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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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3
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Takazawa T, Yamaura K, Hara T, Yorozu T, Mitsuhata H, Morimatsu H. Practical guidelines for the response to perioperative anaphylaxis. J Anesth 2021; 35:778-793. [PMID: 34651257 DOI: 10.1007/s00540-021-03005-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/21/2021] [Indexed: 02/07/2023]
Abstract
Perioperative anaphylaxis is a severe adverse event during anesthesia that requires prompt diagnosis and treatment by physicians, including anesthesiologists. Muscle relaxants and antibiotics are the most common drugs that cause perioperative anaphylaxis in Japan, as in many countries. In addition, sugammadex appears to be a primary causative agent. Obtaining previous anesthesia records is necessary in a patient with a history of allergic reactions during anesthesia, whenever possible, to avoid recurrence of anaphylaxis. Although medical staff are likely to notice abnormal vital signs because of complete monitoring during anesthesia, surgical drapes make it difficult to notice the appearance of skin symptoms. Even if there are no skin symptoms, anaphylaxis should be suspected, especially when hypotension resistant to inotropes and vasopressors persists. For improving the diagnostic accuracy of anaphylaxis, it is helpful to collect blood samples to measure histamine/tryptase concentrations immediately after the events and at baseline. The first-line treatment for anaphylaxis is adrenaline. In the perioperative setting, adrenaline should be administered through the intravenous route, which has a faster effect onset and is secured in most cases. Adrenaline can cause serious complications including severe arrhythmias if the appropriate dose is not selected according to the severity of symptoms. The anesthesiologist should identify the causative agent after adverse events. The gold standard for identifying the causative agent is the skin test, but in vitro tests including specific IgE antibody measurements and basophil activation tests are also beneficial. The Working Group of the Japanese Society of Anesthesiologists has developed this practical guide to help appropriate prevention, early diagnosis and treatment, and postoperative diagnosis of anaphylaxis during anesthesia.Grade of recommendations and levels of evidence Anaphylaxis is a relatively rare condition with few controlled trials, and thus a so-called evidence-based scrutiny is difficult. Therefore, rather than showing evidence levels and indicating the level of recommendation, this practical guideline only describes the results of research available to date. The JSA will continue to investigate anaphylaxis during anesthesia, and the results may lead to an amendment of this practical guideline.
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Affiliation(s)
- Tomonori Takazawa
- Intensive Care Unit, Gunma University Hospital, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
| | - Ken Yamaura
- Department of Anesthesiology and Critical Care Medicine, Kyushu University Graduate School of Medicine, Fukuoka, Japan
| | - Tetsuya Hara
- Department of Anesthesiology and Intensive Care Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomoko Yorozu
- Department of Anesthesiology, Kyorin University School of Medicine, Tokyo, Japan
| | | | - Hiroshi Morimatsu
- Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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McKenzie CI, Varese N, Aui PM, Wines BD, Hogarth PM, Thien F, Hew M, Rolland JM, O’Hehir RE, Zelm MC. CytoBas: Precision component-resolved diagnostics for allergy using flow cytometric staining of basophils with recombinant allergen tetramers. Allergy 2021; 76:3028-3040. [PMID: 33772805 PMCID: PMC8518718 DOI: 10.1111/all.14832] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Diagnostic tests for allergy rely on detecting allergen-specific IgE. Component-resolved diagnostics incorporate multiple defined allergen components to improve the quality of diagnosis and patient care. OBJECTIVE To develop a new approach for determining sensitization to specific allergen components that utilizes fluorescent protein tetramers for direct staining of IgE on blood basophils by flow cytometry. METHODS Recombinant forms of Lol p 1 and Lol p 5 proteins from ryegrass pollen (RGP) and Api m 1 from honeybee venom (BV) were produced, biotinylated, and tetramerized with streptavidin-fluorochrome conjugates. Blood samples from 50 RGP-allergic, 41 BV-allergic, and 26 controls were incubated with fluorescent protein tetramers for flow cytometric evaluation of basophil allergen binding and activation. RESULTS Allergen tetramers bound to and activated basophils from relevant allergic patients but not controls. Direct fluorescence staining of Api m 1 and Lol p 1 tetramers had greater positive predictive values than basophil activation for BV and RGP allergy, respectively, as defined with receiver operator characteristics (ROC) curves. Staining intensities of allergen tetramers correlated with allergen-specific IgE levels in serum. Inclusion of multiple allergens coupled with distinct fluorochromes in a single-tube assay enabled rapid detection of sensitization to both Lol p 1 and Lol p 5 in RGP-allergic patients and discriminated between controls, BV-allergic, and RGP-allergic patients. CONCLUSION Our novel flow cytometric assay, termed CytoBas, enables rapid and reliable detection of clinically relevant allergic sensitization. The intensity of fluorescent allergen tetramer staining of basophils has a high positive predictive value for disease, and the assay can be multiplexed for a component-resolved and differential diagnostic test for allergy.
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Affiliation(s)
- Craig I. McKenzie
- Department of Immunology and Pathology Central Clinical School Monash University Melbourne VIC Australia
| | - Nirupama Varese
- Department of Immunology and Pathology Central Clinical School Monash University Melbourne VIC Australia
- Department of Allergy, Immunology and Respiratory Medicine Central Clinical School Monash University Melbourne VIC Australia
| | - Pei M. Aui
- Department of Immunology and Pathology Central Clinical School Monash University Melbourne VIC Australia
| | - Bruce D. Wines
- Department of Immunology and Pathology Central Clinical School Monash University Melbourne VIC Australia
- Immune Therapies Group Burnet Institute Melbourne Australia
- Department of Pathology The University of Melbourne Parkville VIC Australia
| | - Philip Mark Hogarth
- Department of Immunology and Pathology Central Clinical School Monash University Melbourne VIC Australia
- Immune Therapies Group Burnet Institute Melbourne Australia
- Department of Pathology The University of Melbourne Parkville VIC Australia
| | - Francis Thien
- Respiratory Medicine Eastern HealthBox Hill and Monash University Melbourne VIC Australia
| | - Mark Hew
- School of Public Health and Preventive Medicine Monash University Melbourne VIC Australia
- Allergy, Asthma and Clinical Immunology Alfred Health Melbourne VIC Australia
| | - Jennifer M. Rolland
- Department of Immunology and Pathology Central Clinical School Monash University Melbourne VIC Australia
- Department of Allergy, Immunology and Respiratory Medicine Central Clinical School Monash University Melbourne VIC Australia
| | - Robyn E. O’Hehir
- Department of Immunology and Pathology Central Clinical School Monash University Melbourne VIC Australia
- Department of Allergy, Immunology and Respiratory Medicine Central Clinical School Monash University Melbourne VIC Australia
- Allergy, Asthma and Clinical Immunology Alfred Health Melbourne VIC Australia
| | - Menno C. Zelm
- Department of Immunology and Pathology Central Clinical School Monash University Melbourne VIC Australia
- Allergy, Asthma and Clinical Immunology Alfred Health Melbourne VIC Australia
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Santos AF, Alpan O, Hoffmann H. Basophil activation test: Mechanisms and considerations for use in clinical trials and clinical practice. Allergy 2021; 76:2420-2432. [PMID: 33475181 DOI: 10.1111/all.14747] [Citation(s) in RCA: 117] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/15/2020] [Accepted: 11/17/2020] [Indexed: 12/11/2022]
Abstract
The basophil activation test (BAT) is a functional assay that measures the degree of degranulation following stimulation with allergen or controls by flow cytometry. It correlates directly with histamine release. From the dose-response curve resulting from BAT in allergic patients, basophil reactivity (%CD63+ basophils) and basophil sensitivity (EC50 or similar) are the main outcomes of the test. BAT takes into account all characteristics of IgE and allergen and thus can be more specific than sensitization tests in the diagnosis of allergic disease. BAT reduces the need for in vivo procedures, such as intradermal tests and allergen challenges, which can cause allergic reactions of unpredictable severity. As it closely reflects the patients' phenotype in most cases, it may be used to support the diagnosis of food, venom and drug allergies and chronic urticaria, to monitor the natural resolution of food allergies and to predict and monitor clinical the response to immunomodulatory treatments, such as allergen-specific immunotherapy and biologicals. Clinical application of BAT requires analytical validation, clinical validation, standardization of procedures and quality assurance to ensure reproducibility and reliability of results. Currently, efforts are ongoing to establish a platform that could be used by laboratories in Europe and in the USA for quality assurance and certification.
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Affiliation(s)
- Alexandra F. Santos
- Department of Women and Children's Health (Pediatric Allergy) School of Life Course Sciences Faculty of Life Sciences and Medicine King's College London London UK
- Peter Gorer Department of Immunobiology School of Immunology and Microbial Sciences King's College London London UK
- Asthma UK Centre in Allergic Mechanisms of Asthma London UK
- Children's Allergy ServiceEvelina London Children's HospitalGuy's and St Thomas' Hospital London UK
| | | | - Hans‐Jürgen Hoffmann
- Department of Clinical Medicine Aarhus University Aarhus Denmark
- Department of Respiratory Diseases and Allergy Aarhus University Hospital Aarhus Denmark
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Goto T, Hayashi S, Tsugane H, Iinuma M, Sakurai S. A Case of Anaphylaxis in Which a Basophil Activation Test Was Used to Identify the Suspected Agent. Anesth Prog 2020; 67:172-173. [PMID: 32992332 DOI: 10.2344/anpr-67-03-05] [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: 08/28/2019] [Accepted: 10/31/2019] [Indexed: 11/11/2022] Open
Abstract
This is a case report of anaphylaxis in which the basophil activation test (BAT) was used to identify the etiological agent. Although skin tests are considered the most effective methods for identifying anaphylactic triggers, the test itself presents a risk of inducing anaphylaxis. The BAT is advantageous because of its inherent lack of risk, high sensitivity and specificity to identify the suspected anaphylactic agents, and diagnostic accuracy comparable to conventional skin testing. Therefore, in the future, the BAT is likely to become the preferred test for the detection of allergens over conventional skin tests.
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Affiliation(s)
- Takashi Goto
- Department of Dental Anesthesiology, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
| | - Shintaro Hayashi
- Department of Dental Anesthesiology, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
| | - Hiroko Tsugane
- Department of Pediatric Dentistry, Division of Oral Structure, Function and Development, Asahi University School of Dentistry, Gifu, Japan
| | - Mitsuo Iinuma
- Department of Pediatric Dentistry, Division of Oral Structure, Function and Development, Asahi University School of Dentistry, Gifu, Japan
| | - Satoru Sakurai
- Department of Dental Anesthesiology, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry, Gifu, Japan
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Takazawa T, Sabato V, Ebo DG. In vitro diagnostic tests for perioperative hypersensitivity, a narrative review: potential, limitations, and perspectives. Br J Anaesth 2019; 123:e117-e125. [DOI: 10.1016/j.bja.2019.01.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 12/25/2018] [Accepted: 01/03/2019] [Indexed: 12/28/2022] Open
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Hemmings O, Kwok M, McKendry R, Santos AF. Basophil Activation Test: Old and New Applications in Allergy. Curr Allergy Asthma Rep 2018; 18:77. [PMID: 30430289 PMCID: PMC6244909 DOI: 10.1007/s11882-018-0831-5] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW The basophil activation test (BAT) using flow cytometry has supplanted traditional methods of measuring basophil degranulation using histamine and other mediator release, and can be used for clinical applications as well as to explore the immune mechanisms of effector cell response to allergen. This review discusses the advancements made in clinical, diagnostic and laboratory research of allergy utilizing an ever-evolving BAT. RECENT FINDINGS Being an in vitro surrogate of the allergic reaction that happens in vivo in the sick patient, the BAT can be used to support the diagnosis of various allergic conditions, such as food, drug, respiratory and insect venom allergies, and the assessment of clinical response to allergen-specific immunotherapy and other immunomodulatory treatments. The BAT can also be used for research purposes to explore the mechanisms of allergy and tolerance at the level of the basophil, for instance by manipulating IgE and IgG and their receptors and by studying intracellular signalling cascade in response to allergen. This review covers the applications of the BAT to the clinical management of allergic patients and the increased understanding of the mechanisms of immune response to allergens as well as technological advancements made in recent years.
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Affiliation(s)
- Oliver Hemmings
- Department of Women and Children's Health (Paediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.,Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.,MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - Matthew Kwok
- Department of Women and Children's Health (Paediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.,Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.,MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - Richard McKendry
- Department of Women and Children's Health (Paediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.,Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.,MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - Alexandra F Santos
- Department of Women and Children's Health (Paediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK. .,Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK. .,MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK. .,Children's Allergies Department, Guy's and St. Thomas' NHS Foundation Trust, St. Thomas' Hospital, Westminster Bridge Road, London, UK.
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Horiuchi T, Takazawa T, Orihara M, Sakamoto S, Yokohama A, Takahashi J, Tomioka A, Yoshida N, Hagiwara K, Saito S. Required cefazolin concentration to maximize diagnostic accuracy of the basophil activation test for cefazolin-induced anaphylaxis. J Anesth 2018; 32:797-805. [DOI: 10.1007/s00540-018-2555-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Accepted: 09/11/2018] [Indexed: 10/28/2022]
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Dewachter P, Chollet-Martin S, Mouton-Faivre C, de Chaisemartin L, Nicaise-Roland P. Comparison of Basophil Activation Test and Skin Testing Performances in NMBA Allergy. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:1681-1689. [DOI: 10.1016/j.jaip.2017.12.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 11/28/2017] [Accepted: 12/27/2017] [Indexed: 12/31/2022]
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Sabogal-Cuadro P, Zakzuk J. Prueba de activación de basófilos: aspectos técnicos, metodológicos y su utilidad clínica. REVISTA DE LA FACULTAD DE MEDICINA 2018. [DOI: 10.15446/revfacmed.v66n3.61820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. La prueba de activación de basófilos (PAB) se considera una técnica confiable y segura para el diagnóstico de problemas alérgicos.Objetivo. Profundizar en el estado del arte de la PAB y su utilidad clínica.Materiales y métodos. Se realizó una revisión narrativa de la literatura mediante la búsqueda electrónica en las bases de datos y metabuscadores Ovid Medline, Google Scholar y PubMed, sin limitar la búsqueda por fecha, idioma o tipo de artículo. Se buscaron artículos sobre los detalles técnicos de la PAB y su utilidad clínica en el manejo de las enfermedades alérgicas.Resultados. De los marcadores de activación, CD63 ha sido el más estudiado y es el que mejor representa un evento de degranulación anafiláctica, mientras que CD203c es representativo de varias formas de degranulación. La superioridad de uno sobre otro como prueba diagnóstica depende del problema alérgico estudiado. En cuanto a los métodos de detección de basófilos, su selección con un único marcador, CCR3, se propone como una opción con buena relación de costo-efectividad.Conclusiones. La PAB es una herramienta prometedora para evaluar en clínica las reacciones alérgicas de forma segura. Es necesario una mayor estandarización de protocolos para obtener resultados más reproducibles.
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12
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Matas S, Broto M, Corominas M, Lleonart R, Babington R, Marco MP, Galve R. Immediate hypersensitivity to penicillins. Identification of a new antigenic determinant. J Pharm Biomed Anal 2018; 148:17-23. [DOI: 10.1016/j.jpba.2017.08.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 08/10/2017] [Accepted: 08/17/2017] [Indexed: 01/12/2023]
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13
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Basophil Degranulation Assay. Methods Mol Biol 2017. [PMID: 28315217 DOI: 10.1007/978-1-4939-6925-8_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
Abstract
Basophil degranulation assay has gained importance over the last decade in both diagnosis of food allergy and evaluation of progression of immunotherapy. This assay involves the identification and quantification of the expression of CD63 molecule on basophil membrane. CD63 is a marker of multivesicular bodies that is exposed to cell membrane during the process of degranulation in which the contents of basophil granules are released. This chapter describes the methodology for performing this assay.
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Prevention of Anaphylaxis Based on Risk Factors and Cofactors. CURRENT TREATMENT OPTIONS IN ALLERGY 2016. [DOI: 10.1007/s40521-016-0095-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Philpott H, Nandurkar S, Royce SG, Thien F, Gibson PR. Allergy tests do not predict food triggers in adult patients with eosinophilic oesophagitis. A comprehensive prospective study using five modalities. Aliment Pharmacol Ther 2016; 44:223-33. [PMID: 27247257 DOI: 10.1111/apt.13676] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 04/25/2016] [Accepted: 05/06/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND The use of allergy tests to guide dietary treatment for eosinophilic oesophagitis (EoE) is controversial and data are limited. Aeroallergen sensitisation patterns and food triggers have been defined in Northern Hemisphere cohorts only. AIMS To determine if allergy tests that are routinely available can predict food triggers in adult patients with EoE. To define the food triggers and aeroallergen sensitisation patterns in a novel Southern Hemisphere (Australian) cohort of patients. METHODS Consecutive patients with EoE who elected to undergo dietary therapy were prospectively assessed, demographic details and atopic characteristics recorded, and allergy tests, comprising skin-prick and skin-patch tests, serum allergen-specific IgE, basophil activation test and serum food-specific IgG, were performed. Patients underwent a six-food elimination diet with a structured algorithm that included endoscopic and histological examination of the oesophagus a minimum of 2 weeks after each challenge. Response was defined as <15 eosinophils per HPF. Foods defined as triggers were considered as gold standard and were compared with those identified by allergy testing. RESULTS No allergy test could accurately predict actual food triggers. Concordance among skin-prick and serum allergen-specific IgE was high for aeroallergens only. Among seasonal aeroallergens, rye-grass sensitisation was predominant. Food triggers were commonly wheat, milk and egg, alone or in combination. CONCLUSIONS None of the currently-available allergy tests predicts food triggers for EoE. Exclusion-rechallenge methodology with oesophageal histological assessment remains the only effective investigation. The same food triggers were identified in this southern hemisphere cohort as previously described.
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Affiliation(s)
- H Philpott
- Monash University, Melbourne, Vic., Australia.,Eastern Health Department of Gastroenterology, Eastern Health Clinical School, Melbourne, Vic., Australia.,The Alfred Hospital, Melbourne, Vic., Australia
| | - S Nandurkar
- Monash University, Melbourne, Vic., Australia.,Eastern Health Department of Gastroenterology, Eastern Health Clinical School, Melbourne, Vic., Australia
| | - S G Royce
- Monash University, Melbourne, Vic., Australia
| | - F Thien
- Monash University, Melbourne, Vic., Australia.,Eastern Health Department of Gastroenterology, Eastern Health Clinical School, Melbourne, Vic., Australia
| | - P R Gibson
- Monash University, Melbourne, Vic., Australia.,The Alfred Hospital, Melbourne, Vic., Australia
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Chirumbolo S. Commentary: Mutual interaction of basophils and T cells in chronic inflammatory diseases. Front Immunol 2016; 7:135. [PMID: 27092145 PMCID: PMC4824792 DOI: 10.3389/fimmu.2016.00135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 03/27/2016] [Indexed: 01/08/2023] Open
Affiliation(s)
- Salvatore Chirumbolo
- Unit of Geriatry, Department of Medicine, University Laboratory of Medical Research-LURM est, Policlinico GB Rossi , Verona , Italy
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Kumagai T, Yamaguchi N, Hirai H, Kojima S, Kodani Y, Hashiguchi A, Haida M, Nakamura M. Loxoprofen sodium induces the production of complement C5a in human serum. Int Immunopharmacol 2016; 33:55-62. [DOI: 10.1016/j.intimp.2016.01.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 01/08/2016] [Accepted: 01/26/2016] [Indexed: 12/27/2022]
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Metcalfe DD, Pawankar R, Ackerman SJ, Akin C, Clayton F, Falcone FH, Gleich GJ, Irani AM, Johansson MW, Klion AD, Leiferman KM, Levi-Schaffer F, Nilsson G, Okayama Y, Prussin C, Schroeder JT, Schwartz LB, Simon HU, Walls AF, Triggiani M. Biomarkers of the involvement of mast cells, basophils and eosinophils in asthma and allergic diseases. World Allergy Organ J 2016; 9:7. [PMID: 26904159 PMCID: PMC4751725 DOI: 10.1186/s40413-016-0094-3] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 01/14/2016] [Indexed: 12/19/2022] Open
Abstract
Biomarkers of disease activity have come into wide use in the study of mechanisms of human disease and in clinical medicine to both diagnose and predict disease course; as well as to monitor response to therapeutic intervention. Here we review biomarkers of the involvement of mast cells, basophils, and eosinophils in human allergic inflammation. Included are surface markers of cell activation as well as specific products of these inflammatory cells that implicate specific cell types in the inflammatory process and are of possible value in clinical research as well as within decisions made in the practice of allergy-immunology.
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Affiliation(s)
- Dean D. Metcalfe
- />Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892 USA
| | - Ruby Pawankar
- />Division of Allergy, Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Steven J. Ackerman
- />Department of Biochemistry and Molecular Genetics, College of Medicine, University of Illinois, Chicago, IL USA
| | - Cem Akin
- />Harvard Medical School, Brigham and Women’s Hospital, Boston, MA USA
| | - Frederic Clayton
- />Department of Pathology, University of Utah Health Sciences Center, Salt Lake City, UT USA
| | - Franco H. Falcone
- />The School of Pharmacy, University of Nottingham, Nottingham, United Kingdom
| | - Gerald J. Gleich
- />Department of Dermatology, University of Utah, School of Medicine, Salt Lake City, UT USA
| | - Anne-Marie Irani
- />Virginia Commonwealth University, Children’s Hospital of Richmond, Richmond, VA USA
| | - Mats W. Johansson
- />Department of Biomolecular Chemistry, University of Wisconsin, Madison, WI USA
| | - Amy D. Klion
- />Human Eosinophil Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD USA
| | | | | | - Gunnar Nilsson
- />Clinical Immunology and Allergy, Department of Medicine, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
| | - Yoshimichi Okayama
- />Allergy and Immunology Group, Research Institute of Medical Science, Nihon University Graduate School of Medicine, Tokyo, Japan
| | - Calman Prussin
- />Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892 USA
| | - John T. Schroeder
- />Division of Allergy and Clinical Immunology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | | | - Hans-Uwe Simon
- />University of Bern, Institute of Pharmacology, Bern, Switzerland
| | - Andrew F. Walls
- />Southampton General Hospital, Immunopharmacology Group, Southampton, Hampshire UK
| | - Massimo Triggiani
- />Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy
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19
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Mangodt EA, Van Gasse AL, Bastiaensen A, Decuyper II, Uyttebroek A, Faber M, Sabato V, Bridts CH, Hagendorens MM, De Clerck LS, Ebo DG. Flow-assisted basophil activation tests in immediate drug hypersensitivity: two decades of Antwerp experience. Acta Clin Belg 2016; 71:19-25. [PMID: 27075810 DOI: 10.1080/17843286.2015.1122871] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The last two decades have witnessed that flow-assisted analysis of in vitro-activated basophils can constitute a valuable adjunct in the in vitro diagnostic approach of immediate drug hypersensitivity reactions (IDHR). This article summarises the current experience with the basophil activation test in the diagnosis of IDHR, with particular focus on allergy to curarising neuromuscular blocking agents, antibiotics (β-lactams and fluoroquinolones), iodinated radiocontrast media and opiates.
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20
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Molekulare Allergiediagnostik mit IgE-Einzelbestimmungen: methodische und praktische Aspekte für die Anwendung im klinischen Alltag. ALLERGO JOURNAL 2015. [DOI: 10.1007/s15007-015-0898-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Kleine-Tebbe J, Jakob T. Molecular allergy diagnostics using IgE singleplex determinations: methodological and practical considerations for use in clinical routine: Part 18 of the Series Molecular Allergology. ALLERGO JOURNAL INTERNATIONAL 2015; 24:185-197. [PMID: 27069839 PMCID: PMC4792337 DOI: 10.1007/s40629-015-0067-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 05/26/2015] [Indexed: 12/12/2022]
Abstract
Allergen molecules (synonyms: single allergens, allergen components) open up new horizons for the targeted allergen-specific diagnostics of immunoglobulin E (IgE) in singleplex determination. The following rationales support the targeted use of allergen molecules and, more importantly, improve test properties: (1) increased test sensitivity ("analytical sensitivity"), particularly when important allergens are under-represented or lacking in the extract; (2) improved test selectivity (analytical specificity), particularly when the selected IgE repertoire against an allergen yields additional information on: (a) potential risk, (b) possible cross-reactivity, or (c) primary (species-specific) sensitization. However, the appropriate indication for the use of single allergens can only be established on a case-by-case basis (depending on the clinical context and previous history) and in an allergen-specific manner (depending on the allergen source and the single allergens available), rather than in a standardized way. Numerous investigations on suspected food allergy, insect venom allergy, or sensitization to respiratory allergens have meanwhile demonstrated the successful use of defined molecules for allergen-specific singleplex IgE diagnosis. Specific IgE to single allergens is limited in its suitability to predict the clinical relevance of sensitivity on an individual basis. In food allergies, one can at best identify the relative risk of a clinical reaction on the basis of an IgE profile, but no absolutely reliable prediction on (future) tolerance can be made. Ultimately, the clinical relevance of all IgE findings depends on the presence of corresponding symptoms and can only be assessed on an individual basis (previous history, symptom log, and provocation testing with the relevant allergen source where appropriate). Thus, also in molecular allergology, the treating physician and not the test result should determine the clinical relevance of diagnostic findings. ELECTRONIC SUPPLEMENTARY MATERIAL Supplementary material is available for this article at 10.1007/s40629-015-0067-z and is accessible for authorized users.
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Affiliation(s)
- Jörg Kleine-Tebbe
- />Allergy & Asthma Center Westend, Outpatient Clinic Hanf, Ackermann & Kleine-Tebbe, Spandauer Damm 130, Haus 9, 14050 Berlin, Germany
| | - Thilo Jakob
- />Allergy Department and Allergy Research Group, Department of Dermatology and Venereology, Freiburg University Hospital, Freiburg, Germany, Berlin, Germany
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22
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Cop N, Uyttebroek AP, Sabato V, Bridts CH, De Clerck LS, Ebo DG. Flow cytometric analysis of drug-Induced basophil histamine release. CYTOMETRY PART B-CLINICAL CYTOMETRY 2015; 90:285-8. [DOI: 10.1002/cyto.b.21226] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 12/16/2014] [Accepted: 01/14/2015] [Indexed: 11/10/2022]
Affiliation(s)
- N. Cop
- Department of Immunology; Allergology; Rheumatology; Faculty of Medicine and Health Science; University of Antwerp, Antwerp University Hospital; Antwerpen 2610 Belgium
| | - A. P. Uyttebroek
- Department of Immunology; Allergology; Rheumatology; Faculty of Medicine and Health Science; University of Antwerp, Antwerp University Hospital; Antwerpen 2610 Belgium
| | - V. Sabato
- Department of Immunology; Allergology; Rheumatology; Faculty of Medicine and Health Science; University of Antwerp, Antwerp University Hospital; Antwerpen 2610 Belgium
| | - C. H. Bridts
- Department of Immunology; Allergology; Rheumatology; Faculty of Medicine and Health Science; University of Antwerp, Antwerp University Hospital; Antwerpen 2610 Belgium
| | - L. S. De Clerck
- Department of Immunology; Allergology; Rheumatology; Faculty of Medicine and Health Science; University of Antwerp, Antwerp University Hospital; Antwerpen 2610 Belgium
| | - D. G. Ebo
- Department of Immunology; Allergology; Rheumatology; Faculty of Medicine and Health Science; University of Antwerp, Antwerp University Hospital; Antwerpen 2610 Belgium
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