Basophil activation test

2 Correlations of CAST with the Clinical Situation and Other Diagnostic Tests 

When CAST results are compared to allergen-specific serum IgE antibody results, correlations are found but they are generally not high, for example, for protein allergens involved in inhalant allergies. However, with allergy to p-lactam antibiotics, the determination of drug-specific IgE is claimed to be less sensitive than the CAST . 

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The detection of reactions mediated by specific IgE to agents triggering anaphylaxis may be achieved by means of serological methods serum-specific IgE, or by means of cellular tests which determine the release of basophil mediators (leukotrienes and histamine) or by means of the analysis of basophil expression markers, a technique known as the basophil activation test (BAT). 

Sanz ML, Gamboa PM, Antepara I, Uasuf C, Vila L, Garda-Aviles C, Chazot M, De Week L Flow cytometric basophil activation test by detection of CD63 expression in patients with immediate-type reactions to (J-lactam antibiotics. Clin Exp Allergy 2002 32 277-286. 

Garda BE, Barber D, Salcedo G, Rihs HP, Raulf-Heimsoth M Basophil activation test and specific IgE measurements using a panel of recombinant natural rubber latex allergen to determine the latex allergen sensitization profile in children. Pediatr 52 Allergy Immunol 2006 17 148-156. 

No increase of plasma leukotrienes after RCM administration Mast cell mediator release correlates with severity of reaction, positive basophil activation test to RCM in patients... 

Positive basophil activation tests were reported in patients with immediate RCM hypersensitivity reactions, which may be regarded as another indirect indication for an IgE-mediated allergy [35]. 

Unfortunately there is no commercial assay for routine measurement of serum levels of RCM-specific IgE antibodies. The reliability of other in vitro tests, such as the basophil activation test, has not yet been established. Results from individual patients indicate that the basophil activation test may be helpful [36]. However, at the moment it is only added on an experimental scientific basis. Provocation is not generally recommended, as intravenous applications of as low as 0.5-1 ml RCM have led to severe anaphylaxis [41]. 

R. Kwiecien, B. Maderegger, and K. Hoffmann-Sommergruber. 2005. In vitro analysis of birch-pollen-associated food allergy by use of recombinant allergens in the basophil activation test. Int Arch Allergy Immunol 136 (3) 230-238. 

Sanz ML, Gamboa, PM, De Week AL. In vitro tests basophil activation tests. In Drug Hypersensitivity, edited by Pichler WJ, pp. 391 02. Basel Karger, 2007. 

In contrast to the above results, the basophil activation test was positive to the implicated quinolone in all five subjects with immediate reactions to a quinolone who were tested [19 ]. However, this assay quantified CD203C, which may be a more sensitive marker than CD63 for detecting IgE-mediated allergy. 

Ben Said B, Berard F, Bienvenu J, Nicolas JF, Rozieres A. Usefulness of basophil activation tests for the diagnosis of IgE-mediated allergy to quinolones. Allergy 2010 65(4) 535-6. 

Immunologic Glucocorticoids can cause hypersensitivity reactions. An anaphylactic reaction to intravenous methylprednisolone during anesthesia has been reported, with positive skin tests and a positive basophil activation test [18 ]. 

When considering the cellular antigen stimulation and basophil activation tests, an interesting point to bear in mind is the sensitivity of CD63 expression to external Ca concentrations compared to the calcium requirement for LTC4... 

Steiner M, Harrer A, Lang R, et al. Basophil activation test for investigation of IgE-mediated mechanisms in drug hypersensitivity. J Vis Exp. 201 l 55 e3263. doi 10.3791/3263. 

The Basophil Activation Test in the Diagnosis of Penicillin Immediate Hypersensitivity... 

When applied to the diagnosis of immediate hypersensitivity to p-lactams, the basophil activation test demonstrated a sensitivity of about 50 % and specificity of -90-100 %. A high incidence of false positives has been observed. 

When used as a diagnostic aid for allergy to NMBDs, the basophil activation test (BAT) has been found to be specific but disappointingly lacking in sensitivity. Results for specificity have generally been above 90 %, and although a figure... 

Unlike in vitro methodologies that detect binding of serum IgE antibodies, usually to an allergen in solid phase form, the basophil activation test... 

Evidence that immediate reactions to a contrast medium is IgE antibody mediated is based largely on skin test results with or without tryptase measurements and very occasionally serum IgE and basophil activation tests. Delayed reactions mainly manifest as exan-thematons skin eruptions. They are mediated by antigen-specific effector T cells with as yet poorly defined cytokine involvement. 

So far a suitable test for the detection of PPI-specific IgE antibodies does not appear to be available. There are at least two reports of a positive basophil activation test on patients allergic to omeprazole—one utilizing the CD63 basophil marker that was positive to omeprazole but negative to pantoprazole and the other detected by the flow-cytometric cellular allergen simulation test (FAST). 

A suitable test for the detection of PPI-specific IgE antibodies is not yet available, and application of the positive basophil activation test has been limited. 

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