Basophil activation tests were more accurate than other tests in distinguishing between peanut allergy and tolerance in children, reducing the need for oral food challenges, according to recent study results.
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Immunology Diagnosis
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The Journal of Allergy and Clinical Immunology, Volume 132, Issue 4, Pages 777-787, October 2013, Authors:Donald W. MacGlashan, MD, PhD
Alfredo Corell's insight:
Both the treatment of patients with allergic diseases and the study of allergic disease mechanisms depend on a wide variety of assays that in various ways assess the presence and function of IgE antibody. The study of allergic diseases could benefit from the study of its 2 principle cellular participants, mast cells and basophils, but the basophil is more accessible than mast cells for ex vivo studies. Its functionality is tested by using 2 predominant methodologies: the secretion of mediators of allergic inflammation and the expression of proteins on the plasma membrane after stimulation. Each approach has benefits. There are also many operational details to consider regardless of which general approach is taken, and proper interpretation of the methods requires a good understanding of the reagents used and the receptors expressed on basophils and a detailed understanding of the factors regulating aggregation of cell-surface IgE. 
Gilbert C FAURE's curator insight,
October 3, 2013 10:17 AM
of course, we lost cytologist's competencies... to look at cells. We have to rely on secretions assays or cytometric analysis which work pretty well in our experience. Unfortunately, clinical data to correlate biological are not easy to collect and the topic is not very fashionable, somehow outdated. But, if JACI is devoting a review on the topic, the tests might come back on stage? |
July 28, 2014
Researchers studied 43 peanut-allergic (mean age, 5.5 years; 74.4% males), 36 peanut-sensitized but tolerant (mean age, 4 years; 63.9% males) and 25 non-peanut-sensitized nonallergic children (mean age, 5 years; 72% males) using skin prick test (SPT) and specific IgE (sIgE) to peanut.
“BAT [basophil activation test] was performed using flow cytometry, and its diagnostic performance was evaluated in relation to allergy vs. tolerance to peanut and validated in an independent population (n=65),” the researchers wrote.
There was a peanut dose-dependent upregulation of CD63 and CD203c in peanut-allergic children, based on BAT. Non-peanut-sensitized nonallergic and peanut-sensitized children, however, showed no significant response (P<.001, both). There was 97% accuracy, 95% positive predictive value and 98% negative predictive value in the BAT optimal diagnostic cutoffs.