Recent applications of basophil activation tests in the diagnosis of drug hypersensitivity

Song, Woo Jung; Chang, Yoon‐Seok

doi:10.5415/apallergy.2013.3.4.266

Cited by 33 publications

(31 citation statements)

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“…The use of a 16-step (four bags) or a 20-step (five bags) protocol is reserved for high-risk patients. It was also observed that 70% of reactions during desensitization occurred during the 12th and final step of the standard 12-step protocol [1]. …”

Section: Discussionmentioning

confidence: 99%

“…The activation response may be measured at a single-cell level by using fluorochrome-bound mAbs to the specific activation markers CD63 and CD203c. When a patient experiences a reaction, basophil degranulation makes CD63 and CD203c appear on the cell surface [1]. For the BAT procedure, we used fresh whole blood and the drug concentrations were 10 mg/ml with three dilutions: 1:5, 1:25 and 1:125.…”

Section: Case Reportmentioning

confidence: 99%

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A New Pediatric Protocol for Rapid Desensitization to Monoclonal Antibodies

Caimmi¹,

Caimmi²,

Riscassi³

et al. 2014

Int Arch Allergy Immunol

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Monoclonal antibodies are important therapeutic tools, but their usefulness may be limited when patients experience acute hypersensitivity reactions. Patients reporting a history of adverse allergic reaction are likely to discontinue their therapeutic protocol or be switched to an alternative drug, which is sometimes less effective than that originally prescribed. Drug desensitization has proven to be a highly effective strategy to readminister a drug in a patient who has experienced a hypersensitivity reaction. It involves forcing the patient's immune system to accept and tolerate the allergen. Nevertheless, such a procedure is still empiric for monoclonal antibodies and not common in the pediatric population. The aim of our study is to demonstrate the clinical success of a new protocol of rapid desensitization to infliximab in a pediatric patient affected by ulcerative colitis, who developed an anaphylaxis to the drug. We used a protocol of rapid desensitization consisting of 13 steps, with the first being 1/1,000,000 of the cumulative and total dose. Such a protocol has proven to be able to induce a temporary tolerance to infliximab, allowing the patient to achieve complete control of his disease.

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Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

A New Pediatric Protocol for Rapid Desensitization to Monoclonal Antibodies

Caimmi¹,

Caimmi²,

Riscassi³

et al. 2014

Int Arch Allergy Immunol

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show abstract

“…For this reason, the sensitivity of BAT for drugs is poor and depends largely on the offending compound. For instance, the BAT sensitivity in AIHS ranges from 22 to 55% for β-lactams, from 36 to 71% for fluoroquinolones and from 36 to 92% for NMBAs [15]. In AIHS to RCM, the sensitivity of BAT can reach 100% (63-100%) [15].…”

Section: Discussionmentioning

confidence: 99%

The Basophil Activation Test: A Sensitive Test in the Diagnosis of Allergic Immediate Hypersensitivity to Pristinamycin

Viel

Garnier²,

Joly³

et al. 2015

Int Arch Allergy Immunol

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Immediate hypersensitivity (IHS) reactions to macrolides and to macrolide-derived antibiotics like pristinamycin are uncommon. In this context, there is little data available to appreciate the true value of biological tools regarding the diagnosis of immediate allergy to pristinamycin. Here we assess the clinical usefulness of the basophil activation test (BAT) to differentiate allergic from nonallergic IHS to pristinamycin. Thirty-six patients were tested with skin tests as the gold standard and BAT. The BAT achieved a sensitivity of 76% and a specificity of 100%, implying an absence of false positive results. Multicenter studies remain to be performed to better define the sensitivity, specificity and interlaboratory variation of BAT in the diagnosis of allergy to pristinamycin and macrolides.

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“…cell phenotyping protocols [4,5]. Advantages of BAT in allergy diagnosis are closely related to the simple fact that this assay is a cell based investigation procedure [6] and therefore, while its major value is the ability in diagnosing either an IgE-or non IgE-mediated allergy, immunotherapy and anaphylaxis and to prevent the ethical issue associated to skin tests [1], a main concern is represented by the interpretation of activation markers in a good phenotyping FC approach [7]. The Authors reported, particularly in Table 1 of their paper, that BAT false negatives might be due mainly to the existence of non releaser subjects [1].…”

Section: To the Editormentioning

confidence: 99%