Basophil Activation Test identifies the patients with Chronic Spontaneous Urticaria suffering the most active disease

Curto‐Barredo, Laia; Yélamos, José; Gimeno, Ramón; Mojal, Sergi; Giménez‐Arnau, Ana

doi:10.1002/iid3.125

Cited by 46 publications

(37 citation statements)

References 21 publications

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“…(8, 20) Presence of concomitant autoimmune disease and/orAAbs or positivity of ASST was not correlated with disease activity nor with H1-antihistamines response. In the literature, this association between ASST and disease activity remains controversial (16,(20)(21)(22). In line with previous reports, angioedema was more frequent in patients with positive ASST in our cohort (17,18).…”

supporting

confidence: 82%

Correlations between disease activity, autoimmunity and biological parameters in patients with chronic spontaneous urticaria

Montjoye

Darrigade

Giménez‐Arnau

et al. 2021

Eur Ann Allergy Clin Immunol

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Background: Biomarkers of disease activity/severity and criteria of autoimmune chronic spontaneous urticaria (CSU) are still a matter of debate. Objective: To investigate possible correlations between clinical and biological markers and their associations with: (i) disease activity; (ii) resistance to H1-antihistamines; (iii) autoimmunity; and (iiii) autologous serum skin test (ASST) in patients with CSU. To also analyze biological parameter modifications in patients with CSU treated with omalizumab. Materials and methods: Disease activity, H1-antihistamines response and presence of concomitant autoimmune disease were prospectively recorded in 95 patients with CSU. For 60 of them, ASST was performed. Broad biological analysis were performed. Results: C-reactive protein (CRP) serum levels were higher in H1-antihistamines unresponders (p<0.0001) and in more active diseases (p=0.033). D-dimer plasma levels were higher in H1antihistamines unresponders (p=0.008) and in patients with autoimmune status (concomitant autoimmune disease and/or with autoantibodies) (p=0.016). Total immunoglobuline E (IgE) serum level was lower in patients with positive ASST. Blood basophil counts were lower in patients with CSU and especially in H1-antihistamines unresponders (p=0.023), in patients with more active disease (p=0.023), with positive ASST (p=0.001), and with autoimmune status (p=0.057). Conversely, under omalizumab, a decrease of CRP (p=0.0038) and D-dimer serum/plasma levels (p=0.0002) and an increase of blood basophil counts (p=0.0023) and total IgE serum levels (p=0.0007) were observed. Conclusions: This study brings additional evidences of interest to investigate IgE, D-dimer serum/plasma levels and basophil blood counts in patients with CSU as they could be correlated to disease activity, response to treatment and/or autoimmunity.

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supporting

confidence: 82%

Correlations between disease activity, autoimmunity and biological parameters in patients with chronic spontaneous urticaria

Montjoye

Darrigade

Giménez‐Arnau

et al. 2021

Eur Ann Allergy Clin Immunol

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“…Caproni and coworkers showed that the overall frequency of urticarial episodes during the week before skin testing and number of spontaneous wheals were greater in ASST+ patients . In another study, ASST+ and BAT+ CSU patients also had significantly higher UAS7 values than ASST− and BAT− CSU patients . At present, we cannot explain why this is.…”

Section: Discussionmentioning

confidence: 69%

“…35 In another study, ASST+ and BAT+ CSU patients also had significantly higher UAS7 values than ASST− and BAT− CSU patients. 36 and that total IgE serum levels are significantly lower in BAT+ than BAT− CSU patients as well as in ASST+ vs ASST-CSU patients. 38 IgE levels in partial-aiCSU and non-aiCSU PURIST patients were more than three times higher, on average higher than 100 IU/mL (the upper limit of normal).…”

Section: Discussionmentioning

confidence: 79%

Biomarkers and clinical characteristics of autoimmune chronic spontaneous urticaria: Results of the PURIST Study

Schoepke

Asero

Ellrich

et al. 2019

Allergy

176

182

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Background: Autoimmune chronic spontaneous urticaria (aiCSU) is an important subtype of chronic spontaneous urticaria (CSU) in which functional IgG autoantibodies to IgE or its high-affinity receptor (FcεRI) induces mast cell degranulation and subsequent symptom development. However, it has not been tightly characterized. This study aimed to better define the clinical and immunological features and to explore potential biomarkers of aiCSU.Methods: This was a multinational, multicenter study of 182 CSU patients. The clinical features studied included: urticaria activity and impact (UAS7 and quality of life); autologous serum skin test (ASST); IgG anti-FcεRI and IgG anti-IgE; IgG-anti-thyroperoxidase (IgG anti-TPO); total serum IgE; and basophil reactivity (BASO) using the basophil activation test (BAT) and basophil histamine release assay (BHRA). Results:Of the 182 patients, 107 (59%) were ASST+, 46 (25%) were BASO+, and 105 (58%) were IgG anti-FcεRI+/IgE+. Fifteen patients (8%) fulfilled all three criteria of aiCSU. aiCSU patients appeared more severe (UAS7 21 vs 9 P < 0.016) but showed no other clinical or demographic differences from non-aiCSU patients. aiCSU patients also had markedly lower total IgE levels (P < 0.0001) and higher IgG anti-TPO levels (P < 0.001). Of biomarkers, positive BAT and BHRA tests were 69% and 88% predictive of aiCSU, respectively.Conclusions: aiCSU is a relatively small but immunologically distinct subtype of CSU that cannot be identified by routine clinical parameters. Inclusion of BHRA or BAT in the diagnostic workup of CSU patients may aid identification of aiCSU patients, who may have a different prognosis and benefit from specific management. K E Y W O R D Sautoimmune CSU, autologous serum skin test, basophil activation assays, chronic spontaneous urticaria, IgG autoantibodies

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“…BATs assess histamine release or upregulation of activation markers of donor basophils in response to stimulation with the serum of CSU patients. BATs can help to co‐assess disease activity in patients with urticaria as well as to diagnose autoimmune urticaria . Furthermore, BAT can be used as a marker for responsiveness to ciclosporin A or omalizumab …”

Section: Diagnosis Of Urticariamentioning

confidence: 99%

The EAACI/GA²LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria

Zuberbier

Aberer

Asero

et al. 2018

Allergy

1,368

1,953

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This evidence- and consensus-based guideline was developed following the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. The conference was held on 1 December 2016. It is a joint initiative of the Dermatology Section of the European Academy of Allergology and Clinical Immunology (EAACI), the EU-founded network of excellence, the Global Allergy and Asthma European Network (GA²LEN), the European Dermatology Forum (EDF) and the World Allergy Organization (WAO) with the participation of 48 delegates of 42 national and international societies. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS). Urticaria is a frequent, mast cell-driven disease, presenting with wheals, angioedema, or both. The lifetime prevalence for acute urticaria is approximately 20%. Chronic spontaneous urticaria and other chronic forms of urticaria are disabling, impair quality of life and affect performance at work and school. This guideline covers the definition and classification of urticaria, taking into account the recent progress in identifying its causes, eliciting factors and pathomechanisms. In addition, it outlines evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria.

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Basophil Activation Test identifies the patients with Chronic Spontaneous Urticaria suffering the most active disease

Cited by 46 publications

References 21 publications

Correlations between disease activity, autoimmunity and biological parameters in patients with chronic spontaneous urticaria

Correlations between disease activity, autoimmunity and biological parameters in patients with chronic spontaneous urticaria

Biomarkers and clinical characteristics of autoimmune chronic spontaneous urticaria: Results of the PURIST Study

The EAACI/GA²LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria

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