Erdmann S M, Sachs B, Schmidt A, Merk H F, Scheiner O, Moll-Slodowy S, Sauer I, Kwiecien R, Maderegger B, Hoffmann-Sommergruber K
Department of Dermatology and Allergology, University Hospital of Aachen, Aachen, Germany.
Int Arch Allergy Immunol. 2005 Mar;136(3):230-8. doi: 10.1159/000083949. Epub 2005 Feb 15.
Basophil activation is associated with the expression of CD63. In birch-pollen-associated food allergy to celery, carrot and apple, Bet v 1, Api g 1, Dau c 1 and Mal d 1 are major allergens. Recombinant allergens have not yet been used in the CD63-based basophil activation test (BAT).
To evaluate the feasibility of using recombinant allergens in the BAT in the diagnosis of allergy to apple, carrot and celery and to compare results with routine tests, i.e. skin prick tests (SPTs) and specific IgE.
Thirty-two patients with an oral allergy syndrome induced by apple, carrot or celery and 22 controls were studied. SPTs were performed with native foods. Specific IgE was determined by the CAP method and basophil activation by flowcytometry upon double staining with anti-IgE/anti-CD63 monoclonal antibodies after incubating with purified recombinant Bet v 1, Bet v 2, Api g 1, Dau c 1 and Mal d 1.
By the combined use of the BAT and the CAP method, sensitization to Bet v 1 and Bet v 2 was detected in 100 and 25% of all subjects, respectively. Sensitivity of specific IgE for apple, carrot and celery was 60, 70 and 75% with corresponding specificities of 64, 86 and 82%. Sensitivity of the BAT for Mal d 1, Dau c 1 and Api g 1 was 75, 65 and 75% with corresponding specificities of 68, 100 and 77%.
The BAT using recombinant allergens provides a valuable new in vitro method for the detection of sensitization to foods. Although double-blind placebo-controlled food challenges remain the gold standard to confirm food allergy, the CD63-based BAT with recombinant allergens may supplement routine tests for allergy diagnosis.
嗜碱性粒细胞活化与CD63的表达相关。在桦树花粉相关的芹菜、胡萝卜和苹果食物过敏中，Bet v 1、Api g 1、Dau c 1和Mal d 1是主要过敏原。重组过敏原尚未用于基于CD63的嗜碱性粒细胞活化试验（BAT）。
评估在BAT中使用重组过敏原诊断苹果、胡萝卜和芹菜过敏的可行性，并将结果与常规试验（即皮肤点刺试验[SPT]和特异性IgE）进行比较。
对32例由苹果、胡萝卜或芹菜引起口腔过敏综合征的患者和22例对照进行研究。用天然食物进行SPT。通过CAP方法测定特异性IgE，并在用纯化的重组Bet v 1、Bet v 2、Api g 1、Dau c 1和Mal d 1孵育后，用抗IgE/抗CD63单克隆抗体进行双重染色，通过流式细胞术测定嗜碱性粒细胞活化。
联合使用BAT和CAP方法，分别在所有受试者的100%和25%中检测到对Bet v 1和Bet v 2的致敏。苹果、胡萝卜和芹菜特异性IgE的敏感性分别为60%、70%和75%，相应的特异性分别为64%、86%和82%。BAT对Mal d 1、Dau c 1和Api g 1的敏感性分别为75%、65%和75%，相应的特异性分别为68%、100%和77%。
使用重组过敏原的BAT为检测食物致敏提供了一种有价值的新体外方法。尽管双盲安慰剂对照食物激发试验仍然是确认食物过敏的金标准，但基于CD63的重组过敏原BAT可能补充过敏诊断的常规试验。
