Flow-based basophil activation test in immediate drug hypersensitivity. An EAACI task force position paper

Area of Science:

• Allergy and Clinical Immunology
• In Vitro Diagnostics

Background:

• Diagnosing immediate drug hypersensitivity reactions (IDHRs) is challenging, necessitating safe and reliable tests.
• The basophil activation test (BAT), an in vitro assay, shows potential as a complementary diagnostic tool for various drugs.

Purpose of the Study:

• To present survey data on the use and utility of BAT for IDHRs in Europe.
• To formulate consensus-based recommendations for BAT in IDHR diagnosis.
• To address technical and drug-specific aspects, including pediatric considerations.

Main Methods:

• A survey was conducted among European experts on BAT usage for IDHRs.
• Consensus-based recommendations were developed based on survey data and expert opinion.
• The recommendations cover technical aspects, drug-specific considerations, and pediatric evaluations.

Main Results:

• Survey results indicate significant interest in using BAT for IDHR diagnosis.
• Key needs identified include the standardization of BAT protocols.
• Recommendations cover sample handling, drug management, flow cytometry, result interpretation, and specific drug classes.

Conclusions:

• BAT offers a valuable complementary tool for safe IDHR diagnosis.
• Standardization of BAT protocols is essential for broader clinical application.
• The utility of BAT depends on drug class, patient factors, and geographic location.