Basophil activation tests in the evaluation of immediate drug hypersensitivity

Abstract

BAT sensitivity in beta-lactam allergy was 50%, and specificity ranged from 89 to 97%. There are several studies to validate the BAT in allergy to muscle relaxants showing a sensitivity ranging from 54 to 64% with a specificity of 100 and 93%. The sensitivity of a test for evaluating immediate allergic reactions to drugs may decrease over time. To date, the BAT is the only in-vitro diagnostic method that has been validated for the diagnosis of both IgE-mediated and hypersensitivity reactions to NSAIDs. With respect to other drugs, they are nonetheless interesting as they include the evaluation of allergy to drugs that cannot be studied by other in-vitro techniques. All these data suggest that although a full validation of the test is required, BAT is a potential diagnostic method for evaluating immediate allergic reactions to drugs and NSAID hypersensitivity reactions.

Evaluation of Basophil CD203c as a Predictor of Carboplatin-Related Hypersensitivity Reaction in Patients with Gynecologic Cancer

“…[13][14][15][16][17][18] Some researchers suggested that CD203c is more sensitive than CD63 for the diagnosis of drug allergy. 14,20) This may be due to the fact that CD63 is not only a marker of activated basophils but also of platelets and leukocytes.…”

“…Flow cytometry-based tests for peripheral blood basophils can easily quantify these in vitro reactions, which presumably represent their in vivo activity for hymenoptera, latex, food and drug allergies. [9][10][11][12][13] The sensitivity of the basophil activation test for the diagnosis of drug allergy has been reported; the reported sensitivities for the diagnosis of allergy to β-lactams, [14][15][16] quinolones 17) and rocuronium 18) are 33-67%, 71.1% and 80%, respectively. In addition, increased CD63 expression on basophils has been reported in a patient with cisplatin allergy.…”

Antibiotic Allergy

“…Several tests have been developed based on the capacity ofbasophils to be activated and release different mediators (12). The basophil activation test (BAT) is a useful tool in the in-vitro diagnosis of immediate hypersensitivity reactions to drugs, whether these are caused by IgE-dependent mechanisms or other mechanisms leading to the release of histamine and other mediators of immediate hypersensitivity reactions.…”

“…results obtained in terms ofsensitivity and specificity with this technique are encouraging and allow a diagnosis to be made in a not negligible number of cases, thus avoiding the use of chalIenge tests. The combination of the results from BAT and immunoassay increaseds sensitivity to 65.7% or even to 85% when the results of skin tests were also included, without changing the-specificity (12).…”

Drug Hypersensitivity

“…Numerous studies over recent years have shown the usefulness of this technique for the in vitro diagnosis of allergic diseases (Ebo et al, 2006a(Ebo et al, , 2004aKleine-Tebbe et al, 2006) involving different allergens, such as inhalants (Paris-Köhler et al, 2000;Saporta et al, 2001), hymenoptera venoms (Sabbah et al, 1998;Sainte-Laudy et al, 2000), or latex (Ebo et al, 2002;Sanz et al, 2003). For the diagnosis of allergy to drugs like muscle relaxants (Abuaf et al, 1999;Monneret et al, 2002), betalactam antibiotics (Sanz et al, 2001b(Sanz et al, , 2002aTorres et al, 2004), pyrazolones (Sabbah et al, 1997;Sanz et al, 2005) and non steroidal anti-inflammatory drugs (NSAIDs) BAT has opened up an important diagnostic pathway, either on its own or combined with other techniques (de Weck et al, 2008b;Gamboa et al, 2003a), allowing avoidance of challenge tests in an important number of cases (Hausmann et al, 2009;Sanz et al, 2009).…”