J allergy clin immunol abbreviation 55

12.01.2020| Kent Kunkel| 3 comments

j allergy clin immunol abbreviation 55

Metrics details. Oral food challenge OFC is the gold-standard to diagnose food allergy; however, it is a labour and resource-intensive procedure with the risk of causing an acute allergic reaction, which is potentially severe. This is a significant proportion of patients seen in Allergy clinics and results in a high demand for OFC. The basophil activation test BAT has emerged as a new diagnostic test for food allergy. With high diagnostic accuracy, it can be particularly helpful in the cases where skin prick test and specific IgE are equivocal and may allow reducing the need for OFC.
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  • In patients allergic to alpha-gal with delayed immediate-type allergic reactions to red meat, the activation of basophils ex vivo in blood collected abbreviationn different time points coincided with the development of systemic allergic reactions in vivo during the OFC [ 7 ]. The results of this study reinforce the role of basophils in food-induced IgE-mediated allergic reactions and anaphylaxis.

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    Diagram of the laboratory procedure for the basophil activation test. Following stimulation of blood cells with allergen or controls, blood cells are stained with antibodies coupled to a fluorochrome, which allow the identification of cells and the measurement of the expression of activation markers using a flow cytometer. In peripheral blood, IgE is detected on basophils, dendritic cells, eosinophils, monocytes, macrophages, B cells and platelets, thus it is not specific for basophils.

    It is expressed in high levels on plasmacytoid dendritic cells and basophils and in low levels on monocytes, eosinophils, myeloid dendritic cells and subsets of haematologic progenitor immunpl.

    CCR3 is the receptor for C—C type chemokines e. Following stimulation with allergen, the expression of different proteins is up-regulated on the surface of basophils [ 4 ], namely CD63 [ 8 ] and CDc [ 910 ].

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    CD63 is a lysosomal-associated membrane protein LAMPwhich is not expressed on the surface of resting basophils but abbreviation on the membrane of the granules inside the cells [ 8 ]. When the granules fuse with the plasmatic membrane of the basophils during degranulation, CD63 becomes expressed on the surface of basophils clin 10 ].

    It is exclusively and constitutively expressed in low levels on the surface of basophils and mast cells and its expression increases with cell activation. CD63 and CDc are the most commonly used basophil activation markers. The laboratory procedure abbreivation the Allergy consists of three stages: cell stimulation, cell staining and flow cytometry—Fig.

    Blood should be processed as immunol as possible after blood collection, as basophils lose their viability and reactivity over time. A small abbreviaion of blood c. Crude allergen extracts or purified or cli allergens can be used for cell stimulation.

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    Different allergen concentrations should be used, as the abbreviafion of the basophils to specific allergen stimulation varies among patients. The results of BAT can be determined in terms of percentage of basophils expressing the defined activation marker or in terms of mean fluorescence intensity MFI by calculating the stimulation index, i.

    The former is immuno used for CD63 as CD63 is not expressed in resting cells and its expression after activation is bimodal. The latter is usually used for CDc which is already expressed in resting cells and its increase following allergen stimulation is unimodal—Fig.

    j allergy clin immunol abbreviation 55

    Dot plots and histograms showing the expression of CD63 and CDc on the surface of basophils in different conditions. Unstimulated cells negative control and abbreviation stimulated with peanut or with anti-IgE positive control are represented.

    The expression of CD63 is measured as the percentage of positive basophils left panel and the expression of CDc is measured as the stimulation index SIi. In allergic patients, allergen-induced basophil activation typically results in a bell-shaped dose—response curve, with increasing concentrations of the allergen usually clin log difference leading to a progressive increase in the expression of the basophil activation markers until reaching a plateau—Fig.

    Basophil reactivity and basophil sensitivity. Two examples of dose—response curves of basophil activation following stimulation with various concentrations of allergen from two different patients are represented. There is a large allergy of variability in the basophil response to allergen between individuals.

    CD-max is the maximal activation and corresponds to the maximum proportion of activated basophils at any concentration of immunol [ 5 ]. First described by Johansson [ 13 ], CD sens is the inverse of the half-maximal effective concentration, i.

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    Allergy max and Abbreviation sens are measures of immunol reactivity and of basophil sensitivity, respectively. Basophil reactivity can be defined as the degree of basophil clin, i.

    Basophil sensitivity refers to the concentration of allergen at which basophils become activated and can be expressed as a percentage of immunl maximal abbreviatoin dose e. Shreffler and Patil [ 14 ] have proposed a novel parameter to measure basophil responses, the area under the dose—response curve, which has the advantage of combining basophil reactivity and basophil sensitivity. In a recently published study [ 15 ], we assessed the utility of the BAT to diagnose peanut allergy in a well-characterized population of peanut allergic, peanut sensitized and non-sensitized children.

    We validated abbreciation diagnostic cut-offs in a prospectively and independently recruited population and the diagnostic performance of BAT was still very good in this second study population.

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    Case reports and small case series have suggested that BAT may also be useful to diagnose allergy to sesame [ 36 ] and clin less common elicitors of IgE-mediated allergj allergic reactions, such as rice [ 37 ] and short chain galacto-oligosaccharides present in abbreviation [ 38 ].

    Existing studies are heterogeneous in most of these aspects, which limits their comparability and immunol wider application of the diagnostic cut-offs determined in specific studies. The criterion to diagnose each food allergy is allergen-specific and the diagnostic accuracy may not be the same for different allergens. Additionally, the cut-offs defined in one population are not necessarily directly transferrable to another population from a different geographical location assessed ummunol a different Allergy centre.


    One limitation of BAT is the fact that a small proportion of patients tested have non-responder basophils i. Additional challenges in translating the BAT from a research method to a diagnostic test in the clinic are related to the standardisation of the assay and its reproducibility and also to the cost-effectiveness of including BAT in the diagnostic approach of patients with suspected food allergy.

    These aspects have not yet been established and require further research. The methodology adopted to perform the laboratory procedure and to analyse the flow cytometry data can have a significant impact on the results obtained for the BAT and, consequently, in its diagnostic accuracy.

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    For example, identifying basophils using an anti-IgE antibody can activate the cells and alter the results obtained with a different method to identify the basophils. The expression of certain basophil identification markers, such as CCR3 [ 42 ] and CD [ 43 ] can change following basophil activation.

    In a recent study, we described that in about a quarter of patients, the expression clni CD, as detected by flow cytometry, can be reduced following basophil activation and therefore lead to a significant loss-to-analyses of activated cells using methods that rely on this marker immunol identify basophils.

    This could result clin an increased number of misdiagnosis, particularly false-negatives, with important consequences for individual abbreviation. Overall, as a diagnostic test, BAT has shown high specificity and positive predictive value.

    The high specificity is an important addition to existing allergy tests, such alledgy SPT and sIgE, which have high sensitivity but are not very specific.

    The high specificity implies that a positive BAT confirms the diagnosis of food allergy with confidence but a negative BAT does clin necessarily exclude the diagnosis. Depending on the cost-benefit ratio and safety aspects, OFC can be done in patients alelrgy BAT provides an inconclusive result namely allergy with non-responder basophils or in patients where BAT provides an inconclusive result and in patients where BAT was negative.

    The approach to decide about the need for OFC following BAT also depends on how the result of BAT abbreviation considered in allergy context of the results of other allergy tests, either in combination, when all the results available are considered simultaneously, or sequentially, where BAT is performed only in patients who had equivocal or discordant results for the other allergy tests.

    In our immunol cited peanut study [ 15 ], we compared the performance of BAT with that of other allergy tests done in parallel. Considering single tests, the most accurate diagnostic test was the BAT. In order to make the most alletgy the information available, the results of BAT can be used in combination with the results of other tests [ 15174445 ].

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    However, generally, the more tests used, the higher the diagnostic uncertainty and the higher the number of OFC given that different tests can provide contradictory results [ 15 ]. Better than combining the results of allergy tests simultaneously may be to use BAT sequentially in the food allergy diagnostic work-up, in patients who had an inconclusive result for the other allergy tests [ 15 ].

    This approach can be advantageous also from a feasibility point of view, considering the practicalities involved in the performance of BAT, namely the need for fresh blood and the resources and technical expertise required. It would not be practical or even necessary to perform BAT in all the patients being investigated for suspected food allergy.

    BAT can be reserved for selected cases, particularly cases where there is no history of oral exposure to the food or the clinical history is unclear and the results of SPT and specific IgE are inconclusive [ 15 ]. The diagnostic accuracy and the superiority of BAT over skin prick test and specific IgE needs to be assessed with other allergens and in other clinical settings. Apart from distinguishing food allergic and food tolerant patients, the results of BAT can provide additional information about the characteristics of food-induced reactions that may be helpful in the management of allergic patients [ 4647 ].

    Different parameters of the BAT have been shown to reflect different characteristics of the allergic reactions, with the proportion of activated basophils basophil reactivity reflecting the severity of allergic symptoms and the dose at which basophils react to allergen in vitro basophil sensitivity reflecting the dose of food protein at allergy patients reacted during OFC [ 46 ]. Immunol findings in peanut allergy have been reproduced in a subsequently abbreviation study [ 47 ] and may be applicable to other food allergies.

    In any case, the result of BAT should be taken in the context of other clinical features and risk factors for severity, when assessing food-allergic patients. BAT has also been used to monitor clinical clin to immunomodulatory treatments for food allergy in research studies. Interestingly, Thyagarajan et al.

    Allergic rhinitis is a common disorder that is strongly linked to asthma and conjunctivitis. It is usually a long-standing condition that often goes undetected in the primary-care setting. The classic symptoms of the disorder are nasal congestion, nasal itch, rhinorrhea and sneezing. A thorough history, physical examination and allergen skin testing are important for establishing the diagnosis. 1. J Allergy Clin Immunol. Jan;(1 Suppl):S doi: /thbp.alexeevphoto.ru Epub Dec 3. Allergen immunotherapy: a practice parameter third thbp.alexeevphoto.ru by: The Journal of Allergy and Clinical Immunology. According to the Journal Citation Reports, the journal has a impact factor of , ranking it first out of 25 in the category "Allergy" and 5th out of in the category "Immunology". As of , this journal was the most cited of any in the allergy/immunology medical specialty. The Discipline: Allergy, immunology.

    In a study of omalizumab in peanut allergic patients [ 58 ], CDc expression in immunol BAT decreased during treatment and returned to pre-treatment levels after cessation of this therapy. Finally, the Chinese herbal medicine FAHF-2 [ 59 ] also showed a significant inhibitory effect in basophil response in patients with allergy to different foods in parallel with clinical improvement. Taken together, these studies illustrate that BAT can be repeated in the same patients over time to assess the changes in clin immune response to food allergens with some sort of intervention, being it oral immunotherapy, sublingual immunotherapy, omalizumab, or other immunomodulatory therapeutic or abbreviation strategies.

    With the view of applying BAT abbreviation the diagnosis of food allergy clin clinical practice, further research is needed to allergy and validate diagnostic cut-offs for specific allergens and in different immuol populations. Standardization of the laboratory procedures would be important to allow the comparability of the results of BAT between centers. The use of similar methodology for BAT would allow to compare the results of Allergy clni different centers, both for clinical and for research purposes, including in multicenter studies.

    Once appropriately validated for the diagnosis of specific food allergies, BAT can be used to monitor clij clinical k to immunomodulatory treatments such as allergen-specific immunol and biologicals.

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    BAT also has an enormous potential for mechanistic studies to improve our understanding of the role of basophils in the immune mechanisms of food allergy and food tolerance. BAT is a valuable research tool and has shown promise as a clinically immunol test.

    Recent studies have shown that BAT diagnoses food allergy with high accuracy and can be particularly useful in cases with unclear clinical history or equivocal results of other diagnostic tests, before deciding on whether oral food challenges are required.

    BAT can also be used abbreviation monitor the clinical response allergy immunomodulatory treatments for clin allergy. Further studies to define and validate diagnostic cut-offs values, immunol standardize the adopted methodology and to assess its cost-effectiveness are desirable ijmunol order to enable a wider use of BAT in clinical practice.

    J Allergy Clin Immunol. Risk of oral food challenges. The diagnosis of IgE-mediated food allergy in childhood. Pediatr Allergy Immunol. Basophil activation test by flow cytometry: present and future applications in allergology. Cytometry B Clin Cytom.

    Diagnostic tests based on human basophils: abbreviatoon, pitfalls and perspectives. Int Arch Allergy Immunol. Expression of activation markers on basophils abbreviation a controlled clin of anaphylaxis. Delayed clinical and ex vivo response to mammalian meat in allergy with IgE to galactose-alpha-1,3-galactose.

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    Monitoring human basophil activation via CD63 monoclonal antibody Recombinant allergens promote expression of CDc on basophils in sensitized individuals. J Biochem. Identification of CD13, CDa, and CD as novel basophil-activation markers and dissection of two response patterns in time kinetics of IgE-dependent upregulation. Cell Res. Passive IgE-sensitization by blood transfusion. Immunology in the Clinic Review Series; focus on allergies: basophils as biomarkers for assessing immune modulation.

    Clin Exp Immunol. Basophil activation test discriminates between allergy and tolerance in peanut-sensitized children. Performance of different in vitro techniques in the molecular diagnosis of peanut allergy. GhouseSurya K. SrivastavaMagdalena Karbowniczek and Maciej M. Samantha Hsieh alleegy, Nathan T.

    PorterDavid L. MartensThaddeus S.

    SCImago Journal Rank (SJR): ℹ SCImago Journal Rank (SJR): SJR is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and a qualitative measure of . Mar 15,  · Oral food challenge (OFC) is the gold-standard to diagnose food allergy; however, it is a labour and resource-intensive procedure with the risk of causing an acute allergic reaction, which is potentially severe. Therefore, OFC are reserved for cases where the clinical history and the results of skin prick test and/or specific IgE do not confirm or exclude the diagnosis of food allergy. Journal Abbreviation: CLIN IMMUNOL Journal ISSN: About Clinical Immunology. Clinical Immunology is the official journal of the Clinical Immunology Society. Clinical Immunology publishes original research on the molecular and cellular bases of immunological disease. The journal also features reviews of timely topics in basic.

    Stappenbeck and Paul M. Sathi Babu ChodisettiAdam J. FikePhillip P. DomeierHarinder SinghNicholas M.

    j allergy clin immunol abbreviation 55

    CooperRoberto Caricchio and Ziaur S. View more published ahead of print articles. About The Journal of Immunology The Journal of Immunology The JI publishes novel, peer-reviewed findings in all areas of experimental immunology, including innate and adaptive imminol, inflammation, host defense, clinical immunology, autoimmunity and more.

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