Author/Editor		Peternelj, Andreja; Šilar, Mira; Eržen, Renato; Bajrović, Nisera; Mušič, Ema; Košnik, Mitja; Korošec, Peter
Title		Test aktivacije bazofilcev (BAT) in vitro diagnostike pri preobčutljivosti za strup kožekrilcev
Translated title		Basophil activation test (BAT) in "in vitro" diagnosis of hymenoptera venom hypersensitivity
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 77, št. 3
Publication year		2008
Volume		str. 183-7
Language		slo
Abstract		Background The basophil activation test relies on flow cytometric quantitation of the expression of the markers on the surface of basophils, after stimulation with the amount of allergen that cross-link IgE antibodies bound on their surface. In allergy diagnosis, the technique has been applied in the investigation of IgE-mediated allergy caused by classical inhalant allergens, Hevea latex, food, drugs and hymenoptera venoms. The technique also proves valuable in the diagnosis of non-IgE-mediated reactions such as drug hypersensitivity and the detection of autoantibodies in certain forms of chronic urticaria. To strengthen the probability that the working diagnosis for hymenoptera venom hypersensitivity is correct, confirmatory testing for skin test and IgE antibody is often performed. But sometimes clinical history and the results of confirmatory tests are contradictory. In such cases additional tests are necessary, among which flow cytometric quantification of in vitro basophil activation is becoming a valuable tool during the last few years. Material and methods In Laboratory for Clinical Immunology and Molecular Genetic, Golnik, we performed BAT for 127 patients with history of anaphylactic reactions after Hymenoptera sting. Conclusions According to our findings BAT is a highly sensitive and specific technique and as an in vitro provocation assay enables sensibilisation detection, prediction of side effects from specific immunotherapy and differentiates between clinically relevant and irrelevant epitops. This technique also gave us a new information on mechanisms and effects of venom immunotherapy.
Summary		Izhodišča Test aktivacije bazofilcev je metoda, pri kateri s pretočnim citometrom v periferni krvi merimo izražanje označevalcev na površini bazofilcev. Vzorec krvi stimuliramo z določeno količino alergena, ki navzkrižno poveže protitelesa IgE na njihovi površini. V alergološki diagnostiki se označevalec CD63 uporablja pri diagnozi alergijskih bolezni takojšnjega tipa, ki jih pogojujejo protitelesa IgE za klasične vdihane alergene, lateks, hrano, zdravila in strupe kožekrilcev. Test je dobrodošel tudi pri boleznih brez IgE, kot sta preobčutljivost za nekatera zdravila in nekatere oblike urtikarije. Za potrditev diagnoze po piku kožekrilca se izvedejo kožni testi in merijo specifična protitelesa IgE v serumu. Včasih pride do neskladnosti med anamnezo in rezultati potrditvenih testov. V takih primerih nastane potreba po dodatnih testih, med katerimi se zadnja leta vse bolj uveljavlja merjenje aktivacije bazofilcev s pretočnim citometrom. Bolniki in metode V Laboratoriju za klinično imunologijo in molekularno genetiko Bolnišnice Golnik smo od leta 2004 do februarja 2007 izvedli BAT za 127 bolnikov z anamnezo anafilaktične reakcije po piku kožekrilca. Zaključki Ugotovili smo, da je BAT visoko občutljiva in specifična metoda, ki omogoča dokaz senzibilizacije, napoveduje stranske učinke specifične imunoterapije in razmeji klinično pomembne in nepomembne epitope. S to tehniko smo dobili tudi nove podatke o mehanizmih in učinkih imunoterapije pri preobčutljivosti za kožekrilce.
Descriptors		BASOPHIL DEGRANULATION TEST BEE VENOMS WASP VENOMS HYPERSENSITIVITY IGE FLOW CYTOMETRY SKIN TESTS