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Basophil Activation Test for Allergy Diagnosis
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Recent developments and highlights in food allergy.

Thomas Eiwegger1,2,3, Lisa Hung1,2, Kristen Ericka San Diego1

  • 1Translational Medicine Program, Research Institute, Hospital for Sick Children, Toronto, ON, Canada.

Allergy
|October 9, 2019
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Understanding food allergy immunology is key for effective treatments. Advanced diagnostics and cellular tests improve accuracy, guiding personalized therapies for better outcomes.

Keywords:
allergy treatmentbiologicsfood allergyimmune toleranceimmunotherapy

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Area of Science:

  • Immunology of food allergy
  • Diagnostic advancements in allergy testing
  • Food immunotherapy research

Background:

  • Long-lasting, safe food allergy treatments rely on understanding its immunological basis.
  • Accurate diagnosis is crucial for effective food allergy management.
  • Current allergy tests, particularly for tree nuts, show limitations in predicting clinical allergy.

Purpose of the Study:

  • To explore advanced diagnostic methods for more accurate food allergy prediction.
  • To investigate cellular and clinical markers for understanding treatment success predictors.
  • To review current research on food immunotherapy mechanisms and potential biologic interventions.

Main Methods:

  • Analysis of oral food challenge data to assess routine allergy test efficacy.
  • Evaluation of advanced antigen-based tests (component-resolved diagnostics, epitope reactivity).
  • Assessment of cellular tests (basophil activation, mast cell approaches) in clinical trials.
  • Utilizing mouse models to study food allergy mechanisms (epithelial metabolism, regulatory cells, microbiome).
  • Examining immunological markers and clinical determinants in children undergoing food immunotherapy.

Main Results:

  • Advanced diagnostics and cellular tests show promise for improved diagnostic accuracy.
  • Specific T-cell and B-cell populations identified in food-allergic individuals.
  • Clinical markers like tolerance to baked milk/egg inform natural tolerance development.
  • Mouse models provide insights into allergy mechanisms.
  • Lower age and specific IgE levels are potential predictors of successful immunotherapy.

Conclusions:

  • Enhanced diagnostic approaches are needed to improve food allergy management.
  • Further research is required to optimize food immunotherapy (dose, preparation, route).
  • Biologics targeting specific cytokines (TSLP, IL-33, IL-4, IL-13) or IgE offer alternative therapeutic strategies.