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Basophil Activation Test for Allergy Diagnosis
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The expression of CD123 can decrease with basophil activation: implications for the gating strategy of the basophil

Alexandra F Santos1, Natalia Bécares2, Alick Stephens2

  • 1Division of Asthma, Allergy and Lung Biology, Department of Pediatric Allergy, St Thomas' Hospital, King's College London, 2nd Floor, Stairwell B, South Wing, Westminster Bridge Road, London, SE1 7EH UK ; MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK ; Immunoallergology Department, Coimbra University Hospital, Coimbra, Portugal ; Gulbenkian Programme for Advanced Medical Education, Lisbon, Portugal.

Clinical and Translational Allergy
|April 5, 2016
PubMed
Summary
This summary is machine-generated.

The basophil activation test (BAT) can be improved by using CD203c as a marker. This ensures accurate identification of basophils and enhances diagnostic accuracy for allergic reactions.

Keywords:
Basophil activation testCD123CD203cCD63IL-3Peanut allergy

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Area of Science:

  • Immunology
  • Allergy Diagnostics

Background:

  • The basophil activation test (BAT) is a diagnostic tool for IgE-mediated allergic reactions.
  • Identifying basophils using markers like CD123 and HLA-DR impacts test outcomes.
  • Changes in CD123 and HLA-DR expression during basophil activation require investigation for optimal gating strategies.

Purpose of the Study:

  • To assess changes in CD123 and HLA-DR expression during basophil activation.
  • To determine the optimal gating strategy for the basophil activation test (BAT).
  • To evaluate the diagnostic accuracy of different gating strategies.

Main Methods:

  • Basophil activation tests (BAT) were performed on 116 children's whole blood samples.
  • Stimulation was induced using peanut extract, anti-IgE, anti-FcεRI, or fMLP.
  • Flow cytometry was used to evaluate surface expression of CD123, HLA-DR, CD63, and CD203c.

Main Results:

  • Basophils can down-regulate CD123 expression upon activation, particularly with fMLP, anti-IgE, and peanut extract.
  • CD123 expression decrease correlated with increased CD63 and CD203c levels.
  • Gating on CD203c+/CD123+/HLA-DR- improved diagnostic accuracy (97%) and reduced false-negatives compared to CD123+/HLA-DR- (91%) in peanut allergy testing.

Conclusions:

  • Basophil CD123 expression can decrease during activation, necessitating alternative identification markers.
  • Using CD203c for gating, either in conjunction with or instead of CD123/HLA-DR, ensures complete basophil population identification.
  • This refined gating strategy improves the accuracy of basophil activation testing for allergy diagnosis.