darn, M., Clinical routine utility of basophil activation testing for diagnosis of hymenoptera-allergic patients with emphasis on individuals with negative venom-specific IgE antibodies (2013) Int Arch Allergy Immunol, 161, pp. 363-368; Christensen, L.H., Holm, J., Lund, G., Riise, E., Lund, K., Several distinct properties of the IgE repertoire determine effector cell degranulation in response to allergen challenge (2008) J Allergy Clin Immunol, 122, pp. 298-304; Nopp, A., Cardell, L.O., Johansson, S.G., Oman, H., CD-sens: A biological measure of immunological changes stimulated by ASIT (2009) Allergy, 64, pp. 811-814; Patil, S.U., Shreffler, W.G., Immunology in the Clinic Review Series; focus on allergies: Basophils as biomarkers for assessing immune modulation (2012) Clin Exp Immunol, 167, pp. 59-66; Rubio, A., Vivinus-N{\'e}bot, M., Bourrier, T., Saggio, B., Alber-tini, M., Bernard, A., Benefit of the basophil activation test in deciding when to reintroduce cow’s milk in allergic children (2011) Allergy, 66, pp. 92-100; Eržen, R., Košnik, M., Silar, M., Korošec, P., Basophil response and the induction of a tolerance in venom immunotherapy: A long-term sting challenge study (2012) Allergy, 67, pp. 822-830; Mayorga, C., Sanz, M.L., Gamboa, P.M., Garc{\'i}a, B.E., Caballero, M.T., Garc{\'i}a, J.M., In vitro diagnosis of immediate allergic reactions to drugs: An update (2010) J Investig Allergol Clin Immunol, 20, pp. 103-109; Romano, A., Torres, M.J., Castells, M., Sanz, M.L., Blanca, M., Diagnosis and management of drug hypersensitivity reactions (2011) J Allergy Clin Immunol, 127, pp. S67-S73; Blanca-L{\'o}pez, N., Ariza, A., Do{\~n}a, I., Mayorga, C., Monta{\~n}ez, M.I., Garcia-Campos, J., Hypersensitivity reactions to fluoroquinolones: Analysis of the factors involved (2013) Clin Exp Allergy, 43, pp. 560-567; Uyttebroek, A.P., Sabato, V., Bridts, C.H., De Clerck, L.S., Ebo, D.G., Moxifloxacin hypersensitivity: Uselessness of skin testing (2015) J Allergy Clin Immunol Pract, 3, pp. 443-445; Torres, M.J., Padial, A., Mayorga, C., Fern{\'a}ndez, T., Sanchez-Sabate, E., Cornejo-Garc{\'i}a, J.A., The diagnostic interpretation of basophil activation test in immediate allergic reactions to betalactams (2004) Clin Exp Allergy, 34, pp. 1768-1775; Sanz, M.L., Gamboa, P.M., Ant{\'e}para, I., Uasuf, C., Vila, L., Garcia-Avil{\'e}s, C., Flow cytometric basophil activation test by detection of CD63 expression in patients with immediate-type reactions to betalactam antibiotics (2002) Clin Exp Allergy, 32, pp. 277-286; Torres, M.J., Ariza, A., Mayorga, C., Do{\~n}a, I., Blanca-Lopez, N., Rondon, C., Clavulanic acid can be the component in amox-icillin-clavulanic acid responsible for immediate hypersensitivity reactions (2010) J Allergy Clin Immunol, 125, pp. 502–505.. , e2; Rouzaire, P., Nosbaum, A., Denis, L., Bienvenu, F., B{\'e}-rard, F., Cozon, G., Negativity of the basophil activation test in quinolone hypersensitivity: A breakthrough for provocation test decision-making (2012) Int Arch Allergy Immunol, 157, pp. 299-302; Aranda, A., Mayorga, C., Ariza, A., Do{\~n}a, I., Rosado, A., Blanca-Lopez, N., In vitro evaluation of IgE-mediated hypersensitivity reactions to quinolones (2011) Allergy, 66, pp. 247-254; Mayorga, C., Andreu, I., Aranda, A., Do{\~n}a, I., Monta{\~n}ez, M.I., Blanca-Lopez, N., Fluoroquinolone photodegradation influences specific basophil activation (2013) Int Arch Allergy Immunol, 160, pp. 377-382; Kowalski, M.L., Asero, R., Bavbek, S., Blanca, M., Blanca-Lopez, N., Bochenek, G., Classification and practical approach to the diagnosis and management of hypersensitivity to nonsteroidal anti-inflammatory drugs (2013) Allergy, 68, pp. 1219-1232; Abuaf, N., Rajoely, B., Ghazouani, E., Levy, D.A., Pecquet, C., Chabane, H., Validation of a flow cytometric assay detecting in vitro basophil activation for the diagnosis of muscle relaxant allergy (1999) J Allergy Clin Immunol, 104, pp. 411-418; Salas, M., Gomez, F., Fernandez, T.D., Do{\~n}a, I., Aranda, A., Ariza, A., Diagnosis of immediate hypersensitivity reactions to radiocontrast media (2013) Allergy, 68, pp. 1203-1206; Sampson, H.A., Mendelson, L., Rosen, J.P., Fatal and near-fatal anaphylactic reactions to food in children and adolescents (1992) N Engl J Med, 327, pp. 380-384; Commins, S.P., James, H.R., Stevens, W., Pochan, S.L., Land, M.H., King, C., Delayed clinical and ex vivo response to mammalian meat in patients with IgE to galactose-alpha-1,3-galactose (2014) J Allergy Clin Immunol, 134, pp. 108-115; Santos, A.F., Lack, G., Basophil activation test: Food challenge in a test tube or specialist research tool? (2016) Clin Transl Allergy, 6, p. 10; Faber, M.A., Sabato, V., Decuyper, I.I., Van Gasse, A.L., Hagendorens, M.M., Bridts, C.H., Basophil activation test in IgE-mediated food allergy: Should we follow the flow? (2016) Curr Treat Options Allergy, 3, pp. 158-168; Rubio, A., Vivinus-N{\'e}bot, M., Bourrier, T., Saggio, B., Alber-tini, M., Bernard, A., Benefit of the basophil activation test in deciding when to reintroduce cow’s milk in allergic children (2011) Allergy, 66, pp. 92-100; Sato, S., Tachimoto, H., Shukuya, A., Kurosaka, N., Yanagida, N., Utsunomiya, T., Basophil activation marker CD203c is useful in the diagnosis of hen’s egg and cow’s milk allergies in children (2010) Int Arch Allergy Immunol, 152, pp. 54-61; Santos, A.F., Shreffler, W.G., Road map for the clinical application of the basophil activation test in food allergy (2017) Clin Exp Allergy, 47, pp. 1115-1124; Brandstr{\"o}m, J., Nopp, A., Johansson, S.G., Lilja, G., Sundqvist, A.C., Borres, M.P., Basophil allergen threshold sensitivity and component-resolved diagnostics improve hazelnut allergy diagnosis (2015) Clin Exp Allergy, 45, pp. 1412-1418; Wanich, N., Nowak-Wegrzyn, A., Sampson, H.A., Shreffler, W.G., Allergen-specific basophil suppression associated with clinical tolerance in patients with milk allergy (2009) J Allergy Clin Immunol, 123, pp. 789–94.. , e20; Ford, L.S., Bloom, K.A., Nowak-Węgrzyn, A.H., Shreffler, W.G., Masilamani, M., Sampson, H.A., Basophil reactivity, wheal size, and immunoglobulin levels distinguish degrees of cow’s milk tolerance (2013) J Allergy Clin Immunol, 131, pp. 180–6.e1. , 3; Vila, L., Moreno, A., Gamboa, P.M., Mart{\'i}nez-Aranguren, R., Sanz, M.L., Decrease in antigen-specific CD63 basophil expression is associated with the development of tolerance to egg by SOTI in children (2013) Pediatr Allergy Immunol, 24, pp. 463-468; Fleischer, D.M., Burks, A.W., Vickery, B.P., Scurlock, A.M., Wood, R.A., Jones, S.M., Sublingual immunotherapy for peanut allergy: A randomized, double-blind, placebo-controlled multicenter trial (2013) J Allergy Clin Immunol, 131, pp. 119–27.. , e1, 7; D’Auria, E., Mameli, C., Piras, C., Cococcioni, L., Urbani, A., Zuccotti, G.V., Precision medicine in cow’s milk allergy: Proteomics perspectives from allergens to patients (2018) J Pro-Teomics, 188, pp. 173-180; Sturm, G.J., Jin, C., Kranzelbinder, B., Hemmer, W., Sturm, E.M., Griesbacher, A., Inconsistent results of diagnostic tools hamper the differentiation between bee and vespid venom allergy (2011) PLoS One, 6, p. e20842; Sainte-Laudy, J., Sabbah, A., Drouet, M., Lauret, M.G., Loiry, M., Diagnosis of venom allergy by flow cytometry. Correlation with clinical history, skin tests, specific IgE, histamine and leukotriene C4 release (2000) Clin Exp Allergy, 30, pp. 1166-1171; Sturm, G.J., B{\"o}hm, E., Trummer, M., Weiglhofer, I., Heinemann, A., Aberer, W., The CD63 basophil activation test in Hymenoptera venom allergy: A prospective study (2004) Allergy, 59, pp. 1110-1117; Eberlein-K{\"o}nig, B., Varga, R., Mempel, M., Darsow, U., Behrendt, H., Ring, J., Comparison of basophil activation tests using CD63 or CD203c expression in patients with insect venom allergy (2006) Allergy, 61, pp. 1084-1085; Eberlein, B., Krischan, L., Darsow, U., Ollert, M., Ring, J., Double positivity to bee and wasp venom: Improved diagnostic procedure by recombinant allergen-based IgE testing and basophil activation test including data about cross-reactive carbohydrate determinants (2012) J Allergy Clin Immunol, 130, pp. 155-161; Ebo, D.G., Hagendorens, M.M., Schuerwegh, A.J., Beirens, L.M., Bridts, C.H., De Clerck, L.S., Flow-assisted quantification of in vitro activated basophils in the diagnosis of wasp venom allergy and follow-up of wasp venom immunotherapy (2007) Cytometry B Clin Cytom, 72, pp. 196-203",
year = "2019",
doi = "10.23736/S0026-4946.18.05144-7",
language = "English",
volume = "71",
pages = "209--217",
journal = "Minerva Pediatrica",
issn = "0026-4946",
publisher = "Edizioni Minerva Medica S.p.A.",
number = "2",

}

TY - JOUR

T1 - Clinical use of basophil activation test in drug, food and hymenoptera venom allergies

AU - De Amici, M.

AU - Barocci, F.

AU - Caimmi, S.

AU - Nespoli, L.

AU - Licari, A.

AU - Giuliani, G.

AU - Marseglia, G.

N1 - Cited By :1 Export Date: 10 October 2019 CODEN: MIPEA Correspondence Address: Barocci, F.; Laboratory Medicine Unit ASST Rhodense, Garbagnate MilaneseItaly; email: fiorellabarocci@yahoo.it Chemicals/CAS: cyclosporine, 59865-13-3, 63798-73-2, 79217-60-0; histamine, 51-45-6, 56-92-8, 93443-21-1; immunoglobulin E, 37341-29-0; protein kinase Syk, 138674-26-7; Allergens; Immunoglobulin E References: Cardona, V., Demoly, P., Dreborg, S., Kalpaklioglu, A.F., Klimek, L., Muraro, A., Current practice of allergy diagnosis and the potential impact of regulation in Europe (2018) Allergy, 73, pp. 323-327; Knol, E.F., Mul, F.P., Jansen, H., Calafat, J., Roos, D., Monitoring human basophil activation via CD63 monoclonal antibody 435 (1991) J Allergy Clin Immunol, 88, pp. 328-338; Sainte-Laudy, J., Vallon, C., Guérin, J.C., Analysis of membrane expression of the CD63 human basophil activation marker. Applications to allergologic diagnosis] (1994) Allerg Immunol (Paris), 26, pp. 211-214; Hoffmann, H.J., Santos, A.F., Mayorga, C., Nopp, A., Eberlein, B., Ferrer, M., The clinical utility of basophil activation testing in diagnosis and monitoring of allergic disease (2015) Allergy, 70, pp. 1393-1405; Hausmann, O.V., Gentinetta, T., Fux, M., Ducrest, S., Pi-chler, W.J., Dahinden, C.A., Robust expression of CCR3 as a single basophil selection marker in flow cytometry (2011) Allergy, 66, pp. 85-91; Eberlein, B., León Suárez, I., Darsow, U., Ruëff, F., Behrendt, H., Ring, J., A new basophil activation test using CD63 and CCR3 in allergy to antibiotics (2010) Clin Exp Allergy, 40, pp. 411-418; Sturm, E.M., Kranzelbinder, B., Heinemann, A., Groselj-Strele, A., Aberer, W., Sturm, G.J., CD203c-based basophil activation test in allergy diagnosis: Characteristics and differences to CD63 upregulation (2010) Cytometry B Clin Cytom, 78, pp. 308-318; Santos, A.F., Douiri, A., Bécares, N., Wu, S.Y., Stephens, A., Radulovic, S., Basophil activation test discriminates between allergy and tolerance in peanut-sensitized children (2014) J Allergy Clin Immunol, 134, pp. 645-652; Mukai, K., Gaudenzio, N., Gupta, S., Vivanco, N., Bendall, S.C., Maecker, H.T., Assessing basophil activation by using flow cytometry and mass cytometry in blood stored 24 hours before analysis (2017) J Allergy Clin Immunol, 139, pp. 889–899. e11; Puan, K.J., Andiappan, A.K., Lee, B., Kumar, D., Lai, T.S., Yeo, G., Systematic characterization of basophil anergy (2017) Allergy, 72, pp. 373-384; DeWeck, A.L., Sanz, M.L., Flow cytometric cellular allergen stimulation Test (FAST/Flow-CAST): Technical and clinical evaluation of a new diagnostic test in allergy and pseudo-allergy (2002) ACI International, 14, pp. 204-215; Korošec, P., Šilar, M., Eržen, R., Čelesnik, N., Bajrović, N., Zi-darn, M., Clinical routine utility of basophil activation testing for diagnosis of hymenoptera-allergic patients with emphasis on individuals with negative venom-specific IgE antibodies (2013) Int Arch Allergy Immunol, 161, pp. 363-368; Christensen, L.H., Holm, J., Lund, G., Riise, E., Lund, K., Several distinct properties of the IgE repertoire determine effector cell degranulation in response to allergen challenge (2008) J Allergy Clin Immunol, 122, pp. 298-304; Nopp, A., Cardell, L.O., Johansson, S.G., Oman, H., CD-sens: A biological measure of immunological changes stimulated by ASIT (2009) Allergy, 64, pp. 811-814; Patil, S.U., Shreffler, W.G., Immunology in the Clinic Review Series; focus on allergies: Basophils as biomarkers for assessing immune modulation (2012) Clin Exp Immunol, 167, pp. 59-66; Rubio, A., Vivinus-Nébot, M., Bourrier, T., Saggio, B., Alber-tini, M., Bernard, A., Benefit of the basophil activation test in deciding when to reintroduce cow’s milk in allergic children (2011) Allergy, 66, pp. 92-100; Eržen, R., Košnik, M., Silar, M., Korošec, P., Basophil response and the induction of a tolerance in venom immunotherapy: A long-term sting challenge study (2012) Allergy, 67, pp. 822-830; Mayorga, C., Sanz, M.L., Gamboa, P.M., García, B.E., Caballero, M.T., García, J.M., In vitro diagnosis of immediate allergic reactions to drugs: An update (2010) J Investig Allergol Clin Immunol, 20, pp. 103-109; Romano, A., Torres, M.J., Castells, M., Sanz, M.L., Blanca, M., Diagnosis and management of drug hypersensitivity reactions (2011) J Allergy Clin Immunol, 127, pp. S67-S73; Blanca-López, N., Ariza, A., Doña, I., Mayorga, C., Montañez, M.I., Garcia-Campos, J., Hypersensitivity reactions to fluoroquinolones: Analysis of the factors involved (2013) Clin Exp Allergy, 43, pp. 560-567; Uyttebroek, A.P., Sabato, V., Bridts, C.H., De Clerck, L.S., Ebo, D.G., Moxifloxacin hypersensitivity: Uselessness of skin testing (2015) J Allergy Clin Immunol Pract, 3, pp. 443-445; Torres, M.J., Padial, A., Mayorga, C., Fernández, T., Sanchez-Sabate, E., Cornejo-García, J.A., The diagnostic interpretation of basophil activation test in immediate allergic reactions to betalactams (2004) Clin Exp Allergy, 34, pp. 1768-1775; Sanz, M.L., Gamboa, P.M., Antépara, I., Uasuf, C., Vila, L., Garcia-Avilés, C., Flow cytometric basophil activation test by detection of CD63 expression in patients with immediate-type reactions to betalactam antibiotics (2002) Clin Exp Allergy, 32, pp. 277-286; Torres, M.J., Ariza, A., Mayorga, C., Doña, I., Blanca-Lopez, N., Rondon, C., Clavulanic acid can be the component in amox-icillin-clavulanic acid responsible for immediate hypersensitivity reactions (2010) J Allergy Clin Immunol, 125, pp. 502–505.. , e2; Rouzaire, P., Nosbaum, A., Denis, L., Bienvenu, F., Bé-rard, F., Cozon, G., Negativity of the basophil activation test in quinolone hypersensitivity: A breakthrough for provocation test decision-making (2012) Int Arch Allergy Immunol, 157, pp. 299-302; Aranda, A., Mayorga, C., Ariza, A., Doña, I., Rosado, A., Blanca-Lopez, N., In vitro evaluation of IgE-mediated hypersensitivity reactions to quinolones (2011) Allergy, 66, pp. 247-254; Mayorga, C., Andreu, I., Aranda, A., Doña, I., Montañez, M.I., Blanca-Lopez, N., Fluoroquinolone photodegradation influences specific basophil activation (2013) Int Arch Allergy Immunol, 160, pp. 377-382; Kowalski, M.L., Asero, R., Bavbek, S., Blanca, M., Blanca-Lopez, N., Bochenek, G., Classification and practical approach to the diagnosis and management of hypersensitivity to nonsteroidal anti-inflammatory drugs (2013) Allergy, 68, pp. 1219-1232; Abuaf, N., Rajoely, B., Ghazouani, E., Levy, D.A., Pecquet, C., Chabane, H., Validation of a flow cytometric assay detecting in vitro basophil activation for the diagnosis of muscle relaxant allergy (1999) J Allergy Clin Immunol, 104, pp. 411-418; Salas, M., Gomez, F., Fernandez, T.D., Doña, I., Aranda, A., Ariza, A., Diagnosis of immediate hypersensitivity reactions to radiocontrast media (2013) Allergy, 68, pp. 1203-1206; Sampson, H.A., Mendelson, L., Rosen, J.P., Fatal and near-fatal anaphylactic reactions to food in children and adolescents (1992) N Engl J Med, 327, pp. 380-384; Commins, S.P., James, H.R., Stevens, W., Pochan, S.L., Land, M.H., King, C., Delayed clinical and ex vivo response to mammalian meat in patients with IgE to galactose-alpha-1,3-galactose (2014) J Allergy Clin Immunol, 134, pp. 108-115; Santos, A.F., Lack, G., Basophil activation test: Food challenge in a test tube or specialist research tool? (2016) Clin Transl Allergy, 6, p. 10; Faber, M.A., Sabato, V., Decuyper, I.I., Van Gasse, A.L., Hagendorens, M.M., Bridts, C.H., Basophil activation test in IgE-mediated food allergy: Should we follow the flow? 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PY - 2019

Y1 - 2019

N2 - The basophil activation is emerging as a reliable and robust in vitro biomarker of in vivo allergy reactions. Basophil Activation Test (BAT), intended as in vitro stimulation of patient blood basophil with allergens, followed by flow cytometric detection and quantification of such activation, is nowadays a well-established assay in a growing number of routine diagnostic labs. The advancements in the standardization of BAT testing and first convincing clinical evidence are behind this spreading of the assay in clinical lab. BAT is essentially an assay with superior specificity compared to any other allergy testing and, if appropriately used, it can have a valuable clinical utility in different field of allergy diagnosis. In drug allergy, very few testing opportunities are available for the numbers of drugs actually in the market. Antibiotics and analgesics are just two of the categories of drugs were BAT testing can have an added value for the limited specificity of IgE testing or limited availability of other lab testing. In food allergy, BAT is emerging as the more accurate assay to predict an in vivo reaction to food, helping in the discrimination of patients that are only sensitized versus the patient really allergic to an allergen. Furthermore, BAT testing determining the basophil sensitivity can be useful for monitoring the natural resolution of allergies and clinical responses to immunomodulatory treatment for food allergies. For this characteristic, BAT has the potential to reduce the need of OFC. In the hymenoptera venom allergy, BAT is an effective tool in identifying primary sensitizing antigen and in the follow up of patient in venom immunotherapy. With this review, we want to present current state of BAT testing focusing on the clinical laboratory parameters and issue of this assay. A highlight on the standardization needs of BAT is provided, together with considerations on further developments and clinical evidences still to be achieved. © 2018 EDIZIONI MINERVA MEDICA.

AB - The basophil activation is emerging as a reliable and robust in vitro biomarker of in vivo allergy reactions. Basophil Activation Test (BAT), intended as in vitro stimulation of patient blood basophil with allergens, followed by flow cytometric detection and quantification of such activation, is nowadays a well-established assay in a growing number of routine diagnostic labs. The advancements in the standardization of BAT testing and first convincing clinical evidence are behind this spreading of the assay in clinical lab. BAT is essentially an assay with superior specificity compared to any other allergy testing and, if appropriately used, it can have a valuable clinical utility in different field of allergy diagnosis. In drug allergy, very few testing opportunities are available for the numbers of drugs actually in the market. Antibiotics and analgesics are just two of the categories of drugs were BAT testing can have an added value for the limited specificity of IgE testing or limited availability of other lab testing. In food allergy, BAT is emerging as the more accurate assay to predict an in vivo reaction to food, helping in the discrimination of patients that are only sensitized versus the patient really allergic to an allergen. Furthermore, BAT testing determining the basophil sensitivity can be useful for monitoring the natural resolution of allergies and clinical responses to immunomodulatory treatment for food allergies. For this characteristic, BAT has the potential to reduce the need of OFC. In the hymenoptera venom allergy, BAT is an effective tool in identifying primary sensitizing antigen and in the follow up of patient in venom immunotherapy. With this review, we want to present current state of BAT testing focusing on the clinical laboratory parameters and issue of this assay. A highlight on the standardization needs of BAT is provided, together with considerations on further developments and clinical evidences still to be achieved. © 2018 EDIZIONI MINERVA MEDICA.

KW - Allergens

KW - Food

KW - Hymenoptera

KW - Pharmaceutical preparations

KW - allergen

KW - analgesic agent

KW - antibiotic agent

KW - biological marker

KW - cd203c antigen

KW - CD63 antigen

KW - chemokine receptor CCR3

KW - cyclosporine

KW - eotaxin

KW - histamine

KW - Hymenoptera venom

KW - immunoglobulin E

KW - immunoglobulin E receptor

KW - interleukin 3

KW - leukocyte antigen

KW - leukotriene

KW - mitogen activated protein kinase 14

KW - protein kinase Syk

KW - unclassified drug

KW - allergic reaction

KW - antigen specificity

KW - basophil activation test

KW - clinical outcome

KW - clinical study

KW - desensitization

KW - drug hypersensitivity

KW - drug purity

KW - drug screening

KW - drug stability

KW - flow cytometry

KW - fluorescence activated cell sorting

KW - food allergy

KW - health care availability

KW - human

KW - immunomodulation

KW - immunotherapy

KW - macrophage activation

KW - personalized medicine

KW - Review

KW - sensitivity and specificity

KW - serology

KW - signal transduction

KW - skin test

KW - animal

KW - basophil

KW - immunology

KW - insect bite

KW - procedures

KW - Animals

KW - Basophils

KW - Drug Hypersensitivity

KW - Flow Cytometry

KW - Food Hypersensitivity

KW - Humans

KW - Immunoglobulin E

KW - Insect Bites and Stings

KW - Sensitivity and Specificity

U2 - 10.23736/S0026-4946.18.05144-7

DO - 10.23736/S0026-4946.18.05144-7

M3 - Article

VL - 71

SP - 209

EP - 217

JO - Minerva Pediatrica

JF - Minerva Pediatrica

SN - 0026-4946

IS - 2

ER -