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Basophil Activation Test for Allergy Diagnosis
Published on: May 31, 2021
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Optimizing tools for evaluating challenge outcomes in children with cashew nut allergy
Petteri Röntynen1, Kaarina Kukkonen2, Terhi Savinko1
1Skin and Allergy Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Summary
Accurate cashew nut allergy diagnosis in children is crucial. Ana o 3 immunoglobulin E (IgE) shows promise, while basophil activation tests (BAT) may predict reaction severity, with age-specific cutoffs needed for both.
Area of Science:
- Allergy and Immunology
- Pediatric Allergy
- Diagnostic Testing
Background:
- Increasing incidence of cashew nut anaphylaxis necessitates improved diagnostic methods.
- Lack of age-specific diagnostic cutoffs for cashew nut allergy in children.
- Limited data on serum tryptase level changes in pediatric food allergy.
Purpose of the Study:
- Evaluate diagnostic accuracy of various tests for cashew nut allergy.
- Assess the ability of tests to predict cashew nut allergy reaction severity.
- Investigate serum tryptase level changes and their correlation with reaction severity.
Main Methods:
- Open cashew nut challenge in 106 children (aged 1-16 years).
- Analysis of specific immunoglobulin E (IgE) to Ana o 3 and cashew nut, skin prick tests, and basophil activation tests (BAT).
- Measurement of serum tryptase levels at baseline and during allergic reactions.
Main Results:
- Ana o 3 IgE demonstrated the highest diagnostic accuracy (94.1% specificity, 61.1% sensitivity) at a 0.97 kU/L cutoff.
- Basophil activation test (BAT) values predicted reaction severity (91.7% specificity, 60.7% sensitivity) with age-specific cutoffs.
- Serum tryptase levels significantly increased 1-2 hours post-symptom onset.
Conclusions:
- Ana o 3 IgE is the most effective single diagnostic test for pediatric cashew nut allergy.
- Test combinations did not enhance diagnostic accuracy; age-specific cutoffs are essential.
- Basophil activation tests (BAT) show potential for predicting reaction severity, and tryptase levels should be measured 1-2 hours after symptom initiation.
