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Document Details : Title: The basophil activation test in immediate drug allergy Author(s): EBO DG, HAGENDORENS MM, BRIDTS CH, DE CLERCK LS, STEVENS WJ Journal: Acta Clinica Belgica Volume: 64 Issue: 2 Date: 2009 Pages: 129-135 DOI: 10.2143/ACB.64.2.1002476 Abstract : Diagnosis of drug allergy is not always straightforward for several reasons. First, a broad spectrum of drugs can elicit various immune-mediated diseases with distinct pathomechanism, secondly, although exact epitope identification is not mandatory for clinical diagnosis, the epitope that causes the reaction is frequently unknown, thirdly in vitro or in vivo test results might not be predictive of a clinical situation, and finally the gold standard or reference test for diagnosis, the drug challenge, is a complicated and sometimes dangerous endeavour. Upon challenge with specific allergens that cross-link membrane-bound IgE antibodies, basophils upregulate the expression of different activation markers such as CD63 and CD203c. These immunophenotypic alterations can be detected on a single-cell basis by multicolour flow cytometry using specific monoclonal antibodies in the basophil activation test (BAT). This review intends to summarise our current experience with the BAT in the diagnosticmanagement of immediate-type allergy to drugs and related compounds that are generally (but not always) mediated by drug-specific IgE antibodies. |
