title: The clinical utility of basophil activation testing in diagnosis and monitoring of allergic disease.
abstract: The basophil activation test (BAT) has become a pervasive test for allergic response through the development of flow cytometry, discovery of activation markers such as CD63 and unique markers identifying basophil granulocytes. Basophil activation test measures basophil response to allergen cross-linking IgE on between 150 and 2000 basophil granulocytes in <0.1 ml fresh blood. Dichotomous activation is assessed as the fraction of reacting basophils. In addition to clinical history, skin prick test, and specific IgE determination, BAT can be a part of the diagnostic evaluation of patients with food-, insect venom-, and drug allergy and chronic urticaria. It may be helpful in determining the clinically relevant allergen. Basophil sensitivity may be used to monitor patients on allergen immunotherapy, anti-IgE treatment or in the natural resolution of allergy. Basophil activation test may use fewer resources and be more reproducible than challenge testing. As it is less stressful for the patient and avoids severe allergic reactions, BAT ought to precede challenge testing. An important next step is to standardize BAT and make it available in diagnostic laboratories. The nature of basophil activation as an ex vivo challenge makes it a multifaceted and promising tool for the allergist. In this EAACI task force position paper, we provide an overview of the practical and technical details as well as the clinical utility of BAT in diagnosis and management of allergic diseases.
authors.affiliation: Department of Respiratory Diseases and Allergy, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
authors.forename: H J
authors.initials: HJ
authors.lastname: Hoffmann
authors.affiliation: Department of Paediatric Allergy, Division of Asthma, Allergy and Lung Biology, King's College London, London, UK.|MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK.|Immunoallergology Department, Coimbra University Hospital, Coimbra, Portugal.
authors.forename: A F
authors.initials: AF
authors.lastname: Santos
authors.affiliation: Research Laboratory and Allergy Service, IBIMA-Regional University Hospital of Malaga, UMA, Malaga, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Mayorga
authors.affiliation: Clinical Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Nopp
authors.affiliation: Department of Dermatology and Allergy Biederstein, Technische Universität München, Munich, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Eberlein
authors.affiliation: Department of Allergy and Clinical Immunology, Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Ferrer
authors.affiliation: Department of Immunology, University Hospital, Clermont-Ferrand and ERTICa Research Group, University of Auvergne, Clermont-Ferrand, France.
authors.forename: P
authors.initials: P
authors.lastname: Rouzaire
authors.affiliation: Department of Immunology-Allergology-Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium.
authors.forename: D G
authors.initials: DG
authors.lastname: Ebo
authors.affiliation: Department of Immunology-Allergology-Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium.
authors.forename: V
authors.initials: V
authors.lastname: Sabato
authors.affiliation: Department of Allergy and Clinical Immunology, Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: M L
authors.initials: ML
authors.lastname: Sanz
authors.affiliation: Adverse Drug Reactions-Analysis and Consulting (ADR-AC) GmbH, Bern, Switzerland.
authors.forename: T
authors.initials: T
authors.lastname: Pecaric-Petkovic
authors.affiliation: Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: S U
authors.initials: SU
authors.lastname: Patil
authors.affiliation: Department of Rheumatology, Immunology and Allergology, Inselspital, University of Bern, Bern, Switzerland.|Loewenpraxis, Luzern, Switzerland.
authors.forename: O V
authors.initials: OV
authors.lastname: Hausmann
authors.affiliation: Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: W G
authors.initials: WG
authors.lastname: Shreffler
authors.affiliation: Laboratory for Clinical Immunology & Molecular Genetics, University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia.
authors.forename: P
authors.initials: P
authors.lastname: Korosec
authors.affiliation: Department of Immunology and Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: E F
authors.initials: EF
authors.lastname: Knol
mesh_terms: D000465:Algorithms; D000485:Allergens / Q000276:immunology; D015549:Basophil Degranulation Test; D001491:Basophils / Q000276:immunology* / Q000378:metabolism; D015415:Biomarkers; D005434:Flow Cytometry; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000276:immunology*; D060149:Tetraspanin 30 / Q000378:metabolism
chemical_list: D000485:Allergens; D015415:Biomarkers; D060149:Tetraspanin 30
keywords: CD63; allergy diagnosis; allergy monitoring; basophil activation test; basophil granulocyte