Basophil activation test in IgE-mediated food allergy : should we follow the flow?
Faculty of Medicine and Health Sciences
Current treatment options in allergy
, p. 1-11
University of Antwerp
IgE-mediated food allergy constitutes an important and increasing health issue with significant impairment of quality of life and significant morbidity and mortality. It affects children, as well as adolescents, and adults. Correct diagnosis of food allergy relies upon history supplemented by quantification of specific IgE (sIgE) antibodies and/or skin tests. Unfortunately, as these tests do not demonstrate absolute predictive values, controlled oral provocation tests might be needed to confirm/exclude diagnosis. However, it is unlikely oral challenges to enter mainstream application, mainly because of obvious ethical reasons. Therefore, correct diagnosis of food allergy might benefit from novel in vitro diagnostics such as allergen component-based sIgE assays and flow cytometric quantification of in vitro activated basophils. As a matter of fact, these tests might prove to be particularly helpful in discriminating genuine allergy from merely sensitization. Furthermore, they might be useful in establishing individual risk profiles, predicting persistence of allergy, and facilitating therapeutic approach. This review focuses on the applications and limitations of the basophil activation test in IgE-mediated food allergy. Anno 2016 we believe that the utility and usefulness of basophil-activation experiments need to be reevaluated thoroughly, in view of difficulties inherent to the correct preparation and storage of allergen extracts, optimizing and standardizing stimulation conditions, and also the potential of alternative diagnostics such as component resolved diagnosis that are becoming more readily accessible.