Histamine released test

Histamine released test (HRtest)—measurement of histamine release from basophile granulocytes. HR is more complicated for daily clinical practice but may be a helpful tool in certain cases of infrequent food or drug allergy (Burks and Sampson, 1992 Burks, 2000). 

Histamine release by chemokines can be tested using either purified basophils or total leukocyte preparations (11). The preparation of purified basophils is described above. In this section we will first describe the preparation of peripheral blood leukocytes and then present the histamine release test. 

Additional biological tests have been suggested to improve the accuracy further. The leukocyte histamine release test has been found helpful (75) but it is expensive and time-consuming. Several surface molecules have been studied as markers, for example CD63. IgE-mediated degranulation of basophils after incubation of the patient s serum with a neuromuscular blocking agent can... 

PrzybiUa B, Schwab-Przybilla U, Ruzicka T, Ring J. Phototoxicity of non-steroidal anti-inflammatory drugs demonstrated in vitro by a photo-basophil-histamine-release test. Photodermatol 1987 4(2) 73-8. 

Skin prick and intradermal tests, with increasing concentrations of hydroxocobalamin and cyanocobalamin, and histamine release tests on blood basophils with hydroxocobalamin and cyanocobalamin were negative in the second and third patients. 

The leucocyte histamine release test (referred to in greater detail in Chaps. 1-7) is one of the in vitro correlates of immediate allergy which may find useful application in investigating reactions to local anaesthetics. It is of some value in detecting acute reactions, whether they are truly anaphylactic or due to direct (non-immune) histamine release (anaphylactoid). It is also more accurate (quantitative), more reliable and more predictive than skin tests, and above all it is free from risk. 

In three of the patients with reactions to local anaesthetics in whom both the skin and the leucocyte histamine release tests were negative, it was thought that their reaction might have been due to an immune mechanism other than anaphylaxis. The lymphocyte transformation test was carried out in these three patients, but the results were negative. 

Previous work by Assem (1977) had suggested that the leucocyte histamine release test was a particularly useful diagnostic tool in patients who developed reactions to muscle relaxants. In that work, it was essential to assay the histamine released by a non-biological method (i.e., not on isolated guinea-pig ileum) because of the interference by muscle relaxants with the bioassay. The assay procedure used was chemical, using an automated spectrofluorometric technique (Technicon). Good... 

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