Pros and Cons of Clinical Basophil Testing (BAT)

Abstract

There are many tools available to assess the presence and severity of allergic diseases in patients. For 50 years, peripheral blood basophils have been used as tools to study these diseases. It is a very accessible cell that binds IgE antibody and secretes the classical mediators responsible for the symptoms of allergic reactions. In the last decade, an even more accessible methodology, using flow cytometry, has been developed to enhance the ability to use basophils for both mechanistic and clinical diagnostics. Basophil testing has been included in diagnostics for different forms of allergies as well as to monitor disease status. A variety of studies have begun to establish both precise methods and their clinical relevance for disease diagnosis, but there remain some important questions on how to take optimal advantage of the behaviours of basophils.

A comparative study on basophil activation test, histamine release assay, and passive sensitization histamine release assay in the diagnosis of peanut allergy

“…HR and passive HR are being used for allergy testing, and BAT is considered for clinical diagnostics . However, it has to our knowledge not been investigated whether these three cellular allergy tests yield similar diagnostic results.…”

Using a CD45dim/CD123bright/HLA-DRneg Phenotyping Protocol to Gate Basophils in FC for Airway Allergy. CD123 Does Not Decrease

“…For example, on BD instruments, FITC has a stain index of about 50, PerCp-Cy5.5 ≈ 80 while PE ≈ 250 but FITC has a relevant spillover on PE, which is usually conjugated with the activation marker CD203c [1,11,12]. moreover, it is widely known that, in order to optimize gating, bias from fluorescence spillover must be considered if the compensation process has not been properly done.…”

“…In the very recent years, the basophil activation test (BAT) has become an outstanding tool to diagnose allergy, though still with some contradictory opinion [1]. The way by which basophil activity is investigated in a BAT involves the adoption of flow cytometry methods, which are generally suited to capture cells in a virtual electronic approach, not physically, and therefore this might generate bias and misinterpretation on the real nature of the events dotted in a gated channel.…”

Immune monitoring for precision medicine in allergy and asthma

“…Other promising non-invasive immune monitoring tests include basophil activation tests (BATs), which measure blood basophil activation upon allergen challenge[18,19]. Blood basophil phenotype and function in vitro may be useful in distinguishing between peanut-sensitized children who have clinical allergy versus those who are sensitized but tolerant to peanut[19].…”