Upregulation of CD63 or CD203c alone or in combination is not sensitive in the diagnosis of nonsteroidal anti-inflammatory drug intolerance.
BACKGROUND
The oral aspirin (ASA) provocation test is considered to be the gold standard in the diagnosis of ASA sensitivity. However, since it may be associated with severe adverse reactions, safer alternatives would be highly desirable. The basophil activation test has been proposed as such an alternative, but there is limited information about its usefulness. Our aim was to evaluate the clinical usefulness of flow cytometric basophil activation in the diagnosis of ASA sensitivity.


METHODS
Patients with ASA sensitivity (n = 18), patients with ASA tolerance (n = 12) and healthy volunteers (n = 12) were included in the study. A 2-day single-blind placebo-controlled oral ASA provocation test was performed on all patients. Basophil activation after lysine-ASA and diclofenac stimulation was measured by Flow-CAST (Buhlmann Laboratories) for CD63 and an allergenicity kit (Beckman Coulter) for CD203c. The results of CD63 and CD203c were compared within groups, and sensitivity and specificity of the assay were measured against oral ASA provocation.


RESULTS
The highest sensitivity and specificity of CD63 were 33.3 and 79.2%, respectively, and of CD203c were 16.7 and 100%, respectively, for ASA. The highest sensitivity and specificity of CD63 were 16.7 and 91.7%, respectively, and of CD203c were 22.2 and 100%, respectively, fordiclofenac. Neither the addition of CD203c to CD63 nor the addition of diclofenac improves the overall sensitivity and specificity of CD63 to ASA.


CONCLUSIONS
At present, basophil activation using CD63 and CD203c does not seem to be optimally sensitive for the diagnosis of ASA sensitivity.
Bavbek
Sevim
S
Department of Allergy, School of Medicine, Ankara University, Ankara, Turkey. bavbek@medicine.ankara.edu.tr
Ikincioğullari
Aydan
A
Dursun
A Berna
AB
Guloğlu
Deniz
D
Arikan
Meltem
M
Elhan
Atilla Halil
AH
Misirligil
Zeynep
Z
D000284:Administration, Oral; D000328:Adult; D015703:Antigens, CD / Q000235:genetics / Q000276:immunology / Q000378:metabolism*; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects; D015549:Basophil Degranulation Test; D001491:Basophils / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D015415:Biomarkers / Q000378:metabolism*; D002469:Cell Separation; D004008:Diclofenac / Q000008:administration & dosage / Q000009:adverse effects; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008297:Male; D008875:Middle Aged; D010727:Phosphoric Diester Hydrolases / Q000235:genetics / Q000276:immunology / Q000378:metabolism*; D010980:Platelet Membrane Glycoproteins / Q000235:genetics / Q000276:immunology / Q000378:metabolism*; D011755:Pyrophosphatases / Q000235:genetics / Q000276:immunology / Q000378:metabolism*; D012680:Sensitivity and Specificity; D060149:Tetraspanin 30
D015703:Antigens, CD; D015415:Biomarkers; C554586:CD63 protein, human; C427944:ENPP3 protein, human; D010980:Platelet Membrane Glycoproteins; D060149:Tetraspanin 30; D004008:Diclofenac; D010727:Phosphoric Diester Hydrolases; D011755:Pyrophosphatases; D001241:Aspirin