Comparison of two basophil activation markers CD63 and CD203c in the diagnosis of amoxicillin allergy.

Full Abstract

BACKGROUND: To confirm allergy to beta-lactam (BL), a basophil activation test in flow cytometry based on CD63 up-regulation was described. CD203c is a more recent basophil activation marker and up to day there is no consensus about which marker is the more sensitive one. CD203c has not yet been evaluated in the diagnosis of BL allergy. OBJECTIVE: The aim of the study was to compare the reliability of CD203c to CD63 for the diagnosis of amoxicillin (AX) allergy, which is nowadays the most frequent BL allergy. METHODS: Twenty-seven patients with an immediate positive skin test (ST) to AX, 20 had had anaphylaxis with AX and 7 had urticaria and/or angioedema, were compared with 14 controls with no allergy to BL and to six patients with delayed positive ST to AX. RESULTS: In the anaphylaxis group, AX induced up-regulation of CD203c in the basophils of 12 patients out of 20 (60%) and of CD63 in four patients (20%) (P<0.02). Two patients out of seven with urticaria or angioedema had a positive result with CD203c and CD63. In patients who had anaphylaxis, ampicillin (AMP) induced CD203c up-regulation in eight out of 12 (67%) patients tested, and CD63 up-regulation in 4 out of 12 (33%) (all patients who had anaphylaxis could not be tested with AMP). False-positive results were observed with CD203c as well as CD63, and for 10 patients indeed this was confirmed by a negative drug provocation test. The origin of conflicting results between CD63 and CD203c might be at least the targeting of basophils based on anti-IgE labelling. Among IgE(+) gated cells, by means of CD33, a marker of monocytes, a contamination up to 50% by monocytes was detected. In contrast to CD63, CD203c is an activation marker specific of basophils with a basal low-level expression in resting basophils. Thus, IgE and CD203c double targeting of basophils avoids the contamination by monocytes. CONCLUSION: CD203c seems to be a more sensitive activation marker of basophils than CD63 for the diagnosis of amoxicillin allergy.

Author information

Author/s: Abuaf, N (N); Rostane, H (H); Rajoely, B (B); Gaouar, H (H); Autegarden, J E (JE); Leynadier, F (F); Girot, R (R);

Affiliation: Department of Hematology and Immunology, Hôpital Tenon and Université e Pierre et Marie Curie, Paris, France. nissen.abuaf(-atsign-)tnn.aphp.fr

Journal and publication information

Publication Type: Comparative Study; Controlled Clinical Trial; Journal Article

Journal: Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology (Clin Exp Allergy), published in England. (Language: eng)

Reference: 2008-Jun; vol 38 (issue 6) : pp 921-8

Dates: Created 2008/05/23; Completed 2008/07/28; Revised 2008/10/27;

PMID: 18331364, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: Clin Exp Allergy. 2008 Jul;38(7):1239-40. (PMID: 18477015)

External Links for this article
(including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.

MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Aged
Amoxicillin - adverse effects
Anaphylaxis - chemically induced; diagnosis; immunology
Antigens, CD - metabolism
Basophils - metabolism
Biological Markers - metabolism
Drug Hypersensitivity - diagnosis; immunology
False Positive Reactions
Female
Flow Cytometry
Humans

Humans
Hypersensitivity, Delayed - chemically induced; diagnosis; immunology
Hypersensitivity, Immediate - chemically induced; diagnosis; immunology
Immunoglobulin E - metabolism
Immunologic Tests - methods
Male
Middle Aged
Monocytes - metabolism
Platelet Membrane Glycoproteins - metabolism
Skin Tests
Up-Regulation
Urticaria - chemically induced; diagnosis; immunology

Associated Chemicals: Antigens, CD (0) ; Biological Markers (0) ; Platelet Membrane Glycoproteins (0) ; lysosomal protein GP53 (0) ; Amoxicillin (26787-78-0) ; Immunoglobulin E (37341-29-0)

These are the highest related articles currently in the database: