TY - JOUR
T1 - Basophil activation test in children with autoimmune chronic spontaneous urticaria
T2 - Is it ready for clinical practice?
AU - D'Auria, Enza
AU - De Amici, Mara
AU - Licari, Amelia
AU - Caimmi, Silvia
AU - Mantegazza, Cecilia
AU - Zuccotti, Gian Vincenzo
AU - Marseglia, Gianluigi
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Introduction: Chronic spontaneous urticaria (CSU) is characterized by recurrent itchy wheals, angioedema or both, that persist for longer than six weeks. In children, up to 40% of chronic spontaneous urticaria is due to mast cells and basophils-activating autoantibodies, mostly directed against the IgE high-affinity receptor subunit (FcεRI). Indirect basophil activation test (BAT) has been proposed in the diagnosis of autoimmune urticaria. Materials and methods: Sera from sixteen patients, aged from 2 to 15 yrs, with CSU were evaluated through indirect BAT by flow cytometry using a commercial kit (Flow CAST®, BUHLMANN Laboratories, Schonenbuch, Switzerland) according to the manufacturer's instructions. Results: Indirect BAT test gave a much better diagnosis in our cohort than the gold standard ASST. Six children (37.5%) showed a positive indirect BAT while we could perform ASST in only 3 patients with just one patients showing a positive ASST. The specificity of BAT positive results was confirmed by the absence of significant difference between the BAT results obtained from negative controls vs negative sera of the patient (p = 0.65) on the basophil donors, indicating that the serum is not activating basophil per se. Conclusions: This pilot study suggests the utility of BAT to identify the subtype of autoimmune CSU in children in clinical practice.
AB - Introduction: Chronic spontaneous urticaria (CSU) is characterized by recurrent itchy wheals, angioedema or both, that persist for longer than six weeks. In children, up to 40% of chronic spontaneous urticaria is due to mast cells and basophils-activating autoantibodies, mostly directed against the IgE high-affinity receptor subunit (FcεRI). Indirect basophil activation test (BAT) has been proposed in the diagnosis of autoimmune urticaria. Materials and methods: Sera from sixteen patients, aged from 2 to 15 yrs, with CSU were evaluated through indirect BAT by flow cytometry using a commercial kit (Flow CAST®, BUHLMANN Laboratories, Schonenbuch, Switzerland) according to the manufacturer's instructions. Results: Indirect BAT test gave a much better diagnosis in our cohort than the gold standard ASST. Six children (37.5%) showed a positive indirect BAT while we could perform ASST in only 3 patients with just one patients showing a positive ASST. The specificity of BAT positive results was confirmed by the absence of significant difference between the BAT results obtained from negative controls vs negative sera of the patient (p = 0.65) on the basophil donors, indicating that the serum is not activating basophil per se. Conclusions: This pilot study suggests the utility of BAT to identify the subtype of autoimmune CSU in children in clinical practice.
KW - Autoimmune chronic urticaria
KW - Autologous serum skin test
KW - Basophil activation test
KW - Chronic spontaneous urticaria
KW - IgE high-affinity receptor subunit
UR - http://www.scopus.com/inward/record.url?scp=85056754121&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85056754121&partnerID=8YFLogxK
U2 - 10.1016/j.imbio.2018.11.001
DO - 10.1016/j.imbio.2018.11.001
M3 - Article
AN - SCOPUS:85056754121
SN - 0171-2985
JO - Immunobiology
JF - Immunobiology
ER -