Guidelines for the use and interpretation of diagnostic methods in adult food allergy

Macchia, Donatella; Melioli, Giovanni; Pravettoni, Valerio; Nucera, Eleonora; Piantanida, Marta; Caminati, Marco; Campochiaro, Corrado; Yacoub, Mona‐Rita; Schiavino, Domenico; Paganelli, Roberto; Gioacchino, Mario Di

doi:10.1186/s12948-015-0033-9

Cited by 35 publications

(29 citation statements)

References 70 publications

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“…The Basophil Activation Test (BAT) is a good ex vivo alternative for measuring IgE mediated hypersensitivity to allergens in sensitized patients, without exposing the patient to skin tests risks (1)(2)(3)(4)(5). The Basophil Activation Test (BAT) is a good ex vivo alternative for measuring IgE mediated hypersensitivity to allergens in sensitized patients, without exposing the patient to skin tests risks (1)(2)(3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

“…Diagnosis of allergy is based on skin tests, but these tests are not always possible because of skin status or because the risks would be too high to challenge the patients who have had a previous severe reaction to allergen. The Basophil Activation Test (BAT) is a good ex vivo alternative for measuring IgE mediated hypersensitivity to allergens in sensitized patients, without exposing the patient to skin tests risks (1)(2)(3)(4)(5). The BAT is based on detection of phenotype changes of allergen induced basophil degranulation.…”

Section: Introductionmentioning

confidence: 99%

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Basophil activation test: Implementation and standardization between systems and between instruments

et al. 2017

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The basophil activation test (BAT) is a good ex vivo alternative for measuring hypersensitivity to an allergen in sensitized patients but still lacks standardization. In this present study, we have implemented one of the systems and proposed inter-systems, inter-instrument standardization. Our method for basophil activation and labeling on whole blood: EDTA in one step using BasoflowEx and FlowCast . Setup on Navios and fluorescence targets converted to set up FACSCanto™ instrument. Our results: 1) A CD203c/CD63 (BasoflowEx) method was adapted for EDTA samples and simplified. 2) Final washing and concentration and use of time parameter help acquiring as many basophils as possible, spare acquisition time and noise. 3) The modified method was validated according to ISO15189 with a precision at 5.1% RCV, linearity between 1 and 1/8 of anti-IgE stimulation. Results were very close with CCR3/CD63 system (FlowCast). 4) Standardization, between systems and even between instruments. Mean Fluorescence Intensity targets are proposed using standard beads (Cytocal ) middle peak: FITC = 19.4; PE = 28.8 on Navios corresponding to FITC = 4,966; PE = 7,373 for FACSCanto. Data analyzed on common software (Kaluza ) were very closely correlated. 5) Co-labeling of B cells (CD20+) gives the possibility to monitor a significant drop of basophils under stimulation that could explain some underestimation in case of strong hypersensitivity. In conclusion, BAT would strongly benefit from easy implementation [EDTA, one step stimulation/labeling, wash, full sample analysis over time parameter, B cell relative basophil count] and standardization of instrument settings on MFI targets whatever system or instrument is used. © 2017 International Society for Advancement of Cytometry.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Basophil activation test: Implementation and standardization between systems and between instruments

et al. 2017

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“…No se realizó prueba de punción cutánea con exposición directa a papaya fresca, dado el antecedente de anafi laxia, de acuerdo con las recomendaciones de las guías internacionales. 5,22 Los pacientes que presentaron anafi laxia durante las pruebas cutáneas a extracto de látex fueron diagnosticados, clasifi cados y tratados de acuerdo con las guías de la WAO y Guía de Actuación en Anafi laxia 2016 (GALAXIA 2016). 20,23 Todos los resultados fueron analizados con estadís-tica descriptiva usando el programa SPSS versión 22.…”

Section: 21unclassified

Síndrome látex-papaya: una asociación poco frecuente

Rojas-Mandujano

González-Juárez

Hernández-Fernández

et al. 2018

RAM

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Background: Latex-fruit syndrome (LFS) is characterized by allergy to latex and plants. Papain, chymopapain, caricaine and class I chitinases are papaya's most allergenic proteins. The similarity between latex hevein epitopes and papaya class I chitinases might explain the latex-papaya syndrome (LPS). Objective: To describe the clinical characteristics of patients with LPS. Methods: Cross-sectional, observational, descriptive study where 11 patients diagnosed with latex allergy by skin prick test and clinically diagnosed with papaya-induced anaphylaxis were included The results were analyzed with descriptive statistics. Results: Out of 11 patients with LPS, 72.7% were females (7 to 46 years), all with a history of papaya-induced anaphylaxis, identifi ed by medical history and medical notes plus latex-positive skin prick tests, with 63.3% exhibiting anaphylaxis in the skin prick tests. Risk factors included multiple surgeries, another allergic disease, and being employed in the fi eld of health; 63.6% were allergic to to other foods, 45.4% to medications, 45.4% had allergic rhinitis and 27.3% had asthma. Conclusions: Hypersensitivity to papaya increases the risk of anaphylaxis in patients with latex allergy and, therefore, mortality. Clinical data is the main diagnostic tool. Education for the management of anaphylaxis with adrenaline self-administration is essential.

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“…In diagnosing food allergy, the in vivo test to be considered as a reference standard is challenge with the suspected food 70,88. In patients with suspected EIAn or FDEIAn, the challenge must be performed under strict medical control, with blood pressure and lung-function monitoring and prompt availability of drugs and equipment to manage anaphylaxis.…”

Section: In Vivo Testingmentioning

confidence: 99%

Diagnosis of exercise-induced anaphylaxis: current insights

Pravettoni¹,

Incorvaia²

2016

JAA

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Exercise-induced anaphylaxis (EIAn) is defined as the occurrence of anaphylactic symptoms (skin, respiratory, gastrointestinal, and cardiovascular symptoms) after physical activity. In about a third of cases, cofactors, such as food intake, temperature (warm or cold), and drugs (especially nonsteroidal anti-inflammatory drugs) can be identified. When the associated cofactor is food ingestion, the correct diagnosis is food-dependent EIAn (FDEIAn). The literature describes numerous reports of FDEIAn after intake of very different foods, from vegetables and nuts to meats and seafood. One of the best-characterized types of FDEIAn is that due to ω5-gliadin of wheat, though cases of FDEIAn after wheat ingestion by sensitization to wheat lipid transfer protien (LTP) are described. Some pathophysiological mechanisms underlying EIAn have been hypothesized, such as increase/alteration in gastrointestinal permeability, alteration of tissue transglutaminase promoting IgE cross-linking, enhanced expression of cytokines, redistribution of blood during physical exercise leading to altered mast-cell degranulation, and also changes in the acid–base balance. Nevertheless, until now, none of these hypotheses has been validated. The diagnosis of EIAn and FDEIAn is achieved by means of a challenge, with physical exercise alone for EIAn, and with the assumption of the suspected food followed by physical exercise for FDEIAn; in cases of doubtful results, a double-blind placebo-controlled combined food–exercise challenge should be performed. The prevention of this particular kind of anaphylaxis is the avoidance of the specific trigger, ie, physical exercise for EIAn, the assumption of the culprit food before exercise for FDEIAn, and in general the avoidance of the recognized cofactors. Patients must be supplied with an epinephrine autoinjector, as epinephrine has been clearly recognized as the first-line intervention for anaphylaxis.

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Guidelines for the use and interpretation of diagnostic methods in adult food allergy

Cited by 35 publications

References 70 publications

Basophil activation test: Implementation and standardization between systems and between instruments

Basophil activation test: Implementation and standardization between systems and between instruments

Síndrome látex-papaya: una asociación poco frecuente

Diagnosis of exercise-induced anaphylaxis: current insights

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