Basophil Activation Test Utility as a Diagnostic Tool in LTP Allergy

Area of Science:

• Immunology
• Allergology
• Clinical Diagnostics

Background:

• Plant-food allergy is rising, with nonspecific lipid transfer proteins (nsLTPs) causing reactions.
• Pru p 3 is a key sensitizer in nsLTP food allergy, but diagnosing clinical relevance is challenging.
• Basophil activation test (BAT) is an ex vivo method to detect allergy-specific IgE.

Purpose of the Study:

• To evaluate the diagnostic value of BAT for identifying nsLTP-allergic patients.
• To differentiate between asymptomatic sensitization and clinically relevant nsLTP allergy.
• To assess BAT's ability to distinguish peanut tolerance in nsLTP-allergic individuals.

Main Methods:

• Ninety-two nsLTP-allergic patients (Pru p 3) and 16 healthy controls were studied.
• BAT was performed using Pru p 3 and Ara h 9 (peanut nsLTP) at various concentrations.
• Flow cytometry measured CD63 and CD203c expression, CD-Sens, and AUC.

Main Results:

• BAT showed significant differences in activation markers (%CD63+, %CD203chigh) between patients and controls.
• BAT parameters did not differentiate symptom severity among nsLTP-allergic patients.
• ROC analysis established cut-offs with high sensitivity (>87.5%) and specificity (>85%) for BAT.

Conclusions:

• BAT is a valuable tool for diagnosing nsLTP allergy and identifying peanut tolerance.
• BAT can distinguish nsLTP allergy from tolerance but not symptom severity.
• Further research may refine BAT's role in managing nsLTP food allergies.