Tags

Type your tag names separated by a space and hit enter

The basophil activation test differentiates between patients with alpha-gal syndrome and asymptomatic alpha-gal sensitization.
J Allergy Clin Immunol. 2019 01; 143(1):182-189.JA

Abstract

BACKGROUND

Galactose-alpha-1,3-galactose (alpha-gal) syndrome is characterized by the presence of serum specific IgE antibodies to alpha-gal and delayed type I allergic reactions to the carbohydrate alpha-gal after consumption of mammalian (red) meat products and drugs of mammalian origin. Diagnostics currently rely on patient history, skin tests, determination of serum specific IgE antibodies, and oral food or drug challenges.

OBJECTIVE

We sought to assess the utility of different basophil parameters (basophil reactivity and sensitivity, the ratio of the percentage of CD63+ basophils induced by the alpha-gal-containing allergen to the percentage of CD63+ basophils after stimulation with anti-FcεRI antibody [%CD63+/anti-FcεRI], and area under the dose-response curve [AUC]) as biomarkers for the clinical outcome of patients with alpha-gal syndrome compared with subjects with asymptomatic alpha-gal sensitization.

METHODS

In addition to routine diagnostics, a basophil activation test (Flow CAST) with different concentrations of alpha-gal-containing allergens (eg, commercially available alpha-gal-carrying proteins and pork kidney extracts) was performed in 21 patients with alpha-gal syndrome, 12 alpha-gal-sensitized subjects, and 18 control subjects.

RESULTS

Alpha-gal-containing allergens induced strong basophil activation in a dose-dependent manner in patients. Basophil reactivity at distinct allergen concentrations, the %CD63+/anti-FcεRI ratio across most allergen concentrations, the AUC of dose-response curves, and basophil allergen threshold sensitivity (CD-sens) with pork kidney extract were significantly higher in patients with alpha-gal syndrome compared with those in sensitized subjects. All parameters were negative in control subjects.

CONCLUSION

The basophil activation test should be considered as an additional diagnostic test before performing time-consuming and potentially risky oral provocation tests. The %CD63+/anti-FcεRI ratio for all allergens and AUCs for pork kidney were the best parameters for distinguishing patients with alpha-gal syndrome from subjects with asymptomatic alpha-gal sensitization.

Authors+Show Affiliations

Department of Dermatology and Allergy Biederstein, Technical University of Munich, Munich, Germany.Department of Dermatology, Faculty of Medicine, Eberhard Karls University Tuebingen, Tuebingen, Germany.Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.Immunology-Allergology Department, Luxembourg Hospital, Luxembourg-Ville, Luxembourg.Immunology-Allergology Department, Luxembourg Hospital, Luxembourg-Ville, Luxembourg.Center of Allergy and Environment (ZAUM), Technical University of Munich and Helmholtz Center Munich, Munich, Germany.Center of Allergy and Environment (ZAUM), Technical University of Munich and Helmholtz Center Munich, Munich, Germany.Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.Department of Dermatology and Allergy Biederstein, Technical University of Munich, Munich, Germany.Department of Dermatology and Allergy Biederstein, Technical University of Munich, Munich, Germany.Department of Dermatology and Allergy Biederstein, Technical University of Munich, Munich, Germany. Electronic address: bernadette.eberlein@tum.de.

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30125663

Citation

Mehlich, Jana, et al. "The Basophil Activation Test Differentiates Between Patients With Alpha-gal Syndrome and Asymptomatic Alpha-gal Sensitization." The Journal of Allergy and Clinical Immunology, vol. 143, no. 1, 2019, pp. 182-189.
Mehlich J, Fischer J, Hilger C, et al. The basophil activation test differentiates between patients with alpha-gal syndrome and asymptomatic alpha-gal sensitization. J Allergy Clin Immunol. 2019;143(1):182-189.
Mehlich, J., Fischer, J., Hilger, C., Swiontek, K., Morisset, M., Codreanu-Morel, F., Schiener, M., Blank, S., Ollert, M., Darsow, U., Biedermann, T., & Eberlein, B. (2019). The basophil activation test differentiates between patients with alpha-gal syndrome and asymptomatic alpha-gal sensitization. The Journal of Allergy and Clinical Immunology, 143(1), 182-189. https://doi.org/10.1016/j.jaci.2018.06.049
Mehlich J, et al. The Basophil Activation Test Differentiates Between Patients With Alpha-gal Syndrome and Asymptomatic Alpha-gal Sensitization. J Allergy Clin Immunol. 2019;143(1):182-189. PubMed PMID: 30125663.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The basophil activation test differentiates between patients with alpha-gal syndrome and asymptomatic alpha-gal sensitization. AU - Mehlich,Jana, AU - Fischer,Jörg, AU - Hilger,Christiane, AU - Swiontek,Kyra, AU - Morisset,Martine, AU - Codreanu-Morel,Françoise, AU - Schiener,Maximilian, AU - Blank,Simon, AU - Ollert,Markus, AU - Darsow,Ulf, AU - Biedermann,Tilo, AU - Eberlein,Bernadette, Y1 - 2018/08/17/ PY - 2018/03/15/received PY - 2018/06/03/revised PY - 2018/06/28/accepted PY - 2018/8/21/pubmed PY - 2019/11/13/medline PY - 2018/8/21/entrez KW - Basophil activation test KW - CCR3 KW - CD63 KW - alpha-gal syndrome KW - asymptomatic alpha-gal sensitization KW - basophil allergen threshold sensitivity (CD-sens) KW - galactose-alpha-1,3-galactose KW - red meat allergy SP - 182 EP - 189 JF - The Journal of allergy and clinical immunology JO - J. Allergy Clin. Immunol. VL - 143 IS - 1 N2 - BACKGROUND: Galactose-alpha-1,3-galactose (alpha-gal) syndrome is characterized by the presence of serum specific IgE antibodies to alpha-gal and delayed type I allergic reactions to the carbohydrate alpha-gal after consumption of mammalian (red) meat products and drugs of mammalian origin. Diagnostics currently rely on patient history, skin tests, determination of serum specific IgE antibodies, and oral food or drug challenges. OBJECTIVE: We sought to assess the utility of different basophil parameters (basophil reactivity and sensitivity, the ratio of the percentage of CD63+ basophils induced by the alpha-gal-containing allergen to the percentage of CD63+ basophils after stimulation with anti-FcεRI antibody [%CD63+/anti-FcεRI], and area under the dose-response curve [AUC]) as biomarkers for the clinical outcome of patients with alpha-gal syndrome compared with subjects with asymptomatic alpha-gal sensitization. METHODS: In addition to routine diagnostics, a basophil activation test (Flow CAST) with different concentrations of alpha-gal-containing allergens (eg, commercially available alpha-gal-carrying proteins and pork kidney extracts) was performed in 21 patients with alpha-gal syndrome, 12 alpha-gal-sensitized subjects, and 18 control subjects. RESULTS: Alpha-gal-containing allergens induced strong basophil activation in a dose-dependent manner in patients. Basophil reactivity at distinct allergen concentrations, the %CD63+/anti-FcεRI ratio across most allergen concentrations, the AUC of dose-response curves, and basophil allergen threshold sensitivity (CD-sens) with pork kidney extract were significantly higher in patients with alpha-gal syndrome compared with those in sensitized subjects. All parameters were negative in control subjects. CONCLUSION: The basophil activation test should be considered as an additional diagnostic test before performing time-consuming and potentially risky oral provocation tests. The %CD63+/anti-FcεRI ratio for all allergens and AUCs for pork kidney were the best parameters for distinguishing patients with alpha-gal syndrome from subjects with asymptomatic alpha-gal sensitization. SN - 1097-6825 UR - https://www.unboundmedicine.com/medline/citation/30125663/The_basophil_activation_test_differentiates_between_patients_with_alpha_gal_syndrome_and_asymptomatic_alpha_gal_sensitization_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(18)31143-6 DB - PRIME DP - Unbound Medicine ER -