In vitro Diagnosis of Anaphylaxis

Sánz, M L; Gamboa, P. M.; García-Figueroa, B.E; Ferrer, Marta

doi:10.1159/000315947

Cited by 16 publications

(11 citation statements)

References 61 publications

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“…Several mediators including tryptase, histamine (and metabolites), PG, LTC4, LTD4, pro‐inflammatory cytokines and chemokines determined in serum, plasma, urine or the involved tissue during the active phase of the reaction may be useful for the diagnosis of DHR . For IR, tryptase and histamine are the two most studied mediators, and for NIR, the cellular analysis, including studies in skin biopsies and peripheral blood, has been also used (Table ).…”

Section: In Vitro Diagnostic Testsmentioning

confidence: 99%

In vitrotests for drug hypersensitivity reactions: anENDA/EAACIDrug Allergy Interest Group position paper

Mayorga

Çelik

Rouzaire

et al. 2016

Allergy

261

353

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Drug hypersensitivity reactions (DHRs) are a matter of great concern, both for outpatient and in hospital care. The evaluation of these patients is complex, because in vivo tests have a suboptimal sensitivity and can be time-consuming, expensive and potentially risky, especially drug provocation tests. There are several currently available in vitro methods that can be classified into two main groups: those that help to characterize the active phase of the reaction and those that help to identify the culprit drug. The utility of these in vitro methods depends on the mechanisms involved, meaning that they cannot be used for the evaluation of all types of DHRs. Moreover, their effectiveness has not been defined by a consensus agreement between experts in the field. Thus, the European Network on Drug Allergy and Drug Allergy Interest Group of the European Academy of Allergy and Clinical Immunology has organized a task force to provide data and recommendations regarding the available in vitro methods for DHR diagnosis. We have found that although there are many in vitro tests, few of them can be given a recommendation of grade B or above mainly because there is a lack of well-controlled studies, most information comes from small studies with few subjects and results are not always confirmed in later studies. Therefore, it is necessary to validate the currently available in vitro tests in a large series of well-characterized patients with DHR and to develop new tests for diagnosis.

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Section: In Vitro Diagnostic Testsmentioning

confidence: 99%

In vitrotests for drug hypersensitivity reactions: anENDA/EAACIDrug Allergy Interest Group position paper

Mayorga

Çelik

Rouzaire

et al. 2016

Allergy

261

353

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“…This is the best characterized anaphylaxis endotype. In IgE‐mediated endotypes, mast cells and basophils, upon cross‐linking of sIgE bound to FcεRI, release preformed mediators such as histamine, tryptase, chymase, carboxypeptidase A, and tumor necrosis factor . Amplification and prolongation of allergic response occurs in the late phase with the synthesis of lipid‐derived mediators such as PAF, prostaglandins, and leukotrienes .…”

Section: Precision Medicine In Anaphylaxismentioning

confidence: 99%

Precision medicine in allergic disease—food allergy, drug allergy, and anaphylaxis—PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma and Immunology

Muraro¹,

Lemanske

Castells

et al. 2017

Allergy

168

128

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This consensus document summarizes the current knowledge on the potential for precision medicine in food allergy, drug allergy, and anaphylaxis under the auspices of the PRACTALL collaboration platform. PRACTALL is a joint effort of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma and Immunology, which aims to synchronize the European and American approaches to allergy care. Precision medicine is an emerging approach for disease treatment based on disease endotypes, which are phenotypic subclasses associated with specific mechanisms underlying the disease. Although significant progress has been made in defining endotypes for asthma, definitions of endotypes for food and drug allergy or for anaphylaxis lag behind. Progress has been made in discovery of biomarkers to guide a precision medicine approach to treatment of food and drug allergy, but further validation and quantification of these biomarkers are needed to allow their translation into practice in the clinical management of allergic disease.

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“…Based on the receiver operating characteristics-generated cutoff value of 17% for CD63-positive basophils, as captured by the usual anti-IgE-FITC method, Ebo et al [43] estimated a BAT sensitivity and specificity of 93.1 and 91.7%, respectively, as evaluated in a population of subjects allergic to latex, encouraging results that were then confirmed in subsequent reports by others [44]. Several reviews about this promising test began to appear, aimed at achieving possible acceptance while describing the state of the art of its application in allergy diagnosis [45,46,47,48,49,50,51], issues that are still being faced nowadays [52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74]. However, despite promising initial studies and some encouraging evidence, many authors agreed that CD63-based BAT remained disappointing in terms of sensitivity, while CD203c-based BAT showed a higher sensitivity (75 vs. 50%), though not as exciting as some reports suggested [39].…”

Section: The Use Of Basophil Flow Cytometry In Allergy Diagnosis: Stamentioning

confidence: 99%

Basophil Activation Test in Allergy: Time for an Update?

Chirumbolo

2012

Int Arch Allergy Immunol

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A wide range of reported evidence in the literature has shown that the quantification of basophil activation by flow cytometry (basophil activation test, BAT) has proven to be a useful tool for the assessment of immediate-type responses to allergens mediated by IgE or other mechanisms in allergic patients. The usefulness of BAT in anaphylactic adverse reactions, late-onset allergy and immunotherapy follow-up has also been demonstrated. To date, most BAT studies reported in the literature involved the capture of basophils only with a fluorochrome-labeled anti-IgE antibody and application of CD63 upregulation in order to evaluate the basophil response to allergens. Many issues need to be addressed, such as optimizing the analytical performance of the test, checking preanalytical conditions, the selection of the flow cytometry best gating protocol, the introduction of new algorithms and parameters, the search for new activation markers and the introduction of anti-IgE controls. BAT is certainly a useful technique, also for isolated cases of hypersensitivity to various other compounds and drugs, and an update of its application is certainly an interesting topic to expand the debate on allergy diagnosis.

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In vitro Diagnosis of Anaphylaxis

Cited by 16 publications

References 61 publications

In vitrotests for drug hypersensitivity reactions: anENDA/EAACIDrug Allergy Interest Group position paper

In vitrotests for drug hypersensitivity reactions: anENDA/EAACIDrug Allergy Interest Group position paper

Precision medicine in allergic disease—food allergy, drug allergy, and anaphylaxis—PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma and Immunology

Basophil Activation Test in Allergy: Time for an Update?

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