A. Nopp

The clinical utility of basophil activation testing in diagnosis and monitoring of allergic disease

The basophil activation test (BAT) has become a pervasive test for allergic response through the development of flow cytometry, discovery of activation markers such as CD63 and unique markers identifying basophil granulocytes. Basophil activation test measures basophil response to allergen cross‐linking IgE on between 150 and 2000 basophil granulocytes in <0.1 ml fresh blood. Dichotomous activation is assessed as the fraction of reacting basophils. In addition to clinical history, skin prick test, and specific IgE determination, BAT can be a part of the diagnostic evaluation of patients with food‐, insect venom‐, and drug allergy and chronic urticaria. It may be helpful in determining the clinically relevant allergen. Basophil sensitivity may be used to monitor patients on allergen immunotherapy, anti‐IgE treatment or in the natural resolution of allergy. Basophil activation test may use fewer resources and be more reproducible than challenge testing. As it is less stressful for the patient and avoids severe allergic reactions, BAT ought to precede challenge testing. An important next step is to standardize BAT and make it available in diagnostic laboratories. The nature of basophil activation as an ex vivo challenge makes it a multifaceted and promising tool for the allergist. In this EAACI task force position paper, we provide an overview of the practical and technical details as well as the clinical utility of BAT in diagnosis and management of allergic diseases.

Basophil allergen threshold sensitivity: a useful approach to anti-IgE treatment efficacy evaluation

Background:  Monitoring of the allergen sensitivity of a patient is most important for optimal patient care and a basic prerequisite for immunomodulating treatment. The objective of this study was to investigate how basophil allergen sensitivity can be applied in the monitoring of anti‐immunoglobulin E (IgE) treatment.

After 6 years with Xolair; a 3-year withdrawal follow-up

Background:  This study reports the clinical and immunological state of patients 3 years after a 6‐year period of Xolair treatment for severe allergic asthma.

Passive IgE-sensitization by blood transfusion

Background:  To study the mechanisms of passive sensitization of patients receiving plasma containing IgE antibodies to a defined allergen.

Basophil allergen threshold sensitivity, CD‐sens, IgE‐sensitization and DBPCFC in peanut‐sensitized children

To cite this article: Glaumann S, Nopp A, Johansson SGO, Rudengren M, Borres MP, Nilsson C. Basophil allergen threshold sensitivity, CD‐sens, IgE‐sensitization and DBPCFC in peanut‐sensitized children. Allergy 2012; 67: 242–247.

CD-sens and clinical changes during withdrawal of Xolair after 6 years of treatment

Background:  Many clinical trials with omalizumab, Xolair, have been reported but the treatment period has always been short, i.e. <12 months. After withdrawal, the clinical symptoms tend to return. A group of patients who stopped treatment after approx. 6 years allowed studies of the long‐term effects of Xolair.

Pholcodine stimulates a dramatic increase of IgE in IgE-sensitized individuals. A pilot study.

Background:  A previous study showed a relation between pholcodine (PHO) consumption, prevalence of IgE‐sensitization to PHO, morphine (MOR) and suxamethonium (SUX) and anaphylaxis to neuromuscular blocking agents (NMBA). The purpose of this pilot study was to explore the effect on IgE production, in IgE‐sensitized and nonsensitized individuals, of exposure to cough syrup and environmental chemicals containing PHO, MOR and SUX related allergenic structures.

The size of the disease relevant IgE antibody fraction in relation to total-IgE predicts the efficacy of anti-IgE (Xolair ) treatment

Background:  Some patients with allergic asthma treated with anti‐IgE (Xolair®) do not become symptom free. Better criteria for response assessment than allergy skin tests or IgE determination are needed. The impact of the size of the disease relevant allergen‐specific IgE antibody fraction, i.e. the percentage of IgE antibody of total IgE, was evaluated in cat allergic patients treated with the recommended doses of Xolair®. Results were measured as changes in basophil allergen threshold sensitivity (CD‐sens).

Simultaneous exposure of several allergens has an additive effect on multisensitized basophils

Background:  Patients immunoglobulin (Ig)E‐sensitized to more than one allergen in their environment often have more symptoms than mono‐sensitized individuals, which indicates that the allergens may have an additive effect. In order to study if such an effect could be detected on the inflammatory, cellular level, multisensitized basophils were challenged with various dose combinations of two relevant allergens.

CD-sens : a biological measure of immunological changes stimulated by ASIT

Background:  Allergen‐specific immunotherapy (ASIT) in allergic rhinitis and asthma is the only treatment that effects the long‐term development of these diseases. Basophil allergen threshold sensitivity, CD‐sens, which is a valuable complement to resource‐demanding clinical challenge tests, was used to monitor the initiation of ASIT induced allergen ‘blocking activity’.