Romantowski Jan, Gawinowska Marika, Trzonkowski Piotr, Niedoszytko Marek
Department of Allergology, Medical University of Gdansk, Gdansk, Poland.
Department of Immunology, Medical University of Gdansk, Poland.
Immun Inflamm Dis. 2025 May;13(5):e70206. doi: 10.1002/iid3.70206.
Since the outbreak of the coronavirus pandemic in 2019, vaccinations have proven to be a key strategy in disease prophylaxis. Although vaccines are safe from the perspective of the general population, hypersensitivity reactions have still been described, causing individuals to be reluctant in their vaccination decision. Since the description of first reports of COVID-19 vaccine allergy, many protocols of allergy work-up have been developed, including In Vitro and In Vivo tests. Although In Vivo tests were more accessible, many patients preferred In Vitro tests that would not involve contact with the allergen and be safe. This applied in particular to patients that had experienced a severe delayed hypersensitivity reaction in which In Vivo tests were highly limited and provocations were deemed high risk. Taking into account these circumstances, In Vitro tests might significantly enhance allergy work-up.
National Center for Biotechnology Information (Pubmed) database was searched in May 2024 for articles on In Vitro diagnostic methods for COVID-19 vaccine allergy and hypersensitivity.
This article describes the In Vitro tests developed to date in the diagnosis of COVID-19 vaccine hypersensitivity: (1) analysis of specific IgE and IgG, (2) Basophil Activation Test, (3) Histamine Release Test, (4) IgM-dependent complement activation, (5) Lymphocyte Transformation Test, (6) Flow cytometry T-Cell markers, (7) Th1/Th2 cytokines concentration in cell culture.
The article highlights the tests' advantages, flaws and possible clinical applications.
自2019年冠状病毒大流行爆发以来，疫苗接种已被证明是疾病预防的关键策略。尽管从普通人群的角度来看疫苗是安全的，但仍有过敏反应的报道，这使得一些人在疫苗接种决策上有所犹豫。自首次报道新冠病毒疫苗过敏以来，已经制定了许多过敏检查方案，包括体外和体内试验。尽管体内试验更容易进行，但许多患者更喜欢体外试验，因为体外试验不涉及与过敏原接触且更安全。这尤其适用于经历过严重迟发性过敏反应的患者，在这些患者中，体内试验受到很大限制，激发试验被认为风险很高。考虑到这些情况，体外试验可能会显著加强过敏检查。
2024年5月在国家生物技术信息中心（PubMed）数据库中搜索关于新冠病毒疫苗过敏和超敏反应的体外诊断方法的文章。
本文介绍了迄今为止开发的用于诊断新冠病毒疫苗超敏反应的体外试验：（1）特异性IgE和IgG分析，（2）嗜碱性粒细胞活化试验，（3）组胺释放试验，（4）IgM依赖性补体活化，（5）淋巴细胞转化试验，（6）流式细胞术T细胞标志物，（7）细胞培养中Th1/Th2细胞因子浓度。
本文强调了这些试验的优点、缺陷及可能的临床应用。
