Basophil activation can predict clinical sensitivity in patients after venom immunotherapy.
نویسندگان
چکیده
OBJECTIVE At present, no reliable in vitro test is available to monitor the success of specific venom immunotherapy (VIT) in preventing insect venom anaphylaxis. We investigated usefulness of the basophil activation test (BAT) in predicting the outcome of sting challenge in bee venom-allergic patients after VIT. PATIENTS AND METHODS Twenty-one patients with bee venom anaphylaxis at the end of VIT and 6 control participants were enrolled. BAT (flow-cytometric evaluation of allergen-induced expression of CD63), skin testing, and specific immunoglobulin (Ig) E determination were performed prior to sting challenge. RESULTS Five of the 21 patients (23.8%) reacted to sting challenge. At a bee venom concentration of 100 ng/mL, the mean proportion of basophils expressing CD63 was 56% in reactors and 13.2% in nonreactors (P = .0321). Four of the 5 reactors had positive results and 14 of the 16 nonreactors had negative results. Thus, using 18.4% and 21.6% (receiver operating characteristic curve analysis) as the cutoff for expression of the CD63 marker, the positive and the negative predictive values were 67% and 93%, respectively, and specificity and sensitivity for BAT were 80% and 83%, respectively. However, at a concentration of 1000 ng/mL, no significant differences in basophil activation were observed between reactors and nonreactors. CONCLUSION We found BAT to be a helpful tool in predicting the clinical sensitivity of bee venom-allergic patients after VIT (correlation between BAT at submaximal venom concentration and sting challenge).
منابع مشابه
Importance of basophil activation testing in insect venom allergy
BACKGROUND Venom immunotherapy (VIT) is the only effective treatment for prevention of serious allergic reactions to bee and wasp stings in sensitized individuals. However, there are still many questions and controversies regarding immunotherapy, like selection of the appropriate allergen, safety and long term efficacy. METHODS Literature review was performed to address the role of basophil a...
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The diagnosis of insect venom allergy and the indication for specific immunotherapy is based on history, skin tests and demonstration of hymenoptera venom-specific IgE-antibodies. Cellular tests can add useful information but the role of basophil activation tests for the different venoms has to be elucidated further. We evaluated positive reactions in a basophil activation test using CD63 expre...
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PURPOSE The basophil activation test (BAT) has been used to monitor venom immunotherapy (VIT) due to its high specificity. A previous study has reported a good correlation between a significant decrease in basophil activation during 5 years of VIT and clinical protection assessed by sting challenge. The following prospective study was performed to examine changes in basophil reactivity over a c...
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BACKGROUND There is need for an accurate diagnostic test in mastocytosis patients with wasp venom allergy (WVA) and monitoring of these patients during immunotherapy (IT). In this study, we aimed to evaluate sensitivity and specificity of the Basophil Activation Test (BAT) as a diagnostic and monitoring test in patients with mastocytosis and WVA. METHODS Seventeen patients with mastocytosis a...
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ورودعنوان ژورنال:
- Journal of investigational allergology & clinical immunology
دوره 20 2 شماره
صفحات -
تاریخ انتشار 2010