Do cellular in-vitro assays have a clinical value in the diagnosis of immediate-type-allergies?

Do cellular in-vitro assays have a clinical value in the diagnosis of immediate-type-allergies? Introduction. The diagnosis of IgE-mediated immediate-type reactions is based on the history, skin tests, determination of specific IgE-antibodies and, as required, provocation tests to determine the clinical relevance. In the case of contradictory test results, provocation tests which cannot be performed, or lack of availability of the allergens for the skin test and/or for the determination of the sIgE, additional cellular tests can be performed. Methods. These tests (histamine release test, measurement of leucotrienes, and basophil activation tests) are based on the measurement of pre-formed or de-novo synthesized mediators or the activation of certain markers on the cellular surface of basophil granulocytes. Results: Until now, these tests have been performed above all for the diagnosis of patients with allergic reactions to insect venoms, food and drugs. The basophil activation test (BAT) is thus particularly clinically meaningful for the detection of IgE-mediated reactions with negative or contradictory results in the skin test and/or for the determination of the sIgE in patients allergic to insect venoms. For reactions to rare food allergens and for the lack of availability of the allergens for the skin tests and/or the determination of the sIgE in routine diagnosis, the BAT has proven to be a suitable diagnostic instrument. An association was found between the magnitude of the basophil activation and the clinical symptoms for certain food allergens and for the administration of anti-IgE antibodies as well as a successful insect venom immunotherapy under sub-maximal stimulation conditions. The application of the BAT during administration of antihistamines appears to be possible. Discussion: The limitations of the method are certain methodical and apparative efforts and also the fact that non-responders cannot be evaluated. Moreover, the samples should be analyzed within one day. Conclusion: For specific clinical indications, the cellular in-vitro diagnosis of immediate-type allergies can make an important contribution to the identification of the relevant allergens.     «

Do cellular in-vitro assays have a clinical value in the diagnosis of immediate-type-allergies? Introduction. The diagnosis of IgE-mediated immediate-type reactions is based on the history, skin tests, determination of specific IgE-antibodies and, as required, provocation tests to determine the clinical relevance. In the case of contradictory test results, provocation tests which cannot be performed, or lack of availability of the allergens for the skin test and/or for the determination of the s...     »