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Rodríguez-Vázquez V, López-Freire S, Méndez-Brea P, González-Fernández MT, Hernández-Pérez C, Vidal C. [Basophil activation test to follow-up of patients treated with hymenoptera venom immunotherapy: a review of current evidence]. REVISTA ALERGIA MÉXICO 2023; 69:125-137. [PMID: 36869012 DOI: 10.29262/ram.v69i3.1135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 10/22/2022] [Indexed: 02/05/2023] Open
Abstract
Hymenoptera venom immunotherapy (HVI) is a long-term effective treatment to avoid new systemic reactions in patients with Hymenoptera allergy. The sting challenge test is considered the gold standard to confirm the tolerance. However, the use of this technique is not generalized in clinical practice, being the basophil activation test (BAT), which functionally explores allergen response, an alternative that does not entail any of the provocation risks associated with the sting challenge test. This study reviews the publications that used the BAT to follow up and evaluate the success of the HVI. Studies assessing the changes between a baseline BAT before the start and BATs performed between the starting and maintenance phases of the HVI were selected. Ten articles were found, comprising information from 167 patients, of which 29% used the sting challenge test. The studies concluded the importance of evaluating the responses with submaximal allergen concentrations, which reflect basophil sensitivity, to monitor the HVI using the BAT. It was also observed that changes in the maximum response (reactivity) could not reflect the clinical status of tolerance, particularly in the initial phases of HVI.
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Affiliation(s)
- Virginia Rodríguez-Vázquez
- Servicio de Alergología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España.
| | - Sara López-Freire
- Servicio de Alergología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España
| | - Paula Méndez-Brea
- Servicio de Alergología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España
| | | | | | - Carmen Vidal
- Servicio de Alergología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España.,Facultad de Medicina, Universidad de Santiago de Compostela, España
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Transcriptomic analysis to elucidate the response of honeybees (Hymenoptera: Apidae) to amitraz treatment. PLoS One 2020; 15:e0228933. [PMID: 32143212 PMCID: PMC7060074 DOI: 10.1371/journal.pone.0228933] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 01/27/2020] [Indexed: 12/01/2022] Open
Abstract
Amitraz is an acaricide that is widely used in apiculture. Several studies have reported that in honeybees (Apis mellifera Linnaeus; Hymenoptera: Apidae), amitraz affects learning, memory, behavior, immunity, and various other physiological processes. Despite this, few studies have explored the molecular mechanisms underlying the action of amitraz on honeybees. Here, we investigated the transcriptome of honeybees after exposure to 9.4 mg/L amitraz for 10 d, a subchronic dose. Overall, 279 differentially expressed genes (DEGs) were identified (237 upregulated, 42 downregulated). Several, including Pla2, LOC725381, LOC413324, LOC724386, LOC100577456, LOC551785, and P4504c3, were validated by quantitative PCR. According to gene ontology, DEGs were mainly involved in metabolism, biosynthesis, and translation. Kyoto Encyclopedia of Genes and Genomes pathway analyses revealed that amitraz treatment affected the relaxin signaling pathway, platelet activation, and protein digestion and absorption.
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Bonadonna P, Scaffidi L. Hymenoptera Anaphylaxis as a Clonal Mast Cell Disorder. Immunol Allergy Clin North Am 2018; 38:455-468. [DOI: 10.1016/j.iac.2018.04.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Bidad K, Nawijn MC, van Oosterhout AJM, van der Heide S, Elberink JNGO. Basophil activation test in the diagnosis and monitoring of mastocytosis patients with wasp venom allergy on immunotherapy. CYTOMETRY PART B-CLINICAL CYTOMETRY 2014; 86:183-90. [PMID: 24478037 DOI: 10.1002/cyto.b.21148] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 11/27/2013] [Accepted: 12/03/2013] [Indexed: 11/09/2022]
Abstract
BACKGROUND There is need for an accurate diagnostic test in mastocytosis patients with wasp venom allergy (WVA) and monitoring of these patients during immunotherapy (IT). In this study, we aimed to evaluate sensitivity and specificity of the Basophil Activation Test (BAT) as a diagnostic and monitoring test in patients with mastocytosis and WVA. METHODS Seventeen patients with mastocytosis and WVA and six mastocytosis patients without WVA were included. BAT was performed before the start of IT (first visit) and at 6 weeks (second visit) and 1 year (third visit), after reaching the maintenance dose. Of 17 patients included, 11 completed the third visit. In mastocytosis patients with WVA, dose-dependent wasp-venom induced upregulation of CD63 and CD203c expression on basophils was observed compared with mastocytosis patients without WVA. Serum specific IgE, IgG4, and tryptase levels were measured in all patients. RESULTS BAT had a sensitivity of 87% and specificity of 100% in diagnosing WVA in mastocytosis patients. Basophil allergen threshold sensitivity with respect to CD63 and CD203c was significantly decreased in the second visit compared with the first visit and increased significantly in the third visit compared with the second visit. Specific IgE levels increased significantly in the second visit compared with first and decreased significantly in the third visit compared with the second. Specific IgG4 levels rose significantly in the second visit compared with the first and on the third visit compared with the second. Tryptase levels did not change significantly during the study. CONCLUSIONS BAT represents a diagnostic test with 100% specificity in allergic patients with mastocytosis and these patients are better to be monitored for a longer period during IT.
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Affiliation(s)
- Katayoon Bidad
- Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Pathology and Medical Biology, Laboratory of Allergology and Pulmonary Diseases, University Medical Center of Groningen, University of Groningen, Groningen, The Netherlands
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Carroccio A, Mansueto P, D'Alcamo A, Iacono G. Non-celiac wheat sensitivity as an allergic condition: personal experience and narrative review. Am J Gastroenterol 2013; 108:1845-52; quiz 1853. [PMID: 24169272 DOI: 10.1038/ajg.2013.353] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 09/03/2013] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Non-celiac wheat sensitivity (NCWS) is a newly described clinical entity characterized by symptoms, which can involve the gastrointestinal tract, the nervous system, the skin, and other organs. There is little data on the pathogenesis of NCWS and it is probable that different pathogenic mechanisms are involved in the different clinical manifestations of the disease. The only common denominator of NCWS "syndrome" is wheat consumption: the symptoms disappear on exclusion of wheat from the diet, and reappear on wheat consumption. The objective of this study was to review our prior data regarding NCWS and to review relevant medical literature regarding NCWS, with particular attention to the hypothesis that NCWS patients could suffer from non-immunoglobulin E (IgE)-mediated wheat allergy. METHODS We reviewed our data on 276 patients diagnosed with NCWS by means of double-blind placebo-controlled (DBPC) wheat challenge. The data indicating a possible wheat allergy diagnosis were examined and other data in the literature were reviewed; we review the role of serum immunoglobulin G antibodies and the basophil activation assay in food allergy, and the histology findings in the food allergy diagnosis. RESULTS The comparison between patients suffering from NCWS and presenting with irritable bowel syndrome (IBS) and controls with IBS not due to NCWS showed that NCWS was characterized by: a personal history of food allergy in the pediatric age (0.01), coexistent atopic diseases (0.0001), positive serum anti-gliadin (0.0001) and anti-betalactoglobulin (0.001) antibodies, positive cytofluorimetric assay revealing in vitro basophil activation by food antigens (0.0001), and a presence of eosinophils in the intestinal mucosa biopsies (0.0001). CONCLUSIONS Patients with NCWS and multiple food sensitivity show several clinical, laboratory, and histological characteristics that suggest they might be suffering from non-IgE-mediated food allergy. However, other pathogenic mechanisms need to be considered.
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Affiliation(s)
- Antonio Carroccio
- Internal Medicine, Hospital of Sciacca, ASP Agrigento and University of Palermo, Palermo, Italy
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Bonadonna P, Zanotti R, Melioli G, Antonini F, Romano I, Lenzi L, Caruso B, Passalacqua G. The role of basophil activation test in special populations with mastocytosis and reactions to hymenoptera sting. Allergy 2012; 67:962-5. [PMID: 22676063 DOI: 10.1111/j.1398-9995.2012.02849.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Systemic mastocytosis (SM) may be associated with hymenoptera allergy. In such cases, immunotherapy is a life-saving treatment, but a circumstantiated diagnosis is needed for its prescription. Patients with SM and previous reactions to stings, but with negative tests represent a diagnostic dilemma. The basophil activation test (BAT) may be helpful in refining the diagnosis. OBJECTIVE We assessed the usefulness of BAT in subpopulations of mastocytosis patients, including those with negative tests for insect allergy. METHODS Within a population of patients with mastocytosis and previous stings, we studied by BAT and augmented intradermal test (IDT) (10 µg/ml) two groups: (1) with reactions to stings and negative tests; (2) without reactions and negative tests. Basophil activation test was performed with different venoms, assessing at flow cytometry basophils' activation. RESULTS Sixty-three patients had mastocytosis and 52 had reactions to previous hymenoptera stings. Of them, seven proved negative to diagnostic tests. In six of seven of those patients, BAT was negative with all venoms, and in one, basophils resulted activated also with the negative control. In six patients without previous reactions and negative tests, BAT was totally negative in five of six patients and weakly positive to Hornet in one. Finally, the IDT at 10 µg/ml venom produced nonspecific positive results in most cases. CONCLUSION In patients with mastocytosis, the negative results of standard tests are reliable, because BAT and IDT at higher concentration do not add useful information.
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Affiliation(s)
- P. Bonadonna
- Allergy Unit; Azienda Ospedaliera Universitaria Integrata; Verona; Italy
| | - R. Zanotti
- Section of Haematology; Deparment of Clinical and Experimental Medicine; University of Verona; Verona; Italy
| | - G. Melioli
- Deparment of Research and Medical Diagnostics; Istituto Giannina Gaslini; Genoa; Italy
| | - F. Antonini
- Deparment of Research and Medical Diagnostics; Istituto Giannina Gaslini; Genoa; Italy
| | - I. Romano
- Deparment of Research and Medical Diagnostics; Istituto Giannina Gaslini; Genoa; Italy
| | - L. Lenzi
- Deparment of Research and Medical Diagnostics; Istituto Giannina Gaslini; Genoa; Italy
| | - B. Caruso
- Laboratory of Clinical Chemistry and Haematology; Azienda Ospedaliera Universitaria Integrata; Verona; Italy
| | - G. Passalacqua
- Allergy and Respiratory Diseases; DIMI; University of Genoa; Genoa; Italy
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Chirumbolo S. Basophil Activation Test in Allergy: Time for an Update? Int Arch Allergy Immunol 2012; 158:99-114. [DOI: 10.1159/000331312] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Accepted: 07/29/2011] [Indexed: 11/19/2022] Open
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Abstract
Cellular in-vitro assays are able to detect antigen-dependent cellular processes without any risk for the patient. After antigen stimulation, both the cellular antigen stimulation test assessing sulfidoleukotriene production in leukocyte suspension, and flow cytometric basophil activation assays determining surface activation markers (CD63, CD203c), represent accepted models for in-vivo mast cell stimulation particularly in IgE-dependent reactions of immediate type. The value of these assays should be estimated considering the type of antigen and further diagnostic options. Most studies can not be compared due to different allergen concentrations, conditions of stimulation, methods, and defined cut-offs. Therefore, it is difficult to evaluate published evidence. Because of the logistic effort, cellular assays are often available only in specialized laboratories. However, in daily routine they are important in cases with clear-cut history but negative conventional allergy diagnostic procedures, in case of rare allergens (drugs, exotic food), as well as contraindications for skin and/or provocation test (hymenoptera venom allergy, anaphylaxis).
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Affiliation(s)
- B Wedi
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Ricklinger Str. 5, 30449, Hannover.
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González-de-Olano D, Alvarez-Twose I, Morgado JM, Esteban López MI, Vega Castro A, Díaz de Durana MDA, Sánchez-Muñoz L, Matito A, de la Hoz Caballer B, Sanz ML, Orfao A, Escribano L. Evaluation of basophil activation in mastocytosis with Hymenoptera venom anaphylaxis. CYTOMETRY PART B-CLINICAL CYTOMETRY 2010; 80:167-75. [PMID: 21520404 DOI: 10.1002/cyto.b.20577] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Revised: 09/01/2010] [Accepted: 09/30/2010] [Indexed: 11/08/2022]
Abstract
BACKGROUND Basophil activation tests (BATs) have been demonstrated to be useful in detecting IgE-mediated sensitization by measuring basophil activation surface markers (CD63 and CD203c). Hymenoptera venom is one of the best known mediators-release trigger in patients with systemic mastocytosis (SM). The aim of this study was to investigate the use of BATs as an additional diagnostic tool in patients with mastocytosis suffering from hymenoptera venom anaphylaxis (HVA). METHODS A total of 22 patients with history of HVA and SM, together with a group of 11 patients with HVA in whom SM was ruled out after a complete bone marrow study, were analyzed. RESULTS Among 11 SM patients who had specific serum IgE (sIgE) against hymenoptera venom and an evaluable BAT, a positive BAT was found in nine. Additionally, a positive BAT was detected in three of seven patients who had no sIgE. These three patients had low levels of total IgE compared with control population (mean of 20 vs. 78 IU/mL); one had discontinued immunotherapy after 5 years, when sIgE levels had turned negative, and, in the other two patients, BAT identified the culprit insect. CONCLUSIONS BAT is a useful complementary diagnostic tool to sIgE in mastocytosis patients with HVA, and it may contribute to predict or confirm these nearly fatal reactions, especially before discontinuing venom immunotherapy in patients who are negative for skin tests or sIgE or display low total IgE levels; in such cases, it also provides evidence on the culprit insect prompting HVA.
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Diagnosis of stinging insect allergy: utility of cellular in-vitro tests. Curr Opin Allergy Clin Immunol 2009; 9:343-50. [DOI: 10.1097/aci.0b013e32832dd1f5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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