title: Correlations between basophil activation, allergen-specific IgE with outcome and severity of oral food challenges.
abstract: BACKGROUND
  Double-blinded, placebo-controlled food challenges (DBPCFCs) remain the gold standard for diagnosing food allergies. Skin prick tests (SPTs) and allergen-specific IgE (sIgE) are routinely used in medical practice but are not sufficient to predict severity of clinical reactivity.
  
  
  OBJECTIVE
  To compare the utility of SPT wheal diameter, sIgE, allergen-specific IgG4 (sIgG4), total IgE (tIgE), sIgE/sIgG4 and sIgE/tIgE ratios, peanut component-specific IgE, and basophil activation in predicting outcome and severity of reactions at DBPCFCs.
  
  
  METHODS
  Sixty-seven subjects (12-45 years old) underwent DBPCFCs for peanut, tree nut, fish, shrimp, and/or sesame as part of screening for enrollment in a clinical trial. The SPT, sIgE, tIgE, sIgG4, and peanut component-specific IgE (if applicable) levels were measured. CD63 upregulation on basophils in response to in vitro allergen challenge was analyzed by flow cytometry. Correlations between these measurements and DBPCFC severity scores were analyzed.
  
  
  RESULTS
  The SPT and sIgE showed a weak correlation with DBPCFC severity scores, but tIgE and sIgG4 did not. The sIgE/sIgG4 ratio differentiated between positive and negative reactions but did not correlate with DBPCFC severity scores. A low positive correlation was seen between DBPCFC severity score and Ara h 2 IgE, whereas a low negative correlation with Ara h 8 IgE was observed. Basophil activation was positively correlated with DBPCFC severity scores. Receiver operating characteristic curves showed basophil reactivity had the largest area under the curve at 0.904 and sIgE at 0.870.
  
  
  CONCLUSIONS
  These results indicate that basophil activation testing can enhance discrimination between allergic and nonallergic individuals and could serve as an additional tool to predict clinical severity.
authors.affiliation: Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Ying
authors.initials: Y
authors.lastname: Song
authors.affiliation: Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Julie
authors.initials: J
authors.lastname: Wang
authors.affiliation: Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Nicole
authors.initials: N
authors.lastname: Leung
authors.affiliation: Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York; Shanghai Municipal Hospital of Traditional Chinese Medicine affiliated with Shanghai TCM University, Shanghai, China.
authors.forename: Li Xin
authors.initials: LX
authors.lastname: Wang
authors.affiliation: Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Lauren
authors.initials: L
authors.lastname: Lisann
authors.affiliation: Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Scott H
authors.initials: SH
authors.lastname: Sicherer
authors.affiliation: Division of Allergy and Immunology, Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital Research Institute, Little Rock, Arkansas.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Scurlock
authors.affiliation: Division of Allergy and Immunology, Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital Research Institute, Little Rock, Arkansas.
authors.forename: Robbie
authors.initials: R
authors.lastname: Pesek
authors.affiliation: Division of Allergy and Immunology, Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital Research Institute, Little Rock, Arkansas.
authors.forename: Tamara T
authors.initials: TT
authors.lastname: Perry
authors.affiliation: Division of Allergy and Immunology, Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital Research Institute, Little Rock, Arkansas.
authors.forename: Stacie M
authors.initials: SM
authors.lastname: Jones
authors.affiliation: Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: xiu-min.li@mssm.edu.
authors.forename: Xiu-Min
authors.initials: XM
authors.lastname: Li
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000485:Allergens; D015549:Basophil Degranulation Test; D001491:Basophils / Q000276:immunology*; D002478:Cells, Cultured; D002648:Child; D018849:Controlled Clinical Trials as Topic; D005512:Food Hypersensitivity / Q000175:diagnosis*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011379:Prognosis; D012882:Skin Tests; D055815:Young Adult
chemical_list: D000485:Allergens; D007073:Immunoglobulin E