Rodríguez-Trabado Ana, Cámara-Hijón Carmen, Ramos-Cantariño Alfonso, Porcel-Carreño Sergio Luis, Jiménez-Timón Soledad, Pereira-Navarro Gema, Hernández-Arbeiza Francisco Javier, Fernández-Pereira Luis
Department of Allergy, University of Extremadura, Caceres, Spain.
Allergy Asthma Proc. 2008 May-Jun;29(3):241-9. doi: 10.2500/aap.2008.29.3114.
There is need for an in vitro diagnostic test for hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs). The purpose of this study was to assess the reliability of one such diagnostic, the basophil activation test. Forty-three drug hypersensitive patients referring several immediate reactions (anaphylaxis, urticaria, angioedema, asthma, and rhinoconjunctivitis) to one or more NSAIDs and 29 controls participated. Using the Basotest commercial kit, 63 determinations were performed with the drugs implicated in the adverse reactions (ASA, ibuprofen, metamizol, diclofenac, paracetamol, and ketorolac). In 16 patients additional determinations were made with other chemically unrelated NSAIDs. Forty-two determinations were made for controls. The analysis was performed by flow colorimetric cytometry and double staining with the monoclonal antibodies anti-IgE and anti-CD63. A Basophil Activation Index (percentage of activated basophils after allergen stimulation/percentage of basally activated basophils) of two or more was considered a positive result. Specificity of 100% and sensitivity of 42.85% were achieved. The positive predictive value was 100%, and the negative predictive value was 53.84%. In 35.29% of intolerant patients there was a positive reaction to at least two drugs implicated in adverse reactions, and in 27.27% of these patients there was a positive reaction to other chemically unrelated NSAIDs. The basophil activation test is useful for the in vitro diagnosis of NSAID hypersensitivity, providing good specificity and positive predictive value and diagnostic reliability in the assessment of NSAID intolerance.
需要一种用于检测对非甾体抗炎药（NSAIDs）过敏的体外诊断测试。本研究的目的是评估一种此类诊断方法——嗜碱性粒细胞活化试验的可靠性。43名药物过敏患者参与了研究，他们出现了一种或多种非甾体抗炎药引起的几种速发型反应（过敏反应、荨麻疹、血管性水肿、哮喘和鼻结膜炎），另有29名对照者参与。使用Basotest商业试剂盒，对与不良反应相关的药物（阿司匹林、布洛芬、安乃近、双氯芬酸、对乙酰氨基酚和酮咯酸）进行了63次检测。对16名患者使用其他化学结构不相关的非甾体抗炎药进行了额外检测。对对照者进行了42次检测。通过流式细胞术和用抗IgE和抗CD63单克隆抗体进行双重染色进行分析。嗜碱性粒细胞活化指数（变应原刺激后活化嗜碱性粒细胞的百分比/基础活化嗜碱性粒细胞的百分比）为2或更高被视为阳性结果。特异性达到100%，敏感性为42.85%。阳性预测值为100%，阴性预测值为53.84%。在35.29%的不耐受患者中，对至少两种与不良反应相关的药物有阳性反应，在这些患者中有27.27%对其他化学结构不相关的非甾体抗炎药有阳性反应。嗜碱性粒细胞活化试验可用于非甾体抗炎药过敏的体外诊断，在评估非甾体抗炎药不耐受方面具有良好的特异性、阳性预测值和诊断可靠性。
