Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1
5-Year Impact Factor – 2.2
Scopus CiteScore – 3.4 (CiteScore Tracker 3.6)
Index Copernicus  – 161.11; MNiSW – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2018, vol. 27, nr 12, December, p. 1737–1744

doi: 10.17219/acem/78563

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

The diagnostic usefulness of the basophil activation test (BAT) with annexin V in an allergy to Alternaria alternata

Emilia Królewicz1,B,C,D, Krzysztof Gomułka2,B, Anna Wolańczyk-Mędrala2,B, Wojciech Mędrala2,A,C, Wojciech Barg3,B, Irena Kustrzeba-Wójcicka1,E,F

1 Department of Medical Biochemistry, Wroclaw Medical University, Poland

2 Department of Internal Diseases and Allergology, Wroclaw Medical University, Poland

3 Department of Physiology, Wroclaw Medical University, Poland

Abstract

Background. The basophil activation test (BAT) is an effective diagnostic tool in mold allergy, which is still not sufficiently known.
Objectives. The aim of our study was to assess the degree of annexin V binding to the surface of the basophil cell membrane after stimulation with anti-immunoglobulin E (anti-IgE) and Alternaria alternata allergenic extract.
Material and Methods. Alternaria alternata allergic patients (n = 32) and healthy volunteers (n = 33) were evaluated using skin prick tests (SPT), quantification of specific IgE (sIgE) and the BAT. Basophil activation was detected as a percentage degree of annexin V binding to the surface of the basophil cell membrane.
Results. Receiver operating characteristic (ROC) curve analysis yielded a threshold value of 4.95% of activated basophils when the tested group and control group were studied, with a sensitivity and specificity of 100% (area under curve [AUC] = 1; p = 0.00000) for 100 SBU/mL Alternaria alternata allergen extract. The threshold value was 10.28% with a sensitivity of 93.8% and specificity of 100% (AUC = 0.98958; p = 0.00000) for 10 SBU/mL mold extract, and 9.37% with a sensitivity of 90.3% and specificity of 100% (AUC = 0.96307; p = 0.00000) for 1 SBU/mL Alternaria alternata allergen extract. The method was least efficacious in antiIgE stimulation, where the threshold value was 5.48% with a sensitivity of 90.6% and specificity of 30.3% (AUC = 0.46780; p = 0.67039).
Conclusion. The BAT with annexin V and sIgE measurement against Alternaria alternata increase the capability of a diagnostic laboratory for detecting mold sensitization. Both methods may certainly replace SPT, which are currently routinely used in allergy diagnosis. Annexin V may be considered a new basophil activation marker with an efficacy comparable to that of CD63 or CD203c.

Key words

Alternaria alternata allergy, basophil activation test, specific immunoglobulins E, flow cytometry, receiver operating characteristic curve

References (26)

  1. Sainte-Laudy J, Vallon C, Guérin JC. Analysis of membrane expression of the CD63 human basophil activation marker. Applications to allergologic diagnosis [in French]. Allerg Immunol (Paris). 1994;26(6):211–214.
  2. Netchiporouk E, Moreau L, Rahme E, Maurer M, Lejtenyi D, Ben-Shoshan M. Positive CD63 basophil activation tests are common in children with chronic spontaneous urticaria and linked to high disease activity. Int Arch Allergy Immunol. 2016;171(2):81–88.
  3. Masilamani M, Kamalakannan M, Sampson HA. Basophil degranulation assay. Methods Mol Biol. 2017;1592:139–146.
  4. Leśniak M, Czarnobilska E. Usefulness of basophil activation test for the diagnosis of inhaled allergies [in Polish]. Przegl Lek. 2015;72(12):773–778.
  5. An S, Shen C, Liu X, et al. Alpha-actinin is a new type of house dust mite allergen. PloS ONE. 2013;8(12):e81377.
  6. Korošec P, Silar M, Kopač P, Eržen R, Zidarn M, Košnik M. Distinct contributory factors determine basophil-allergen sensitivity in grass pollen rhinitis and in anaphylactic wasp venom allergy. Int Arch Allergy Immunol. 2016;171(2):89–101.
  7. Wolańczyk-Mędrala A, Gogolewski G, Liebhart J, et al. A new variant of the basophil activation test for allergen-induced basophil CD63 upregulation. The effect of cetirizine. J Investig Allergol Clin Immunol. 2009;19(6):465–473.
  8. Crockard AD, Ennis M. Laboratory-based allergy diagnosis: Should we go with the flow? Clin Exp Allergy. 2001;31(7):975–977.
  9. Ocmant A, Peignois Y, Mulier S, Hanssens L, Michilis A, Schandené L. Flow cytometry for basophil activation markers: The measurement of CD203c up-regulation is as reliable as CD63 expression in the diagnosis of cat allergy. J Immunol Methods. 2007;320(1–2):40–48.
  10. Herzinger T, Scharrer E, Placzek M, Przybilla B. Contact urticaria to giraffe hair. Int Arch Allergy Immunol. 2005;138(4):324–327.
  11. Bidad K, Navijn MC, van Oosterhout AJ, van der Heide S, Elberink JN. Basophil activation test in the diagnosis and monitoring of mastocytosis patients with wasp venom allergy on immunotherapy. Cytometry B Clin Cytom. 2014;86(3):183–190.
  12. Eberlein-König B, Rakoski J, Behrendt H, Ring J. Use of CD63 expression as marker of in vitro basophil activation in identifying the culprit in insect venom allergy. J Investig Allergol Clin Immunol. 2004;14(1):10–16.
  13. Ariza A, Fernandez TD, Doña I, et al. Basophil activation after nonsteroidal anti-inflammatory drugs stimulation in patients with immediate hypersensitivity reactions to these drugs. Cytometry A. 2014;85(5): 400–407.
  14. Sudheer PS, Hall JE, Read GF, Rowbottom AW, Williams PE. Flow cytometric investigation of per-anaesthetic anaphylaxis using CD63 and CD203c. Anaesthesia. 2005;60:251–256.
  15. Harada N, Hiragun M, Mizuno M, et al. A case of erythritol allergy studied by basophil histamine release and CD203c expression in vitro in addition to a challenge test in vivo. J Investig Allergol Clin Immunol. 2016;26(2):135–136.
  16. De Weck A, Sanz ML, Gamboa PM, et al. Diagnostic tests based on human basophils: More potentials and perspectives than pitfalls. II. Technical issues. J Investig Allergol Clin Immunol. 2008;18(3):143–155.
  17. Boumiza R, Debard AL, Monneret G. The basophil activation test by flow cytometry: Recent developments in clinical studies, standardization and emerging perspectives. Clin Mol Allergy. 2005;3:9.
  18. Wolańczyk-Mędrala A, Barg W, Mędrala W. CD 164 as a basophil activation marker. Curr Pharm Des. 2011;17(34):3786–3796.
  19. Hennersdorf F, Florian S, Jakob A, et al. Identification of CD13, CD107a, and CD164 as novel basophil-activation markers and dissection of two response patterns in time kinetics of IgE-dependent upregulation. Cell Res. 2005;15(5):325–335.
  20. Kustrzeba-Wójcicka I, Siwak E, Terlecki G, Wolańczyk-Mędrala A, Mędrala W. Alternaria alternata and its allergens: A comprehensive review. Clin Rev Allergy Immunol. 2014;47(3):354–365.
  21. Sainte-Laudy J, Ouk C. Use of lipid rafting for the analysis of human basophil activation by flow cytometry. Inflamm Res. 2010;59(Suppl 2):S193–S195.
  22. Pencina MJ, D’Agostino RB Sr, D’Agostino RB Jr, Vasan RS. Evaluating the added predictive ability of a new marker: From area under the ROC curve to reclassification and beyond. Stat Med. 2008;27(2):157–172.
  23. Kleine-Tebbe J, Erdmann S, Knol EF, MacGlashan DW, Poulsen LK, Gibbs BF. Diagnostic tests based on human basophils: Potentials, pitfalls and perspectives. Int Arch Allergy Immunol. 2006,141(1):79–90.
  24. Mirković B, Lavelle GM, Azim AA, et al. The basophil surface marker CD203c identifies Aspergillus species sensitization in patients with cystic fibrosis. J Allergy Clin Immunol. 2016;137(2):436–443.
  25. Sanz ML, Sánchez G, Gamboa PM, et al. Allergen-induced basophil activation: CD63 cell expression detected by flow cytometry in patients allergic to Dermatophagoides pteronyssinus and Lolium perenne. Clin Exp Allergy. 2001;31(7):1007–1013.
  26. González-Muñoz M, Villota J, Moneo I. Analysis of basophil activation by flow cytometry in pediatric house dust mite allergy. Pediatr Allergy Immunol. 2008;19(4):342–347.