Mast cell activation tests by flow cytometry: A new diagnostic asset?

Area of Science:

• Immunology
• Allergy Diagnostics
• Cellular Biology

Background:

• Flow-assisted basophil activation test (BAT) shows promise for allergy diagnosis but has limitations.
• Current diagnostic methods for IgE-dependent allergies and autoimmune urticaria require improvement.
• Mast cells play a crucial role in allergic reactions and hypersensitivity.

Purpose of the Study:

• To review the status of flow cytometric mast cell activation test (MAT) for diagnosing IgE-dependent allergies.
• To provide guidance on generating and analyzing human mast cells for diagnostic purposes.
• To explore the potential of direct mast cell activation (dMAT) in immediate drug hypersensitivity reactions (IDHRs).

Main Methods:

• Review of existing literature on flow cytometric basophil and mast cell activation tests.
• Detailed explanation of passive MAT (pMAT) using cell lines and cultured mast cells.
• Guidance on generating human mast cells from CD34+ progenitor cells (PBCMCs).

Main Results:

• Passive MAT (pMAT) using flow cytometry is a viable diagnostic tool for IgE-dependent allergies.
• Standardized protocols for generating and analyzing mast cells are crucial for reliable diagnostics.
• Direct MAT (dMAT) targeting MRGPRX2 presents a novel approach for IDHRs.

Conclusions:

• Flow cytometric MAT, particularly pMAT, offers advantages over traditional methods for allergy diagnosis.
• Standardized generation and analysis of human mast cells are essential for clinical application.
• Direct MAT (dMAT) holds potential for diagnosing a novel endotype of immediate drug hypersensitivity reactions.