Testera-Montes Almudena, Ariza Adriana, Sola-Martinez Rosa Alba, Aranda Carlos Jose, Bentabol-Ramos Guillermo, Sanchez-Torralvo Dulce, Mayorga Cristobalina, Torres Maria Jose, Eguiluz-Gracia Ibon, Rondon Carmen
Allergy Unit, Hospital Regional Universitario de Malaga, Malaga, Spain.
Allergy Group. IBIMA-Plataforma BIONAND, RICORS Inflammatory Diseases, Malaga, Spain.
Allergy. 2025 Mar;80(3):738-749. doi: 10.1111/all.16390. Epub 2024 Nov 5.
Basophil activation test (BAT) might be an alternative to nasal allergen challenge (NAC) to identify the allergic etiology in rhinitis patients. Here, we investigate the diagnostic performance of BAT for allergic phenotypes of rhinitis.
Rhinitis patients and healthy controls were subjected to NAC with Dermatophagoides pteronyssinus (DP), Alternaria alternata (AA), grass (GP) and olive (OP) pollens. Rhinitis subjects also underwent skin prick test (SPT) with relevant allergens. Patients were classified into allergic rhinitis (AR, positive NAC and SPT), local allergic rhinitis (LAR, positive NAC and negative SPT), dual allergic rhinitis (DAR, defined as AR for ≥1 allergen and LAR for ≥1 allergen), and non-allergic rhinitis (NAR, negative NAC and SPT) phenotypes. BAT with DP, AA, GP and OP was conducted in study individuals and compared with NAC results.
A total of 47 AR, 31 DAR, 26 LAR, 12 NAR and 21 control subjects were recruited. The best positivity cut-offs of BAT for DP-, AA-, GP- and OP-driven allergy (all phenotypes) were a %CD63 cells of 8.650, 14.250, 26.200, and 12.780, respectively (AUC 0.851, 0.701, 0.887, and 0.921, respectively). Sensitivity, specificity, negative and positive predictive values of BAT (all phenotypes) ranged 43.5%(AA)-83.3%(OP), 88.9%(GP)-100%(AA), 87%(GP)-100%(AA), and 61.1%(DP)-80.0%(pollens), respectively. BAT identified 79%-100% of SPT-positive allergies (AR and DAR), and 25%-75% of SPT-negative allergies (LAR and DAR), while ≤10% of NAR/HC subjects tested positive. BAT positivity correlated with rhinitis severity in LAR patients (p = 0.018), and associated with conjunctivitis (p = 0.015) in allergic subjects.
BAT can replace NAC for AR confirmation, and limit the number of NAC required for LAR and DAR diagnosis. BAT can demonstrate sIgE in SPT-negative allergies.
嗜碱性粒细胞活化试验（BAT）可能是鼻过敏原激发试验（NAC）的一种替代方法，用于确定鼻炎患者的过敏病因。在此，我们研究BAT对鼻炎过敏表型的诊断性能。
鼻炎患者和健康对照者接受了用屋尘螨（DP）、链格孢（AA）、草花粉（GP）和橄榄花粉（OP）进行的NAC。鼻炎受试者还接受了相关过敏原的皮肤点刺试验（SPT）。患者被分为变应性鼻炎（AR，NAC和SPT阳性）、局部变应性鼻炎（LAR，NAC阳性和SPT阴性）、双重变应性鼻炎（DAR，定义为对≥1种过敏原呈AR且对≥1种过敏原呈LAR）和非变应性鼻炎（NAR，NAC和SPT阴性）表型。对研究对象进行了用DP、AA、GP和OP的BAT，并与NAC结果进行比较。
共招募了47例AR、31例DAR、26例LAR、12例NAR和21例对照受试者。BAT对由DP、AA、GP和OP引发的过敏（所有表型）的最佳阳性临界值分别为%CD63细胞8.650、14.250、26.200和12.780（AUC分别为0.851、0.701、0.887和0.921）。BAT（所有表型）的敏感性、特异性、阴性和阳性预测值分别为43.5%（AA）-83.3%（OP）、88.9%（GP）-100%（AA）、87%（GP）-100%（AA）和61.1%（DP）-80.0%（花粉）。BAT识别出79%-100%的SPT阳性过敏（AR和DAR），以及25%-75%的SPT阴性过敏（LAR和DAR），而≤10%的NAR/HC受试者检测为阳性。BAT阳性与LAR患者的鼻炎严重程度相关（p = 0.018），并与过敏受试者的结膜炎相关（p = 0.015）。
BAT可替代NAC用于AR的确诊，并减少LAR和DAR诊断所需的NAC数量。BAT可在SPT阴性的过敏中显示sIgE。
