The basophil activation test in immediate-type drug allergy.

Full Abstract

Diagnosis of drug allergy involves first the recognition of sometimes unusual symptoms as drug allergy and, second, the identification of the eliciting drug. This is an often difficult task, as the clinical picture and underlying pathomechanisms are heterogeneous. In clinical routine, physicians frequently have to rely upon a suggestive history and eventual provocation tests, both having their specific limitations. For this reason both in vivo (skin tests) and in vitro tests are investigated intensively as tools to identify the disease-eliciting drug. One of the tests evaluated in drug allergy is the basophil activation test (BAT). Basophils with their high-affinity IgE receptors are easily accessible and therefore can be used as indicator cells for IgE-mediated reactions. Upon allergen challenge and cross-linking of membrane-bound IgE antibodies (via Fc-epsilon-RI) basophils up-regulate certain activation markers on their surface such as CD63 and CD203c, as well as intracellular markers (eg, phosphorylated p38MAPK). In BAT, these alterations can be detected rapidly on a single-cell basis by multicolor flow cytometry using specific monoclonal antibodies. Combining this technique with in vitro passive sensitization of donor basophils with patients' serum, one can prove the IgE dependence of a drug reaction. This article summarizes the authors' current experience with the BAT in the diagnostic management of immediate-type drug allergy mediated by drug-specific IgE antibodies.

Author information

Author/s: Hausmann, Oliver V (OV); Gentinetta, Thomas (T); Bridts, Chris H (CH); Ebo, Didier G (DG);

Affiliation: Department of Allergology, Department of Rheumatology, Allergology and Clinical Immunology, Inselspital, Freiburgstrasse, University of Bern, Bern 3010, Switzerland. oliver.hausmann(-atsign-)insel.ch

Journal and publication information

Publication Type: Journal Article; Review

Journal: Immunology and allergy clinics of North America (Immunol Allergy Clin North Am), published in United States. (Language: eng)

Reference: 2009-Aug; vol 29 (issue 3) : pp 555-66

Dates: Created 2009/06/30; Completed 2009/10/22;

PMID: 19563997, status: MEDLINE (last retrieval date: 10/22/2009, IMS Date: 22 Oct 2009 00:00:00)

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

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Allergens - immunology
Antigens, CD - metabolism
Antigens, Differentiation - metabolism
Basophil Degranulation Test - methods; utilization
Basophils - immunology; metabolism; pathology
Cell Degranulation
Cell Separation
Drug Hypersensitivity - diagnosis; immunology; metabolism; pathology
Flow Cytometry

Flow Cytometry
Humans
Hypersensitivity, Immediate - diagnosis; immunology; metabolism; pathology
Phosphoric Diester Hydrolases - metabolism
Platelet Membrane Glycoproteins - metabolism
Pyrophosphatases - metabolism
Receptors, IgE - metabolism
Skin Tests
p38 Mitogen-Activated Protein Kinases - metabolism

Associated Chemicals: Allergens (0) ; Antigens, CD (0) ; Antigens, Differentiation (0) ; ENPP3 protein, human (0) ; Platelet Membrane Glycoproteins (0) ; Receptors, IgE (0) ; lysosomal protein GP53 (0) ; p38 Mitogen-Activated Protein Kinases (EC 2.7.1.37) ; Phosphoric Diester Hydrolases (EC 3.1.4.-) ; Pyrophosphatases (EC 3.6.1.-)

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