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Basophil Activation Test for Allergy Diagnosis
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Two Different Composite Markers Predict Severity and Threshold Dose in Peanut Allergy.

Nathalie Cottel1, Sarah Saf1, Melisande Bourgoin-Heck2

  • 1Allergology Department, Hôpital A. Trousseau, Sorbonne Université, AP-HP, Paris, France.

The Journal of Allergy and Clinical Immunology. in Practice
|October 10, 2020
PubMed
Summary

Researchers identified biological markers to assess peanut allergy (PA) severity during oral food challenges (OFCs). Specific IgE and basophil activation tests can predict severe reactions and threshold doses in children with PA.

Keywords:
Basophil activation testFcεRI-positive controlOral food challengePeanut allergy

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Area of Science:

  • Allergy and Immunology
  • Pediatric Clinical Research
  • Diagnostic Biomarker Development

Background:

  • Lack of reliable biological markers for evaluating peanut allergy (PA) severity and threshold doses during oral food challenges (OFCs).
  • Need for cost-effective and safe surrogate markers to predict allergic reaction intensity.

Purpose of the Study:

  • To identify and evaluate biological markers correlating with allergic reaction severity and threshold dose in children undergoing peanut OFC.
  • To assess the diagnostic accuracy of these markers in a pediatric PA population.

Main Methods:

  • Collected demographic and biological data from children undergoing peanut OFC, including basophil activation test (BAT) results.
  • Stratified patients into severity groups (mild-to-moderate vs. severe) and cumulative threshold dose groups (low ≤100 mg vs. high >100 mg).
  • Analyzed correlations between markers like Ara h 2-specific IgE, FcεRI, and fMLP-positive controls with reaction severity and threshold dose.

Main Results:

  • High concordance (96%) between OFC and BAT for PA diagnosis.
  • Higher Ara h 2-specific IgE and FcεRI-positive control values correlated with severe peanut allergic reactions.
  • A 2-marker combination (IgE, FcεRI) showed 92% sensitivity and 82% specificity for severe reactions.
  • A 4-variable composite marker demonstrated 97% sensitivity and 61% specificity for low cumulative threshold dose in children.

Conclusions:

  • Composite markers, incorporating both allergen-specific and non-allergen-specific basophil activation test parameters, are associated with peanut allergy severity and threshold dose in children.
  • These findings suggest potential for improved prediction of reaction severity and dose thresholds in pediatric PA.