Basophil Activation Test: Old and New Applications in Allergy
AbstractPurpose of ReviewThe basophil activation test (BAT) using flow cytometry has supplanted traditional methods of measuring basophil degranulation using histamine and other mediator release, and can be used for clinical applications as well as to explore the immune mechanisms of effector cell response to allergen. This review discusses the advancements made in clinical, diagnostic and laboratory research of allergy utilizing an ever-evolving BAT.Recent FindingsBeing an in vitro surrogate of the allergic reaction that happens in vivo in the sick patient, the BAT can be used to support the diagnosis of various allergic conditions, such as food, drug, respiratory and insect venom allergies, and the assessment of clinical response to allergen-specific immunotherapy and other immunomodulatory treatments. The BAT can also be used for research purposes to explore the mechanisms of allergy and tolerance at the level of the basophil, for instance by manipulating IgE and IgG and their receptors and by studying intracellular signalling cascade in response to allergen.SummaryThis review covers the applications of the BAT to the clinical management of allergic patients and the increased understanding of the mechanisms of immune response to allergens as well as technological advancements made in recent years.
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Allergic rhinitis is a common disorder that regularly occurs in children and adolescents. The disease is associated with other allergic diseases, such as asthma, and it carries a heavy burden, with effects on sleep, school performance, and quality of life. Classic symptoms include sneezing, rhinorrhea, nasal obstruction, and nasal itching. When the eyes are involved, the term allergic rhinoconjunctivitis is used. Triggers may include airborne pollens, molds, dust mites, and animals. Skin or blood allergy testing can be a useful diagnostic modality that may guide therapy. Immunotherapy can prevent the development of further...
Oral immunotherapy (OIT) is a form of desensitization proposed as a treatment for food allergy (FA). Oral immunotherapy involves feeding with increasing amounts of an allergen until a small portion is regularly tolerated. The OIT goals range from “bite safe” to induction of tolerance.1,2
Abstract Gluten-related disorders are very common in pediatric patients. Wheat allergy is triggered by an immunoglobulin E (IgE)-dependent mechanism; its prevalence varies according to the age and region, and in Europe has been estimated to be lower than 1%. Many studies investigated the potential role of several external factors that can influence the risk to developing wheat allergy, but results are still inconclusive. It can be responsible for several clinical manifestations depending on the route of allergen exposure: food-dependent exercise-induced anaphylaxis (FDEIA), occupational rhinitis or asthma (also kn...
CONCLUSIONS: Standardized house dust mite extract was more effective than non-standardized house dust extract for subcutaneous immunotherapy; however, the establishment of safer methods is warranted. PMID: 31308334 [PubMed - in process]
Oral food challenges (OFC) and immunotherapy (IT) are common allergy clinic procedures with inherent risk of an allergic reaction, including anaphylaxis. Although exceedingly rare, fatal and near-fatal anaphylactic reactions have occurred.1 –3 Providers must understand the potential risk factors for severe reactions when performing these procedures. Previous studies specifically reviewed risk factors for severe reactions during IT or OFCs individually.3–8 However, data are limited on all-cause allergic reactions in the allergy clin ic and associated predictive factors for epinephrine use in the clinic.
Oral food challenges (OFC) and immunotherapy (IT) are common allergy clinic procedures with inherent risk of an allergic reaction, including anaphylaxis. Although exceedingly rare, fatal and near-fatal anaphylactic reactions have occurred.1-3 It is important that providers understand the potential risk factors for severe reactions when performing these procedures. Previous studies specifically reviewed risk factors for severe reactions during IT or OFCs individually.3-8 However, data is limited on all-cause allergic reactions in the allergy clinic and associated predictive factors for epinephrine use in the clinic.
Conclusions. One-year AIT treatment significantly increases QoL in patients with AR. Moreover, high patients' satisfaction values were reported, together with an adequate safety profile. PMID: 31287263 [PubMed - as supplied by publisher]
ConclusionsThere is an unexplained slight increase in SCIT-related fatalities for 2015-2017, although mean annual reported events over 9 years (0.8 fatal reactions per year) have declined. SCIT-related infections were not identified during 2 years of surveillance. The 15% incidence of delayed-onset SRs (>30 minutes) is similar to a prior annual survey. Prescribing epinephrine autoinjectors for SCIT does not appear to improve outcomes, possibly due to low rates of self-administration.
Subcutaneous allergen immunotherapy (SCIT) is effective for allergic rhinitis, allergic conjunctivitis, and allergic asthma1. Local reactions are the most common adverse effect associated with SCIT1, though systemic reactions to SCIT (SCITSR) are the most serious adverse effect1. The rate of systemic reactions to SCIT with a conventional dosing schedule is reported to be 0.1-0.2% per injection.1,2 It is generally accepted that the potential benefits of SCIT for select atopic conditions outweigh this risk of SCITSR.