Dubois Anthony E J, van der Heide Sicco
Department of Pediatric Pulmonology and Pediatric Allergology, University Medical Center Groningen, Groningen, The Netherlands.
Curr Opin Allergy Clin Immunol. 2007 Aug;7(4):346-9. doi: 10.1097/ACI.0b013e3282638848.
Despite recent advances in our understanding of basophil biology and discovery of new markers for basophil activation, tests measuring basophil activation are not widely utilized in Hymenoptera allergy. Studies of the basophil-activation test in Hymenoptera allergy were examined and the clinical utility of this test was assessed.
It has been demonstrated that the results of basophil-activation tests correlate quite well with those of serum IgE testing or skin-prick tests. Many studies compare test outcomes with history in patients and nonallergic controls, so that specificity in sensitized but clinically nonreactive individuals remains unknown. Although one study showed that the basophil-activation test might predict immunotherapy side effects, this could not be confirmed in a second study, and no role has been established for the basophil-activation test in the monitoring of venom immunotherapy. The basophil-activation test has no extra value in assessing sting challenges, although experience is limited.
The measurement of basophil-activation markers may be useful in detecting IgE-mediated sensitization but the relevance for application of the basophil-activation test in prediction of clinical reactivity in Hymenoptera allergy is very limited. For this reason, this test currently has no established role in the diagnosis and management of patients with insect sting allergy.
尽管我们对嗜碱性粒细胞生物学的理解以及嗜碱性粒细胞活化新标志物的发现取得了最新进展，但用于测量嗜碱性粒细胞活化的检测方法在膜翅目过敏中并未得到广泛应用。本文对膜翅目过敏中嗜碱性粒细胞活化试验的研究进行了审查，并评估了该试验的临床实用性。
已证明嗜碱性粒细胞活化试验的结果与血清IgE检测或皮肤点刺试验的结果相关性良好。许多研究将试验结果与患者及非过敏对照的病史进行比较，因此致敏但临床无反应个体的特异性仍不清楚。尽管一项研究表明嗜碱性粒细胞活化试验可能预测免疫治疗的副作用，但第二项研究未能证实这一点，且嗜碱性粒细胞活化试验在监测毒液免疫治疗中的作用尚未确立。尽管经验有限，但嗜碱性粒细胞活化试验在评估蜇刺激发试验方面并无额外价值。
嗜碱性粒细胞活化标志物的检测可能有助于检测IgE介导的致敏，但嗜碱性粒细胞活化试验在预测膜翅目过敏临床反应性方面的应用相关性非常有限。因此，该试验目前在昆虫蜇刺过敏患者的诊断和管理中尚未确立作用。
