Basophil allergen threshold sensitivity and component‐resolved diagnostics improve hazelnut allergy diagnosis

Brändström, Josef; Nopp, Anna; Johansson, S. G. O.; Lilja, G.; Sundqvist, Ann-Charlotte; Borres, Magnus P.; Nilsson, Caroline

doi:10.1111/cea.12515

Cited by 53 publications

(71 citation statements)

References 23 publications

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“…The specificity of the BAT ranged between 77% and 100% in other studies (Table IV). 11, 67, 68, 69, 70, 71, 72, 73 The BAT with single allergen components can potentially improve its diagnostic accuracy, but further research studies are needed 72, 74, 75. The BAT has been shown to be potentially useful in identifying the culprit allergen in cases of pollen-food allergy syndrome (PFAS),71, 76, 77 allergy to red meat, 78 or food-dependent exercise-induced anaphylaxis 79 .…”

Section: In Vitro Tests For Ige-mediated Food Allergymentioning

confidence: 99%

Making the Most of In Vitro Tests to Diagnose Food Allergy

Santos

Brough

2017

The Journal of Allergy and Clinical Immunology: In Practice

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Various in vitro tests assess different aspects of the underlying immune mechanism of IgE-mediated food allergy. Some can be used for diagnostic purposes; specific IgE to allergen extracts is widely available; specific IgE to allergen components is used in most specialist centers, and the basophil activation test is becoming increasingly used clinically. IgE to allergen peptides, T-cell assays, allergen-specific/total IgE ratios, and allergen-specific IgG4/IgE ratios are currently reserved for research. Different factors can modulate the likelihood of IgE-mediated food allergy of a given allergy test result, namely, the patients' age, ethnicity, previous allergic reaction to the identified food, concomitant atopic conditions, and geographical location, and need to be taken into account when interpreting the allergy test results in the clinic. The importance of the specific food, the clinical resources available, and patient preferences are additional aspects that need to be considered when deciding whether an oral food challenge is required to reach an accurate diagnosis of IgE-mediated food allergy.

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Section: In Vitro Tests For Ige-mediated Food Allergymentioning

confidence: 99%

Making the Most of In Vitro Tests to Diagnose Food Allergy

Santos

Brough

2017

The Journal of Allergy and Clinical Immunology: In Practice

View full text Add to dashboard Cite

show abstract

“…They could show that the BAT adds safety information if sIgE and DBPCFC results were controversial. Thus, the BAT might be useful if clinical history, SPT and/or sIgE measurement are inconsistent or in addition an oral food challenge is not possible [42]. Furthermore, the use of recombinant allergens in the BAT might have added value in discriminating between clinically relevant and mere sensitization [44, 45] and should be considered in future studies.…”

Section: Discussionmentioning

confidence: 99%

Exploratory analysis of CD63 and CD203c expression in basophils from hazelnut sensitized and allergic individuals

Lötzsch

Dölle

Vieths

et al. 2016

Clin Transl Allergy

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BackgroundSensitization to hazelnut (HN) is frequent and requires clarification to determine whether this sensitization is clinically relevant. The aim of this study was to investigate basophil activation profiles in HN-sensitized and allergic subjects.MethodsBasophil activation was determined by flow cytometric analyses of CD63 and CD203c expression using several HN allergen concentrations. Depending on their clinical reaction pattern, an oral allergy symptom group (OAS, n = 20), a systemic reaction group (n = 12) and a sensitized group without clinical symptoms (n = 20) were identified. Additionally, 10 non-allergic and non-sensitized individuals served as controls.ResultsCD63 and CD203c expression differed between allergic (OAS and systemic group) and sensitized subjects. The HN concentration required to activate 30% of CD203c+ basophils [effective concentration (EC)30] was significantly higher in sensitized versus the allergic group (p = 0.0089). This was more pronounced when the basophil allergen threshold sensitivity (CD-sens) was calculated (CD63: p = 0.018; CD203c: p = 0.009).ConclusionOur data indicate that the basophil activation test may provide information to better distinguish between sensitized and allergic subjects if several allergen concentrations are considered. CD203c expression displayed a better discrimination compared to CD63; therefore, its diagnostic value might be superior compared with CD63.Electronic supplementary materialThe online version of this article (doi:10.1186/s13601-016-0134-7) contains supplementary material, which is available to authorized users.

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“…By an in‐vitro dose‐response allergen stimulation of the basophils, their allergen threshold sensitivity, CD‐sens 16 can be accurately determined. Studies have shown that CD‐sens correlates significantly with bronchial allergen threshold sensitivity 9 , nasal allergen challenge 14, 18 , and oral food challenge 15, 19, 20 .…”

Section: Discussionmentioning

confidence: 99%

A clinical follow‐up of omalizumab in routine treatment of allergic asthma monitored by CD‐sens

Johansson

Lilja

Hallberg

et al. 2018

Immunity Inflam & Disease

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IntroductionOmalizumab has been available for treatment of allergic asthma for more than a decade and thus, its efficacy in routine treatment was of interest to evaluate. Basophil allergen threshold sensitivity (CD‐sens) has been shown to correlate with the bronchial allergen threshold sensitivity and can be used to objectively measure omalizumab treatment efficacy. We aimed to evaluate the effect of omalizumab treatment of allergic asthma by CD‐sens, as an objective marker of the IgE‐mediated inflammation, and related to SPT, spirometry, FeNO, Asthma Control Questionnaire (ACQ), and Global Evaluation of Treatment Effectiveness (GETE).MethodsThirty‐two patients were treated with omalizumab for 16 weeks. CD‐sens was used to define the response and related to clinical parameters. If CD‐sens was negative (<0.1) (CD‐sens low Group) the patient continued with the standard dose. If CD‐sens was ≥0.1 (CD‐sens high Group) a second 16 weeks period with 25–50% dosage increase was started and evaluated after a total of 32 weeks.ResultsNine of 32 patients became CD‐sens negative after treatment (CD‐sens start: 8.0; 16 weeks: <0.01) and regarded as successful. 15/23 were unsuccessful (CD‐sens start: 13; 16 weeks: 1.65) and the omalizumab dose was increased. CD‐sens decreased significantly (p < 0.05) and further 3/15 patients became CD‐sens negative (CD‐sens at 32 weeks: 0.5). There was a significantly smaller IgE‐ab fraction (IgE‐ab/IgE) in the CD‐sens low versus the CD‐sens high Group (p < 0.0001). A significant decrease in ACQ was seen in both groups after 16 weeks treatment (p = 0.05 and 0.01, respectively). No significant changes could be detected for the other clinical parameters.ConclusionBy the use of the objective laboratory method CD‐sens, which effectively measure the direct effect of omalizumab, that is, the IgE‐mediated part of the allergic asthma, in combination with clinical parameters it might be possible to more effectively monitor and treat IgE‐mediated allergic asthma.

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Basophil allergen threshold sensitivity and component‐resolved diagnostics improve hazelnut allergy diagnosis

Abstract: CD-sens and component-resolved diagnostics to hazelnut, used separately or in combination, may improve the diagnostic accuracy and safety and reduce overdiagnosis of hazelnut allergy.

Cited by 53 publications

References 23 publications

Making the Most of In Vitro Tests to Diagnose Food Allergy

Making the Most of In Vitro Tests to Diagnose Food Allergy

Exploratory analysis of CD63 and CD203c expression in basophils from hazelnut sensitized and allergic individuals

A clinical follow‐up of omalizumab in routine treatment of allergic asthma monitored by CD‐sens

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