Applications of basophil activation test in paediatric allergic diseases

Basophilic granulocytes, containing and releasing histamine after a specific allergy stimulation, are directly involved in IgE-mediated allergic reactions. CD63 is a transmembrane protein of secretory lysosomes of basophils and its upregulation is related with the release of histamine to the extrace...

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Main Authors: Dodi Giulia, MD, Di Filippo Paola, MD, Di Ludovico Armando, MD, Simeone Pasquale, PhD, De Bellis Domenico, MSc, D'ascanio Francesca, MSc, Di Pillo Sabrina, MD, Chiarelli Francesco, PhD, Lanuti Paola, PhD, Attanasi Marina, PhD
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:World Allergy Organization Journal
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Online Access:http://www.sciencedirect.com/science/article/pii/S1939455124001303
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author Dodi Giulia, MD
Di Filippo Paola, MD
Di Ludovico Armando, MD
Simeone Pasquale, PhD
De Bellis Domenico, MSc
D'ascanio Francesca, MSc
Di Pillo Sabrina, MD
Chiarelli Francesco, PhD
Lanuti Paola, PhD
Attanasi Marina, PhD
author_facet Dodi Giulia, MD
Di Filippo Paola, MD
Di Ludovico Armando, MD
Simeone Pasquale, PhD
De Bellis Domenico, MSc
D'ascanio Francesca, MSc
Di Pillo Sabrina, MD
Chiarelli Francesco, PhD
Lanuti Paola, PhD
Attanasi Marina, PhD
author_sort Dodi Giulia, MD
collection DOAJ
description Basophilic granulocytes, containing and releasing histamine after a specific allergy stimulation, are directly involved in IgE-mediated allergic reactions. CD63 is a transmembrane protein of secretory lysosomes of basophils and its upregulation is related with the release of histamine to the extracellular space during IgE-mediated allergic reactions. Basophil activation test (BAT) measures the activation of circulating basophils upon the in vitro stimulation of living blood cells with specific allergens. Such a test is particularly safe and reproducible and has recently emerged as a new promising diagnostic tool for allergic diseases.BAT can be used to diagnose food allergy and represents a promising alternative to oral food challenge tests, especially in children as it is less invasive, safer, and cheaper than the gold standard tests. As a biomarker of tolerance and reactivity, it is also useful to monitor natural resolution and clinical response to immune-modulatory treatments. Regarding drug allergies, BAT is even the only possible applicable diagnostic tool for allergy reactions to some drugs, because of the lack of alternative test, or given that those commonly used are unreliable, or equivocal. Additionally, BAT allows to screen patients with more active urticarial and identify Hymenoptera-allergic patients with negative venom-specific immunoglobulin (Ig)E. In respiratory allergic diseases, BAT can facilitate the diagnosis of local allergic rhinitis and evaluate basophil allergen sensitivity in allergic asthma. Although IgE-sensitization in allergic asthma is usually demonstrated by skin prick test and specific IgE, those tests do not predict the clinical allergy contribution to asthma pathogenesis. To date, the potential of BAT in the diagnostic work-up of allergic diseases is well established, but a better standardization of its use is needed. This narrative review summarizes the state-of-the-art BAT technology and applications in pediatric allergic diseases, focusing on immune-related mechanisms and the BAT real clinical utility.
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spelling doaj-art-8dfb9f2d37a040be843695f620d076042024-12-13T10:57:05ZengElsevierWorld Allergy Organization Journal1939-45512024-12-011712100998Applications of basophil activation test in paediatric allergic diseasesDodi Giulia, MD0Di Filippo Paola, MD1Di Ludovico Armando, MD2Simeone Pasquale, PhD3De Bellis Domenico, MSc4D'ascanio Francesca, MSc5Di Pillo Sabrina, MD6Chiarelli Francesco, PhD7Lanuti Paola, PhD8Attanasi Marina, PhD9Department of Pediatrics, Pediatric Allergy and Pulmonology Unit, University of Chieti-Pescara, Chieti, ItalyDepartment of Pediatrics, Pediatric Allergy and Pulmonology Unit, University of Chieti-Pescara, Chieti, ItalyDepartment of Pediatrics, Pediatric Allergy and Pulmonology Unit, University of Chieti-Pescara, Chieti, ItalyCenter for Advanced Studies and Technology (CAST), ''G.d'Annunzio'' University, Chieti-Pescara, 66100 Chieti, Italy; Department of Medicine and Aging Sciences, ''G.d'Annunzio'' University, Chieti-Pescara, 66100 Chieti, ItalyCenter for Advanced Studies and Technology (CAST), ''G.d'Annunzio'' University, Chieti-Pescara, 66100 Chieti, Italy; Department of Medicine and Aging Sciences, ''G.d'Annunzio'' University, Chieti-Pescara, 66100 Chieti, ItalyCenter for Advanced Studies and Technology (CAST), ''G.d'Annunzio'' University, Chieti-Pescara, 66100 Chieti, Italy; Department of Medicine and Aging Sciences, ''G.d'Annunzio'' University, Chieti-Pescara, 66100 Chieti, Italy; Department of Humanities, Law and Economics, “Leonardo Da Vinci” University, 66010 Torrevecchia Teatina, ItalyDepartment of Pediatrics, Pediatric Allergy and Pulmonology Unit, University of Chieti-Pescara, Chieti, ItalyDepartment of Pediatrics, Pediatric Allergy and Pulmonology Unit, University of Chieti-Pescara, Chieti, ItalyCenter for Advanced Studies and Technology (CAST), ''G.d'Annunzio'' University, Chieti-Pescara, 66100 Chieti, Italy; Department of Medicine and Aging Sciences, ''G.d'Annunzio'' University, Chieti-Pescara, 66100 Chieti, ItalyDepartment of Pediatrics, Pediatric Allergy and Pulmonology Unit, University of Chieti-Pescara, Chieti, Italy; Corresponding author. Department of Pediatrics, University of Chieti, Chieti, Italy.Basophilic granulocytes, containing and releasing histamine after a specific allergy stimulation, are directly involved in IgE-mediated allergic reactions. CD63 is a transmembrane protein of secretory lysosomes of basophils and its upregulation is related with the release of histamine to the extracellular space during IgE-mediated allergic reactions. Basophil activation test (BAT) measures the activation of circulating basophils upon the in vitro stimulation of living blood cells with specific allergens. Such a test is particularly safe and reproducible and has recently emerged as a new promising diagnostic tool for allergic diseases.BAT can be used to diagnose food allergy and represents a promising alternative to oral food challenge tests, especially in children as it is less invasive, safer, and cheaper than the gold standard tests. As a biomarker of tolerance and reactivity, it is also useful to monitor natural resolution and clinical response to immune-modulatory treatments. Regarding drug allergies, BAT is even the only possible applicable diagnostic tool for allergy reactions to some drugs, because of the lack of alternative test, or given that those commonly used are unreliable, or equivocal. Additionally, BAT allows to screen patients with more active urticarial and identify Hymenoptera-allergic patients with negative venom-specific immunoglobulin (Ig)E. In respiratory allergic diseases, BAT can facilitate the diagnosis of local allergic rhinitis and evaluate basophil allergen sensitivity in allergic asthma. Although IgE-sensitization in allergic asthma is usually demonstrated by skin prick test and specific IgE, those tests do not predict the clinical allergy contribution to asthma pathogenesis. To date, the potential of BAT in the diagnostic work-up of allergic diseases is well established, but a better standardization of its use is needed. This narrative review summarizes the state-of-the-art BAT technology and applications in pediatric allergic diseases, focusing on immune-related mechanisms and the BAT real clinical utility.http://www.sciencedirect.com/science/article/pii/S1939455124001303Basophil activation testPediatricsAllergic diseaseVenom allergySpontaneous chronic urticaria
spellingShingle Dodi Giulia, MD
Di Filippo Paola, MD
Di Ludovico Armando, MD
Simeone Pasquale, PhD
De Bellis Domenico, MSc
D'ascanio Francesca, MSc
Di Pillo Sabrina, MD
Chiarelli Francesco, PhD
Lanuti Paola, PhD
Attanasi Marina, PhD
Applications of basophil activation test in paediatric allergic diseases
World Allergy Organization Journal
Basophil activation test
Pediatrics
Allergic disease
Venom allergy
Spontaneous chronic urticaria
title Applications of basophil activation test in paediatric allergic diseases
title_full Applications of basophil activation test in paediatric allergic diseases
title_fullStr Applications of basophil activation test in paediatric allergic diseases
title_full_unstemmed Applications of basophil activation test in paediatric allergic diseases
title_short Applications of basophil activation test in paediatric allergic diseases
title_sort applications of basophil activation test in paediatric allergic diseases
topic Basophil activation test
Pediatrics
Allergic disease
Venom allergy
Spontaneous chronic urticaria
url http://www.sciencedirect.com/science/article/pii/S1939455124001303
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