title: A comparison between two different in vitro basophil activation tests for gluten- and cow's milk protein sensitivity in irritable bowel syndrome (IBS)-like patients.
abstract: BACKGROUND
  The diagnosis of food hypersensitivity (FH) in adult patients with gastrointestinal symptoms, beyond the immediate IgE-mediated clinical manifestations, is very often difficult. The aims of our study were to: 1) evaluate the frequency of FH in patients with irritable bowel syndrome (IBS)-like clinical presentation; and 2) compare the diagnostic accuracy of two different methods of in vitro basophil activation tests.
  
  
  METHODS
  Three hundred and five patients (235 females, age range 18-66 years) were included and underwent a diagnostic elimination diet and successive double-blind placebo-controlled (DBPC) challenges. Two different methods of in vitro basophil activation tests (BAT) (CD63 expression after in vitro wheat or cow's milk proteins stimulation) were evaluated: one was performed on separated leukocytes, and the other on whole blood.
  
  
  RESULTS
  Ninety patients of the 305 studied (29.5%) were positive to the challenges and were diagnosed as suffering from FH. BAT on separate leukocytes showed a sensitivity of 86% and a specificity of 91% in FH diagnosis. BAT on whole blood showed a sensitivity of 15%-20% and a specificity of 73% in FH diagnosis (p<0.0001 compared to the other method).
  
  
  CONCLUSIONS
  About one third of the IBS patients included in the study were suffering from FH and were cured on the elimination diet. The BAT based on CD63 detection on whole blood samples did not work in FH diagnosis and showed a significantly lower sensitivity, specificity and diagnostic accuracy than the assay based on separated leukocytes.
authors.affiliation: Internal Medicine, Giovanni Paolo II Hospital, Sciacca and University of Palermo, Palermo, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Carroccio
authors.forename: Ignazio
authors.initials: I
authors.lastname: Brusca
authors.forename: Pasquale
authors.initials: P
authors.lastname: Mansueto
authors.forename: Alberto
authors.initials: A
authors.lastname: D'alcamo
authors.forename: Maria
authors.initials: M
authors.lastname: Barrale
authors.forename: Maurizio
authors.initials: M
authors.lastname: Soresi
authors.forename: Aurelio
authors.initials: A
authors.lastname: Seidita
authors.forename: Stella M
authors.initials: SM
authors.lastname: La Chiusa
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Iacono
authors.forename: Delia
authors.initials: D
authors.lastname: Sprini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001491:Basophils / Q000276:immunology*; D002446:Celiac Disease / Q000175:diagnosis / Q000276:immunology; D005260:Female; D005983:Glutens / Q000276:immunology*; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D016269:Milk Hypersensitivity / Q000175:diagnosis* / Q000276:immunology; D008894:Milk Proteins / Q000276:immunology*; D014908:Triticum / Q000276:immunology*; D055815:Young Adult
chemical_list: D008894:Milk Proteins; D005983:Glutens