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Basophil activation test: mechanisms and considerations for use in clinical trials and clinical practice
  • Alexandra Santos,
  • Oral Alpan,
  • Hans Jürgen Hoffmann
Alexandra Santos
King's College London, King's College London
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Oral Alpan
O&O ALPAN
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Hans Jürgen Hoffmann
Aarhus University Hospital
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Abstract

The basophil activation test (BAT) is a functional assay that measures the degree of degranulation following stimulation with allergen or controls by flow cytometry and is directly correlated with histamine release. From the bell-shaped curve resulting from BAT in allergic patients, basophil reactivity (given by %CD63+ basophils) and basophil sensitivity (given by EC50 or similar) are the main outcomes of the test. BAT takes into account all characteristics of IgE and allergen and thus can be more specific than sensitization tests in the diagnosis of allergic disease. BAT reduces the need for in vivo procedures, such as intradermal tests and allergen challenges, which can cause allergic reactions of unpredictable severity. As it closely reflects the patients’ phenotype, it can potentially be used to monitor the natural resolution of food allergies and to predict and monitor clinical response to immunomodulatory treatments, such as allergen-specific immunotherapy and biologicals. Clinical application of BAT requires analytical validation, clinical validation, standardization of procedures and quality assurance to ensure reproducibility and reliability of results. Currently, efforts are ongoing to establish a platform that could be used by laboratories in Europe and in the USA for certification.

Peer review status:IN REVISION

13 Jul 2020Submitted to Allergy
14 Jul 2020Assigned to Editor
14 Jul 2020Submission Checks Completed
15 Jul 2020Reviewer(s) Assigned
31 Jul 2020Review(s) Completed, Editorial Evaluation Pending
01 Aug 2020Editorial Decision: Revise Minor