Flow-assisted quantification of in vitro activated basophils in the diagnosis of wasp venom allergy and follow-up of wasp venom immunotherapy
Flow-assisted quantification of in vitro activated basophils in the diagnosis of wasp venom allergy and follow-up of wasp venom immunotherapy
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DOI：
10.1002/cyto.b.20142
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发表时间：
2007-05-01
影响因子：
3.4
通讯作者：
Stevens, W. J.
中科院分区：
文献类型：
--
作者：
Ebo, D. G.;Hagendorens, M. M.;Stevens, W. J.
背景：正确识别罪犯毒液是特异性毒液免疫治疗（VIT）的先决条件。尽管VIT的疗效，如何监测治疗和何时停止维持治疗的问题仍然有待建立。方法：评估嗜碱性粒细胞活化试验（BAT）在黄蜂毒液过敏的诊断性能，80例患者有明确的历史黄蜂毒液过敏反应（全身反应）和14黄蜂蜇无症状对照（蜇对照）。通过抗IgE和抗CD 63双标记，采用流式细胞术分析毒液诱导的嗜碱性粒细胞活化。结果进行了比较，黄蜂IgE水平和毒液皮肤试验（VST）的结果。为了确定BAT是否构成监测VIT的候选标志物，在22名患者中，在建立过程的第5天和维持VIT 6个月后重复BAT。BAT是否可以有助于在一个横断面分析中的30例患者接受治疗3 years.Results：比较全身反应者和刺痛对照组的决定，停止VIT进行了评估，发现的敏感性为86.4%和特异性为100%的毒液IgE，敏感性为81.8%的VST，分别。与被蜇对照相比，患者表现出剂量依赖性毒液诱导的嗜碱性粒细胞活化。BAT的敏感性为83.8%，特异性为100%。在积累课程结束时，没有证明VIT对最佳可得技术的影响。6个月后重复BAT时，亚最大刺激细胞显示CD 63表达显著降低（P < 0.04）。VIT 3年的患者也表现出明显较低的毒液诱导的CD63表达（P < 0.001）。3年后，60%的患者有一个阴性的BAT的次最大刺激的细胞，而只有17.9%的患者有阴性的黄蜂IgE。结论：BAT是一个可靠的工具，用于诊断黄蜂毒液过敏反应，并可能构成一个仪器，以监测黄蜂VIT。(c)2006年国际分析细胞学学会。
Background: Correct identification of the culprit venom is a prerequisite for specific venom immunotherapy (VIT). Despite the efficacy of VIT, issues as how to monitor treatment and when to discontinue maintenance therapy remain to be established.Methods: To evaluate diagnostic performances of the basophil activation test (BAT) in wasp venom allergy, 80 patients with a definite history of wasp venom anaphylaxis (systemic reactors) and 14 wasp-stung asymptomatic controls (stung controls) were enrolled. Venom-induced basophil activation was analyzed flow cytometrically by double-labeling with anti-IgE and anti-CD63. Results were compared to wasp IgE levels and results of a venom skin test (VST). To establish whether the BAT constitutes a candidate marker to monitor VIT, the BAT was repeated in 22 patients on the 5th day of a build-up course and after 6 months of maintenance VIT. Whether the BAT could contribute in the decision of discontinuing VIT was assessed in a cross-sectional analysis in 30 patients receiving treatment for 3 years.Results: Comparison between systemic reactors and stung controls revealed a sensitivity of 86.4% and specificity of 100% for venom IgE, and sensitivity of 81.8% for VST, respectively. In contrast to stung controls, patients demonstrated dose-dependent venom-induced basophil activation. The BAT attained a sensitivity of 83.8% and specificity of 100%. At the end of the build-up course, no effect of VIT on the BAT was demonstrable. When the BAT was repeated after 6 months of treatment, submaximal stimulation of the cells demonstrated a significant decreased CD63 expression (P < 0.04). Patients having VIT for 3 years also demonstrated significantly lower venom-induced CD63 expression (P < 0.001). After 3 years, 60% of the patients had a negative BAT for submaximal stimulation of the cells whereas only 17.9% of the patients had negativation of wasp IgE.Conclusions: The BAT is a reliable instrument for the diagnosis of wasp venom anaphylaxis and might constitute an instrument to monitor wasp VIT. (c) 2006 International Society for Analytical Cytology.