Basophil activation test in the diagnosis and monitoring of mastocytosis patients with wasp venom allergy on immunotherapy.
BACKGROUND
There is need for an accurate diagnostic test in mastocytosis patients with wasp venom allergy (WVA) and monitoring of these patients during immunotherapy (IT). In this study, we aimed to evaluate sensitivity and specificity of the Basophil Activation Test (BAT) as a diagnostic and monitoring test in patients with mastocytosis and WVA.


METHODS
Seventeen patients with mastocytosis and WVA and six mastocytosis patients without WVA were included. BAT was performed before the start of IT (first visit) and at 6 weeks (second visit) and 1 year (third visit), after reaching the maintenance dose. Of 17 patients included, 11 completed the third visit. In mastocytosis patients with WVA, dose-dependent wasp-venom induced upregulation of CD63 and CD203c expression on basophils was observed compared with mastocytosis patients without WVA. Serum specific IgE, IgG4, and tryptase levels were measured in all patients.


RESULTS
BAT had a sensitivity of 87% and specificity of 100% in diagnosing WVA in mastocytosis patients. Basophil allergen threshold sensitivity with respect to CD63 and CD203c was significantly decreased in the second visit compared with the first visit and increased significantly in the third visit compared with the second visit. Specific IgE levels increased significantly in the second visit compared with first and decreased significantly in the third visit compared with the second. Specific IgG4 levels rose significantly in the second visit compared with the first and on the third visit compared with the second. Tryptase levels did not change significantly during the study.


CONCLUSIONS
BAT represents a diagnostic test with 100% specificity in allergic patients with mastocytosis and these patients are better to be monitored for a longer period during IT.
Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Pathology and Medical Biology, Laboratory of Allergology and Pulmonary Diseases, University Medical Center of Groningen, University of Groningen, Groningen, The Netherlands.
Katayoon
K
Bidad
Martijn C
MC
Nawijn
Antoon J M
AJ
van Oosterhout
Sicco
S
van der Heide
Joanne N G Oude
JN
Elberink
D000328:Adult; D000368:Aged; D000818:Animals; D015549:Basophil Degranulation Test; D001491:Basophils / Q000276:immunology*; D003888:Desensitization, Immunologic / Q000379:methods; D005260:Female; D015870:Gene Expression; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000139:chemically induced / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D007073:Immunoglobulin E / Q000235:genetics / Q000276:immunology; D007074:Immunoglobulin G / Q000235:genetics / Q000276:immunology; D008297:Male; D008415:Mastocytosis / Q000139:chemically induced / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D008875:Middle Aged; D010727:Phosphoric Diester Hydrolases / Q000235:genetics / Q000276:immunology; D011755:Pyrophosphatases / Q000235:genetics / Q000276:immunology; D060149:Tetraspanin 30 / Q000235:genetics / Q000276:immunology; D053802:Tryptases / Q000235:genetics / Q000276:immunology; D014862:Wasp Venoms / Q000633:toxicity*
C554586:CD63 protein, human; C427944:ENPP3 protein, human; D007074:Immunoglobulin G; D060149:Tetraspanin 30; D014862:Wasp Venoms; D007073:Immunoglobulin E; D010727:Phosphoric Diester Hydrolases; D053802:Tryptases; D011755:Pyrophosphatases
basophil activation test; immunotherapy; mastocytosis; wasp venom allergy