Marked improvement of the basophil activation test by detecting CD203c instead of CD63.
BACKGROUND
The flow cytometric basophil activation test by detection of CD63 expression has been developed as an alternative method for in vitro diagnosis of IgE-mediated reactions to various allergens. Despite promising initial studies, the test remains disappointing in terms of sensitivity. CD203c has recently been demonstrated as a specific activation marker of basophils that is rapidly up-regulated after allergen challenge in sensitized patients.


OBJECTIVE
The goal of the present study was to compare basophil activation tests by using either CD203c or CD63 in the diagnosis of immediate-type allergy to latex.


METHODS
Twenty-seven patients (health care workers of our institution) who developed clinical features evocative of allergy after contact with latex were included and classified into two groups. Group 1 (n = 16) comprised true allergic patients who presented with typical signs of immediate allergic reaction associated with a positive skin test (prick test). Group 2 (n = 11) consisted of patients whose clinical history was not typical and had negative skin test. Twelve healthy subjects were also studied as controls. We compared the sensitivity of two triple-staining flow cytometric protocols measuring basophil activation after latex stimulation: CD45-IgE-CD63 and CD45-IgE-CD203c.


RESULTS
The CD203c protocol showed a higher sensitivity than the CD63 protocol (75% vs. 50%). In comparison, latex-specific IgE sensitivity was found to be 69%. Furthermore, the magnitude of the basophil response was significantly higher with CD203c in comparison with CD63. Specificity was 100% for both protocols.


CONCLUSIONS
Due to superior gating of basophils and a higher range of activation in response to allergen, the basophil activation test is markedly improved by use of CD203c instead of CD63.
Boumiza
R
R
Immunology Laboratory, Staff Health Department, Lyon-Sud University Hospital, Lyon, France.
Monneret
G
G
Forissier
M-F
MF
Savoye
J
J
Gutowski
M-C
MC
Powell
W S
WS
Bienvenu
J
J
D000328:Adult; D015703:Antigens, CD / Q000097:blood*; D015549:Basophil Degranulation Test / Q000379:methods*; D001491:Basophils / Q000378:metabolism; D005260:Female; D005434:Flow Cytometry / Q000379:methods; D006282:Health Personnel; D006801:Humans; D007073:Immunoglobulin E / Q000096:biosynthesis; D007840:Latex / Q000276:immunology; D020315:Latex Hypersensitivity / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis*; D010727:Phosphoric Diester Hydrolases / Q000097:blood*; D010980:Platelet Membrane Glycoproteins; D011755:Pyrophosphatases / Q000097:blood*; D012680:Sensitivity and Specificity; D012882:Skin Tests; D060149:Tetraspanin 30
D015703:Antigens, CD; C554586:CD63 protein, human; C427944:ENPP3 protein, human; D007840:Latex; D010980:Platelet Membrane Glycoproteins; D060149:Tetraspanin 30; D007073:Immunoglobulin E; D010727:Phosphoric Diester Hydrolases; D011755:Pyrophosphatases