Comparison of two basophil activation markers CD63 and CD203c in the diagnosis of amoxicillin allergy
Comparison of two basophil activation markers CD63 and CD203c in the diagnosis of amoxicillin allergy
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DOI：
10.1111/j.1365-2222.2008.02960.x
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发表时间：
2008-06-01
影响因子：
6.1
通讯作者：
Girot, R.
中科院分区：
文献类型：
--
作者：
Abuaf, N.;Rostane, H.;Girot, R.
背景 为了确认对 β-内酰胺 (BL) 过敏，描述了基于 CD63 上调的流式细胞术中的嗜碱性粒细胞活化测试。 CD203c 是一种较新的嗜碱性粒细胞激活标记物，迄今为止，对于哪种标记物更敏感尚未达成共识。 CD203c 尚未在 BL 过敏的诊断中得到评估。 目的 本研究的目的是比较 CD203c 与 CD63 诊断阿莫西林 (AX) 过敏的可靠性，阿莫西林 (AX) 过敏是当今最常见的 BL 过敏。 方法 27 例 AX 皮试 (ST) 立即呈阳性的患者，20 例患有 AX 过敏，7 例患有荨麻疹和/或血管性水肿，与 14 名对 BL 无过敏的对照组和 6 名 AX 延迟 ST 阳性患者进行比较。结果 在过敏反应组中，AX 诱导 20 名患者中 12 名患者的嗜碱性粒细胞 CD203c 上调 (60%)，以及 4 名患者 (20%) 中的 CD63 上调 (P < 0.02)。七名荨麻疹或血管性水肿患者中有两名 CD203c 和 CD63 呈阳性。在患有过敏反应的患者中，氨苄西林 (AMP) 在 12 名接受测试的患者中，有 8 名 (67%) 诱导 CD203c 上调，在 12 名接受测试的患者中，有 4 名 (33%) 诱导 CD63 上调（所有有过敏反应的患者都不能用 AMP 进行测试）。 CD203c 和 CD63 观察到假阳性结果，并且对于 10 名患者，确实通过阴性药物激发试验证实了这一点。 CD63 和 CD203c 之间矛盾结果的根源可能至少是基于抗 IgE 标记的嗜碱性粒细胞靶向。在 IgE(+) 门控细胞中，通过单核细胞标记 CD33 检测到单核细胞污染高达 50%。与 CD63 相比，CD203c 是嗜碱性粒细胞特异性的激活标记物，在静息嗜碱性粒细胞中具有基础低水平表达。因此，IgE和CD203c双重靶向嗜碱性粒细胞，避免了单核细胞的污染。结论CD203c似乎是比CD63更敏感的嗜碱性粒细胞激活标志物，用于诊断阿莫西林过敏。
Background To confirm allergy to beta-lactam (BL), a basophil activation test in flow cytometry based on CD63 up-regulation was described. CD203c is a more recent basophil activation marker and up to day there is no consensus about which marker is the more sensitive one. CD203c has not yet been evaluated in the diagnosis of BL allergy.Objective The aim of the study was to compare the reliability of CD203c to CD63 for the diagnosis of amoxicillin (AX) allergy, which is nowadays the most frequent BL allergy.Methods Twenty-seven patients with an immediate positive skin test (ST) to AX, 20 had had anaphylaxis with AX and 7 had urticaria and/or angioedema, were compared with 14 controls with no allergy to BL and to six patients with delayed positive ST to AX.Results In the anaphylaxis group, AX induced up-regulation of CD203c in the basophils of 12 patients out of 20 (60%) and of CD63 in four patients (20%) (P < 0.02). Two patients out of seven with urticaria or angioedema had a positive result with CD203c and CD63. In patients who had anaphylaxis, ampicillin (AMP) induced CD203c up-regulation in eight out of 12 (67%) patients tested, and CD63 up-regulation in 4 out of 12 (33%) (all patients who had anaphylaxis could not be tested with AMP). False-positive results were observed with CD203c as well as CD63, and for 10 patients indeed this was confirmed by a negative drug provocation test. The origin of conflicting results between CD63 and CD203c might be at least the targeting of basophils based on anti-IgE labelling. Among IgE(+) gated cells, by means of CD33, a marker of monocytes, a contamination up to 50% by monocytes was detected. In contrast to CD63, CD203c is an activation marker specific of basophils with a basal low-level expression in resting basophils. Thus, IgE and CD203c double targeting of basophils avoids the contamination by monocytes.Conclusion CD203c seems to be a more sensitive activation marker of basophils than CD63 for the diagnosis of amoxicillin allergy.