The basophil activation test differentiates between patients with wheat-dependent exercise-induced anaphylaxis and control subjects using gluten and isolated gluten protein types.
The basophil activation test differentiates between patients with wheat-dependent exercise-induced anaphylaxis and control subjects using gluten and isolated gluten protein types.
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DOI：
10.1002/clt2.12050
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发表时间：
2021-08
影响因子：
4.4
通讯作者：
Brockow K
中科院分区：
文献类型：
--
作者：
Gabler AM;Gebhard J;Eberlein B;Biedermann T;Scherf KA;Brockow K
使用谷蛋白和辅助因子进行口服食物刺激是诊断小麦依赖性运动诱发过敏性反应（WDEIA）的金标准，但这种方法会使患者面临过敏反应的风险。ω - 5‐麦胶蛋白作为主要过敏原的特异性IgE和小麦的皮肤点刺试验可能产生阴性结果。因此，我们设计了一项原理验证研究来研究嗜碱性粒细胞激活试验（BAT）在WDEIA诊断中的应用。采用不同的谷蛋白类型（α‐，γ‐，ω1， ω 2‐和ω5‐麦胶蛋白，高分子量谷蛋白亚基[HMW‐GS]和低分子量谷蛋白亚基[LMW‐GS]）和谷蛋白在不同浓度下测量了12例WDEIA患者和10例对照组的嗜碱性粒细胞活化。将结果与常规过敏诊断进行比较。分析的参数包括CD63+嗜碱性粒细胞百分比、GPT/谷蛋白诱导的%CD63+嗜碱性粒细胞与抗fc - ε ri抗体诱导的%CD63+嗜碱性粒细胞的比例、剂量-反应曲线下面积以及试验的敏感性和特异性。GPT和谷蛋白在患者中以剂量依赖的方式诱导了%CD63+和%CD63+/anti - Fc / RI比的强碱性粒细胞活化，但在对照组中没有（分别p < 0.001）。根据接收器工作特性曲线下面积评估的特定GPT， BAT性能从可接受（LMW‐GS为0.73）到优异（ω5‐麦胶蛋白为0.91）不等。患者表现出个体致敏性。在确定最佳截断点后，ω5‐麦胶蛋白和HMW‐GS在患者和对照组之间表现出最佳的区分能力，其灵敏度/特异性分别为100/70和75/100。本研究显示了BAT在更好地定义WDEIA和小麦致敏原方面的替代作用。区分WDEIA患者与对照组的最佳BAT参数是ω - 5 -麦胶蛋白和HMW - GS的%CD63+嗜碱性粒细胞值。
Oral food challenge using gluten and cofactors is the gold standard to diagnose wheat‐dependent exercise‐induced anaphylaxis (WDEIA), but this procedure puts patients at risk of an anaphylactic reaction. Specific IgE to ω5‐gliadins as major allergens and skin prick tests to wheat may yield negative results. Thus, we designed a proof‐of‐principle study to investigate the utility of the basophil activation test (BAT) for WDEIA diagnosis. Different gluten protein types (GPT; α‐, γ‐, ω1,2‐ and ω5‐gliadins, high‐molecular‐weight glutenin subunits [HMW‐GS] and low‐molecular‐weight glutenin subunits [LMW‐GS]) and gluten were used in different concentrations to measure basophil activation in 12 challenge‐confirmed WDEIA patients and 10 control subjects. The results were compared to routine allergy diagnostics. Parameters analyzed include the percentage of CD63+ basophils, the ratio of %CD63+ basophils induced by GPT/gluten to %CD63+ basophils induced by anti‐FcεRI antibody, area under the dose‐response curve and test sensitivity and specificity. GPT and gluten induced strong basophil activation for %CD63+ basophils and for %CD63+/anti‐FcɛRI ratio in a dose‐dependent manner in patients, but not in controls (p < 0.001, respectively). BAT performance differed from acceptable (0.73 for LMW‐GS) to excellent (0.91 for ω5‐gliadins) depending on the specific GPT as evaluated by the area under the receiver operating characteristic curve. Patients showed individual sensitization profiles. After determination of the best cut‐off points, ω5‐gliadins and HMW‐GS showed the best discrimination between patients and controls with a sensitivity/specificity of 100/70 and 75/100, respectively. This study shows the alternative role of BAT in better defining WDEIA and the causative wheat allergens. The best BAT parameters to distinguish WDEIA patients from controls were %CD63+ basophil values for ω5‐gliadins and HMW‐GS.
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影响因子：
5.6
作者：
Lexhaller, Barbara;Colgrave, Michelle L.;Scherf, Katharina A.
通讯作者：
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影响因子：
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Ring, Johannes