Basophil activation test compared to skin prick test and fluorescence enzyme immunoassay for aeroallergen-specific Immunoglobulin-E

Abstract

BackgroundSkin prick test (SPT) and fluorescence enzyme immunoassay (FEIA) are widely used for the diagnosis of Immunoglobulin-E (IgE)-mediated allergic disease. Basophil activation test (BAT) could obviate disadvantages of SPT and FEIA. However, it is not known whether BAT gives similar results as SPT or FEIA for aeroallergens.ObjectivesIn this study, we compared the results of SPT, BAT and FEIA for different aeroallergens.MethodsWe performed BAT, SPT and FEIA in 41 atopic subjects (symptomatic and with positive SPT for at least 1 of 9 common aeroallergens) and 31 non-atopic subjects (asymptomatic and with negative SPT).ResultsCorrelations between SPT and BAT, SPT and FEIA, and BAT and FEIA results were statistically significant but imperfect. Using SPT as the "gold standard", BAT and FEIA were similar in sensitivity. However, BAT had lower specificity than FEIA. False positive (BATposSPTneg) results were frequent in those atopic subjects who were allergic by SPT to a different allergen and rare in non-atopic subjects. The false positivity in atopic subjects was due in part to high levels of serum Total-IgE (T-IgE) levels in atopic individuals that lead to basophil activation upon staining with fluorochrome-labeled anti-IgE.ConclusionAs an alternative to SPT in persons allergic to aeroallergens, BAT in its present form is useful for distinguishing atopic from non-atopic persons. However, BAT in its present form is less specific than FEIA when determining the allergen which a patient is allergic to. This is due to IgE staining-induced activation of atopic person's basophils and/or nonspecific hyperreactivity of atopic person's basophils.

Update on the Performance and Application of Basophil Activation Tests

“…They calculated a sensitivity of 57–84 % and specificity of only 73–81 %, and they found a large number of false positives with BAT among atopic patients. They thus concluded that the BAT is not sensitive enough to use for the routine diagnosis of individual pollen allergy, which they believe may have been due to non-specific IgE cross-linking in the performance of the CD63 basophil activation test [63]. In contrast, Ozdemir et al found a sensitivity of 77–100 % and specificity of 100 % when performing the BAT with CD203c expression in grass-allergic patients, and they concluded that this is a reliable tool in the diagnosis of pollen allergy [64].…”

Identification and characterization of ovary development‐related protein EJO1 (Eri s 2) from the ovary of Eriocheir sinensis as a new food allergen

“…Upregulated CD63 or/and CD203c expression on the surface of basophils was considered a marker of basophil activation [34][35][36], so we investigated the effect of rEri s 2 on CD63 and CD 203c expression in basophils. Briefly, whole blood from Patient 13 was collected and incubated with different concentrations (0.04, 0.2, 1, and 5 g/mL) of rEri s 2 or 1 g/mL of CO at 37ЊC for 15 min.…”

Comparison of the basophil activation test versus the nasal provocation test in establishing eligibility for specific immunotherapy

“…Khan et al 24 postulated that it may be due to a high level of total IgE in atopic patients, high level of spleen tyrosine kinase, a key regulatory factor in an IgE--mediated signal transduction route in the allergic reaction in mastocytes or basophils, or activation by interleukin 3. 24 In our study, we did not obtain any false negative results (BAT[-] NPT[+]).…”