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Updated: Jun 23, 2026

Basophil Activation Test for Allergy Diagnosis
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Published on: May 31, 2021

Pathogenesis of chronic urticaria.

A P Kaplan1, M Greaves

  • 1Department of Medicine, Division of Pulmonary and Critical Care Medicine, Allergy and Clinical Immunology, Medical University of South Carolina, Charleston, SC, USA. kaplana@musc.edu

Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology
|April 30, 2009
PubMed
Summary

Autoimmune chronic urticaria involves autoantibodies activating histamine release from cells, leading to more severe symptoms. Some patients show altered basophil responsiveness, which may be linked to disease cause or consequence.

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Area of Science:

  • Immunology
  • Dermatology
  • Allergy

Background:

  • Chronic urticaria (CU) is defined as hives lasting over 6 weeks.
  • CU is divided into autoimmune (45%) and idiopathic (55%) forms.
  • Autoimmune CU involves autoantibodies against IgE or its receptor.

Purpose of the Study:

  • To differentiate between autoimmune and idiopathic chronic urticaria.
  • To investigate the role of autoantibodies in CU pathogenesis.
  • To explore basophil responsiveness in CU patients.

Main Methods:

  • Analysis of autoantibodies (IgG anti-IgE, IgG anti-FcεRIα) using immunoblot and ELISA.
  • In vitro studies of basophil and mast cell activation.
  • Assessment of cellular infiltrate composition (mast cells, T lymphocytes, etc.).
  • Evaluation of basophil responsiveness to anti-IgE and serum.

Main Results:

  • Autoantibodies activate basophils and mast cells, causing histamine release, specific to autoimmune CU.
  • Autoimmune CU shows more severe inflammation and clinical symptoms.
  • A distinct subpopulation (≥50%) exhibits hypo-responsiveness to anti-IgE, linked to cytoplasmic phosphatases.
  • Autoimmune CU patients have higher rates of HLA-DR alleles and antithyroid antibodies.

Conclusions:

  • Autoantibodies are key players in autoimmune chronic urticaria pathogenesis.
  • Basophil hypo-responsiveness is a significant finding in a subset of CU patients.
  • Further research is needed to clarify the cause-and-effect relationship of altered basophil responsiveness in chronic urticaria.