Basophil activation test shows high accuracy in the diagnosis of peanut and tree nut allergy: The Markers of Nut Allergy Study
Background Peanut and tree nut allergies are the most important causes of anaphylaxis. Co‐reactivity to more than one nut is frequent, and co‐sensitization in the absence of clinical data is often obtained. Confirmatory oral food challenges (OFCs) are inconsistently performed. Objective To investiga...
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| Veröffentlicht in: | Allergy (Copenhagen) 2021-06, Vol.76 (6), p.1800-1812 |
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| creator | Duan, Lucy Celik, Alper Hoang, Jennifer A. Schmidthaler, Klara So, Delvin Yin, Xiaojun Ditlof, Christina M. Ponce, Marta Upton, Julia E.M. Lee, Jean‐Soo Hung, Lisa Breiteneder, Heimo Palladino, Chiara Atkinson, Adelle R. Kim, Vy H.D. Berenjy, Alireza Asper, Maria Hummel, David Wong, Samantha Alexanian‐Farr, Mara Magder, Ahuva Chinthrajah, Sharon R. Mukai, Kaori Tsai, Mindy Nadeau, Kari Galli, Stephen J. Ramani, Arun K. Szepfalusi, Zsolt Eiwegger, Thomas |
| description | Background
Peanut and tree nut allergies are the most important causes of anaphylaxis. Co‐reactivity to more than one nut is frequent, and co‐sensitization in the absence of clinical data is often obtained. Confirmatory oral food challenges (OFCs) are inconsistently performed.
Objective
To investigate the utility of the basophil activation test (BAT) in diagnosing peanut and tree nut allergies.
Methods
The Markers Of Nut Allergy Study (MONAS) prospectively enrolled patients aged 0.5–17 years with confirmed peanut and/or tree nut (almond, cashew, hazelnut, pistachio, walnut) allergy or sensitization from Canadian (n = 150) and Austrian (n = 50) tertiary pediatric centers. BAT using %CD63+ basophils (SSClow/CCR3pos) as outcome was performed with whole blood samples stimulated with allergen extracts of each nut (0.001‐1000 ng/mL protein). BAT results were assessed against confirmed allergic status in a blinded fashion to develop a generalizable statistical model for comparison to extract and marker allergen‐specific IgE.
Results
A mixed effect model integrating BAT results for 10 and 100 ng/mL of peanut and individual tree nut extracts was optimal. The area under the ROC curve (AUROC) was 0.98 for peanut, 0.97 for cashew, 0.92 for hazelnut, 0.95 for pistachio, and 0.97 for walnut. The BAT outperformed sIgE testing for peanut or hazelnut and was comparable for walnut (AUROC 0.95, 0.94, 0.92) in a sub‐analysis in sensitized patients undergoing OFC.
Conclusions
Basophil activation test can predict allergic clinical status to peanut and tree nuts in multi‐nut‐sensitized children and may reduce the need for high‐risk OFCs in patients.
BAT can predict allergic clinical status to peanut and individual tree nuts in multi‐nut‐sensitized children from Austria and Canada.
Mixed effect model integrating 10 and 100 ng/mL of peanut and individual tree nut stimulation is effective in diagnosing allergy.
BAT separates allergic from non‐allergic status in patients who underwent clinically indicated OFCs to peanut and individual tree nuts.
Abbreviations: BAT, basophil activation test; OFC, oral food challenge; sIgE, specific IgE. |
| doi_str_mv | 10.1111/all.14695 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8608143</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2469092292</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4435-3d5fab8a2d64e6d60a4f5c08681438834478df68923b1a174a8913f9bf95631e3</originalsourceid><addsrcrecordid>eNp1kUtv1DAUha0K1A5DF_0DlSU2sEhrx4-xu0AaKl7SAAvK2rqTOBO3nniwk1bZ8NtxJ20FSHhjWefT8b3nIHRCyRnN5xy8P6NcanGAZpRpVWitxTM0I5SIggumjtCLlK4JIYtSk0N0xBgjhIrFDP16BynsWucxVL27hd6FDvc29Ti14S7h1m3aLFVDhGrELmutxbWDTReSSzg0eGehG3oMXY37aC3eP7y3cTNe4KtMf4F4Y-Oe_Zq15aTh7_1Qjy_R8wZ8sscP9xz9-PD-6vJTsfr28fPlclVUnDNRsFo0sFZQ1pJbWUsCvBEVUVJRzpRinC9U3UilS7amQBcclKas0etGC8moZXP0dvLdDeutrSvb9RG82UW3hTiaAM78rXSuNZtwa5Qk939kg9cPBjH8HHI-ZutSZb2HzoYhmTLHT3RZ5gnm6NU_6HUYYpfXM6XgRCoipMrUm4mqYkgp2uZpGErMfasmh2j2rWb29M_pn8jHGjNwPgF3ztvx_05muVpNlr8BBC2stA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2540680568</pqid></control><display><type>article</type><title>Basophil activation test shows high accuracy in the diagnosis of peanut and tree nut allergy: The Markers of Nut Allergy Study</title><source>Wiley Free Content</source><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Duan, Lucy ; Celik, Alper ; Hoang, Jennifer A. ; Schmidthaler, Klara ; So, Delvin ; Yin, Xiaojun ; Ditlof, Christina M. ; Ponce, Marta ; Upton, Julia E.M. ; Lee, Jean‐Soo ; Hung, Lisa ; Breiteneder, Heimo ; Palladino, Chiara ; Atkinson, Adelle R. ; Kim, Vy H.D. ; Berenjy, Alireza ; Asper, Maria ; Hummel, David ; Wong, Samantha ; Alexanian‐Farr, Mara ; Magder, Ahuva ; Chinthrajah, Sharon R. ; Mukai, Kaori ; Tsai, Mindy ; Nadeau, Kari ; Galli, Stephen J. ; Ramani, Arun K. ; Szepfalusi, Zsolt ; Eiwegger, Thomas</creator><creatorcontrib>Duan, Lucy ; Celik, Alper ; Hoang, Jennifer A. ; Schmidthaler, Klara ; So, Delvin ; Yin, Xiaojun ; Ditlof, Christina M. ; Ponce, Marta ; Upton, Julia E.M. ; Lee, Jean‐Soo ; Hung, Lisa ; Breiteneder, Heimo ; Palladino, Chiara ; Atkinson, Adelle R. ; Kim, Vy H.D. ; Berenjy, Alireza ; Asper, Maria ; Hummel, David ; Wong, Samantha ; Alexanian‐Farr, Mara ; Magder, Ahuva ; Chinthrajah, Sharon R. ; Mukai, Kaori ; Tsai, Mindy ; Nadeau, Kari ; Galli, Stephen J. ; Ramani, Arun K. ; Szepfalusi, Zsolt ; Eiwegger, Thomas</creatorcontrib><description>Background
Peanut and tree nut allergies are the most important causes of anaphylaxis. Co‐reactivity to more than one nut is frequent, and co‐sensitization in the absence of clinical data is often obtained. Confirmatory oral food challenges (OFCs) are inconsistently performed.
Objective
To investigate the utility of the basophil activation test (BAT) in diagnosing peanut and tree nut allergies.
Methods
The Markers Of Nut Allergy Study (MONAS) prospectively enrolled patients aged 0.5–17 years with confirmed peanut and/or tree nut (almond, cashew, hazelnut, pistachio, walnut) allergy or sensitization from Canadian (n = 150) and Austrian (n = 50) tertiary pediatric centers. BAT using %CD63+ basophils (SSClow/CCR3pos) as outcome was performed with whole blood samples stimulated with allergen extracts of each nut (0.001‐1000 ng/mL protein). BAT results were assessed against confirmed allergic status in a blinded fashion to develop a generalizable statistical model for comparison to extract and marker allergen‐specific IgE.
Results
A mixed effect model integrating BAT results for 10 and 100 ng/mL of peanut and individual tree nut extracts was optimal. The area under the ROC curve (AUROC) was 0.98 for peanut, 0.97 for cashew, 0.92 for hazelnut, 0.95 for pistachio, and 0.97 for walnut. The BAT outperformed sIgE testing for peanut or hazelnut and was comparable for walnut (AUROC 0.95, 0.94, 0.92) in a sub‐analysis in sensitized patients undergoing OFC.
Conclusions
Basophil activation test can predict allergic clinical status to peanut and tree nuts in multi‐nut‐sensitized children and may reduce the need for high‐risk OFCs in patients.
BAT can predict allergic clinical status to peanut and individual tree nuts in multi‐nut‐sensitized children from Austria and Canada.
Mixed effect model integrating 10 and 100 ng/mL of peanut and individual tree nut stimulation is effective in diagnosing allergy.
BAT separates allergic from non‐allergic status in patients who underwent clinically indicated OFCs to peanut and individual tree nuts.
Abbreviations: BAT, basophil activation test; OFC, oral food challenge; sIgE, specific IgE.</description><identifier>ISSN: 0105-4538</identifier><identifier>EISSN: 1398-9995</identifier><identifier>DOI: 10.1111/all.14695</identifier><identifier>PMID: 33300157</identifier><language>eng</language><publisher>Denmark: Blackwell Publishing Ltd</publisher><subject>Allergens ; Allergies ; allergy diagnosis ; Anacardiaceae ; Anaphylaxis ; Arachis ; Austria ; basophil ; Basophils ; Canada ; CD63 antigen ; challenge tests ; Child ; Diagnostic tests ; Food allergies ; food allergy ; Humans ; Immunoglobulin E ; Leukocytes (basophilic) ; Mathematical models ; Medical diagnosis ; molecular allergology ; multiple nut allergy ; Nut Hypersensitivity - diagnosis ; Nuts ; Patients ; Peanut Hypersensitivity - diagnosis ; Pediatrics ; Skin Tests</subject><ispartof>Allergy (Copenhagen), 2021-06, Vol.76 (6), p.1800-1812</ispartof><rights>2020 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.</rights><rights>2021 EAACI and John Wiley and Sons A/S</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4435-3d5fab8a2d64e6d60a4f5c08681438834478df68923b1a174a8913f9bf95631e3</citedby><cites>FETCH-LOGICAL-c4435-3d5fab8a2d64e6d60a4f5c08681438834478df68923b1a174a8913f9bf95631e3</cites><orcidid>0000-0002-0560-583X ; 0000-0002-2146-2955 ; 0000-0003-2022-8689 ; 0000-0001-5320-4232 ; 0000-0001-9620-0303 ; 0000-0003-4852-3102 ; 0000-0003-2467-4256 ; 0000-0002-2914-7829 ; 0000-0001-9264-1881 ; 0000-0001-5736-5340</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fall.14695$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fall.14695$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33300157$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Duan, Lucy</creatorcontrib><creatorcontrib>Celik, Alper</creatorcontrib><creatorcontrib>Hoang, Jennifer A.</creatorcontrib><creatorcontrib>Schmidthaler, Klara</creatorcontrib><creatorcontrib>So, Delvin</creatorcontrib><creatorcontrib>Yin, Xiaojun</creatorcontrib><creatorcontrib>Ditlof, Christina M.</creatorcontrib><creatorcontrib>Ponce, Marta</creatorcontrib><creatorcontrib>Upton, Julia E.M.</creatorcontrib><creatorcontrib>Lee, Jean‐Soo</creatorcontrib><creatorcontrib>Hung, Lisa</creatorcontrib><creatorcontrib>Breiteneder, Heimo</creatorcontrib><creatorcontrib>Palladino, Chiara</creatorcontrib><creatorcontrib>Atkinson, Adelle R.</creatorcontrib><creatorcontrib>Kim, Vy H.D.</creatorcontrib><creatorcontrib>Berenjy, Alireza</creatorcontrib><creatorcontrib>Asper, Maria</creatorcontrib><creatorcontrib>Hummel, David</creatorcontrib><creatorcontrib>Wong, Samantha</creatorcontrib><creatorcontrib>Alexanian‐Farr, Mara</creatorcontrib><creatorcontrib>Magder, Ahuva</creatorcontrib><creatorcontrib>Chinthrajah, Sharon R.</creatorcontrib><creatorcontrib>Mukai, Kaori</creatorcontrib><creatorcontrib>Tsai, Mindy</creatorcontrib><creatorcontrib>Nadeau, Kari</creatorcontrib><creatorcontrib>Galli, Stephen J.</creatorcontrib><creatorcontrib>Ramani, Arun K.</creatorcontrib><creatorcontrib>Szepfalusi, Zsolt</creatorcontrib><creatorcontrib>Eiwegger, Thomas</creatorcontrib><title>Basophil activation test shows high accuracy in the diagnosis of peanut and tree nut allergy: The Markers of Nut Allergy Study</title><title>Allergy (Copenhagen)</title><addtitle>Allergy</addtitle><description>Background
Peanut and tree nut allergies are the most important causes of anaphylaxis. Co‐reactivity to more than one nut is frequent, and co‐sensitization in the absence of clinical data is often obtained. Confirmatory oral food challenges (OFCs) are inconsistently performed.
Objective
To investigate the utility of the basophil activation test (BAT) in diagnosing peanut and tree nut allergies.
Methods
The Markers Of Nut Allergy Study (MONAS) prospectively enrolled patients aged 0.5–17 years with confirmed peanut and/or tree nut (almond, cashew, hazelnut, pistachio, walnut) allergy or sensitization from Canadian (n = 150) and Austrian (n = 50) tertiary pediatric centers. BAT using %CD63+ basophils (SSClow/CCR3pos) as outcome was performed with whole blood samples stimulated with allergen extracts of each nut (0.001‐1000 ng/mL protein). BAT results were assessed against confirmed allergic status in a blinded fashion to develop a generalizable statistical model for comparison to extract and marker allergen‐specific IgE.
Results
A mixed effect model integrating BAT results for 10 and 100 ng/mL of peanut and individual tree nut extracts was optimal. The area under the ROC curve (AUROC) was 0.98 for peanut, 0.97 for cashew, 0.92 for hazelnut, 0.95 for pistachio, and 0.97 for walnut. The BAT outperformed sIgE testing for peanut or hazelnut and was comparable for walnut (AUROC 0.95, 0.94, 0.92) in a sub‐analysis in sensitized patients undergoing OFC.
Conclusions
Basophil activation test can predict allergic clinical status to peanut and tree nuts in multi‐nut‐sensitized children and may reduce the need for high‐risk OFCs in patients.
BAT can predict allergic clinical status to peanut and individual tree nuts in multi‐nut‐sensitized children from Austria and Canada.
Mixed effect model integrating 10 and 100 ng/mL of peanut and individual tree nut stimulation is effective in diagnosing allergy.
BAT separates allergic from non‐allergic status in patients who underwent clinically indicated OFCs to peanut and individual tree nuts.
Abbreviations: BAT, basophil activation test; OFC, oral food challenge; sIgE, specific IgE.</description><subject>Allergens</subject><subject>Allergies</subject><subject>allergy diagnosis</subject><subject>Anacardiaceae</subject><subject>Anaphylaxis</subject><subject>Arachis</subject><subject>Austria</subject><subject>basophil</subject><subject>Basophils</subject><subject>Canada</subject><subject>CD63 antigen</subject><subject>challenge tests</subject><subject>Child</subject><subject>Diagnostic tests</subject><subject>Food allergies</subject><subject>food allergy</subject><subject>Humans</subject><subject>Immunoglobulin E</subject><subject>Leukocytes (basophilic)</subject><subject>Mathematical models</subject><subject>Medical diagnosis</subject><subject>molecular allergology</subject><subject>multiple nut allergy</subject><subject>Nut Hypersensitivity - diagnosis</subject><subject>Nuts</subject><subject>Patients</subject><subject>Peanut Hypersensitivity - diagnosis</subject><subject>Pediatrics</subject><subject>Skin Tests</subject><issn>0105-4538</issn><issn>1398-9995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUtv1DAUha0K1A5DF_0DlSU2sEhrx4-xu0AaKl7SAAvK2rqTOBO3nniwk1bZ8NtxJ20FSHhjWefT8b3nIHRCyRnN5xy8P6NcanGAZpRpVWitxTM0I5SIggumjtCLlK4JIYtSk0N0xBgjhIrFDP16BynsWucxVL27hd6FDvc29Ti14S7h1m3aLFVDhGrELmutxbWDTReSSzg0eGehG3oMXY37aC3eP7y3cTNe4KtMf4F4Y-Oe_Zq15aTh7_1Qjy_R8wZ8sscP9xz9-PD-6vJTsfr28fPlclVUnDNRsFo0sFZQ1pJbWUsCvBEVUVJRzpRinC9U3UilS7amQBcclKas0etGC8moZXP0dvLdDeutrSvb9RG82UW3hTiaAM78rXSuNZtwa5Qk939kg9cPBjH8HHI-ZutSZb2HzoYhmTLHT3RZ5gnm6NU_6HUYYpfXM6XgRCoipMrUm4mqYkgp2uZpGErMfasmh2j2rWb29M_pn8jHGjNwPgF3ztvx_05muVpNlr8BBC2stA</recordid><startdate>202106</startdate><enddate>202106</enddate><creator>Duan, Lucy</creator><creator>Celik, Alper</creator><creator>Hoang, Jennifer A.</creator><creator>Schmidthaler, Klara</creator><creator>So, Delvin</creator><creator>Yin, Xiaojun</creator><creator>Ditlof, Christina M.</creator><creator>Ponce, Marta</creator><creator>Upton, Julia E.M.</creator><creator>Lee, Jean‐Soo</creator><creator>Hung, Lisa</creator><creator>Breiteneder, Heimo</creator><creator>Palladino, Chiara</creator><creator>Atkinson, Adelle R.</creator><creator>Kim, Vy H.D.</creator><creator>Berenjy, Alireza</creator><creator>Asper, Maria</creator><creator>Hummel, David</creator><creator>Wong, Samantha</creator><creator>Alexanian‐Farr, Mara</creator><creator>Magder, Ahuva</creator><creator>Chinthrajah, Sharon R.</creator><creator>Mukai, Kaori</creator><creator>Tsai, Mindy</creator><creator>Nadeau, Kari</creator><creator>Galli, Stephen J.</creator><creator>Ramani, Arun K.</creator><creator>Szepfalusi, Zsolt</creator><creator>Eiwegger, Thomas</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0560-583X</orcidid><orcidid>https://orcid.org/0000-0002-2146-2955</orcidid><orcidid>https://orcid.org/0000-0003-2022-8689</orcidid><orcidid>https://orcid.org/0000-0001-5320-4232</orcidid><orcidid>https://orcid.org/0000-0001-9620-0303</orcidid><orcidid>https://orcid.org/0000-0003-4852-3102</orcidid><orcidid>https://orcid.org/0000-0003-2467-4256</orcidid><orcidid>https://orcid.org/0000-0002-2914-7829</orcidid><orcidid>https://orcid.org/0000-0001-9264-1881</orcidid><orcidid>https://orcid.org/0000-0001-5736-5340</orcidid></search><sort><creationdate>202106</creationdate><title>Basophil activation test shows high accuracy in the diagnosis of peanut and tree nut allergy: The Markers of Nut Allergy Study</title><author>Duan, Lucy ; Celik, Alper ; Hoang, Jennifer A. ; Schmidthaler, Klara ; So, Delvin ; Yin, Xiaojun ; Ditlof, Christina M. ; Ponce, Marta ; Upton, Julia E.M. ; Lee, Jean‐Soo ; Hung, Lisa ; Breiteneder, Heimo ; Palladino, Chiara ; Atkinson, Adelle R. ; Kim, Vy H.D. ; Berenjy, Alireza ; Asper, Maria ; Hummel, David ; Wong, Samantha ; Alexanian‐Farr, Mara ; Magder, Ahuva ; Chinthrajah, Sharon R. ; Mukai, Kaori ; Tsai, Mindy ; Nadeau, Kari ; Galli, Stephen J. ; Ramani, Arun K. ; Szepfalusi, Zsolt ; Eiwegger, Thomas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4435-3d5fab8a2d64e6d60a4f5c08681438834478df68923b1a174a8913f9bf95631e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Allergens</topic><topic>Allergies</topic><topic>allergy diagnosis</topic><topic>Anacardiaceae</topic><topic>Anaphylaxis</topic><topic>Arachis</topic><topic>Austria</topic><topic>basophil</topic><topic>Basophils</topic><topic>Canada</topic><topic>CD63 antigen</topic><topic>challenge tests</topic><topic>Child</topic><topic>Diagnostic tests</topic><topic>Food allergies</topic><topic>food allergy</topic><topic>Humans</topic><topic>Immunoglobulin E</topic><topic>Leukocytes (basophilic)</topic><topic>Mathematical models</topic><topic>Medical diagnosis</topic><topic>molecular allergology</topic><topic>multiple nut allergy</topic><topic>Nut Hypersensitivity - diagnosis</topic><topic>Nuts</topic><topic>Patients</topic><topic>Peanut Hypersensitivity - diagnosis</topic><topic>Pediatrics</topic><topic>Skin Tests</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Duan, Lucy</creatorcontrib><creatorcontrib>Celik, Alper</creatorcontrib><creatorcontrib>Hoang, Jennifer A.</creatorcontrib><creatorcontrib>Schmidthaler, Klara</creatorcontrib><creatorcontrib>So, Delvin</creatorcontrib><creatorcontrib>Yin, Xiaojun</creatorcontrib><creatorcontrib>Ditlof, Christina M.</creatorcontrib><creatorcontrib>Ponce, Marta</creatorcontrib><creatorcontrib>Upton, Julia E.M.</creatorcontrib><creatorcontrib>Lee, Jean‐Soo</creatorcontrib><creatorcontrib>Hung, Lisa</creatorcontrib><creatorcontrib>Breiteneder, Heimo</creatorcontrib><creatorcontrib>Palladino, Chiara</creatorcontrib><creatorcontrib>Atkinson, Adelle R.</creatorcontrib><creatorcontrib>Kim, Vy H.D.</creatorcontrib><creatorcontrib>Berenjy, Alireza</creatorcontrib><creatorcontrib>Asper, Maria</creatorcontrib><creatorcontrib>Hummel, David</creatorcontrib><creatorcontrib>Wong, Samantha</creatorcontrib><creatorcontrib>Alexanian‐Farr, Mara</creatorcontrib><creatorcontrib>Magder, Ahuva</creatorcontrib><creatorcontrib>Chinthrajah, Sharon R.</creatorcontrib><creatorcontrib>Mukai, Kaori</creatorcontrib><creatorcontrib>Tsai, Mindy</creatorcontrib><creatorcontrib>Nadeau, Kari</creatorcontrib><creatorcontrib>Galli, Stephen J.</creatorcontrib><creatorcontrib>Ramani, Arun K.</creatorcontrib><creatorcontrib>Szepfalusi, Zsolt</creatorcontrib><creatorcontrib>Eiwegger, Thomas</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Allergy (Copenhagen)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Duan, Lucy</au><au>Celik, Alper</au><au>Hoang, Jennifer A.</au><au>Schmidthaler, Klara</au><au>So, Delvin</au><au>Yin, Xiaojun</au><au>Ditlof, Christina M.</au><au>Ponce, Marta</au><au>Upton, Julia E.M.</au><au>Lee, Jean‐Soo</au><au>Hung, Lisa</au><au>Breiteneder, Heimo</au><au>Palladino, Chiara</au><au>Atkinson, Adelle R.</au><au>Kim, Vy H.D.</au><au>Berenjy, Alireza</au><au>Asper, Maria</au><au>Hummel, David</au><au>Wong, Samantha</au><au>Alexanian‐Farr, Mara</au><au>Magder, Ahuva</au><au>Chinthrajah, Sharon R.</au><au>Mukai, Kaori</au><au>Tsai, Mindy</au><au>Nadeau, Kari</au><au>Galli, Stephen J.</au><au>Ramani, Arun K.</au><au>Szepfalusi, Zsolt</au><au>Eiwegger, Thomas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Basophil activation test shows high accuracy in the diagnosis of peanut and tree nut allergy: The Markers of Nut Allergy Study</atitle><jtitle>Allergy (Copenhagen)</jtitle><addtitle>Allergy</addtitle><date>2021-06</date><risdate>2021</risdate><volume>76</volume><issue>6</issue><spage>1800</spage><epage>1812</epage><pages>1800-1812</pages><issn>0105-4538</issn><eissn>1398-9995</eissn><abstract>Background
Peanut and tree nut allergies are the most important causes of anaphylaxis. Co‐reactivity to more than one nut is frequent, and co‐sensitization in the absence of clinical data is often obtained. Confirmatory oral food challenges (OFCs) are inconsistently performed.
Objective
To investigate the utility of the basophil activation test (BAT) in diagnosing peanut and tree nut allergies.
Methods
The Markers Of Nut Allergy Study (MONAS) prospectively enrolled patients aged 0.5–17 years with confirmed peanut and/or tree nut (almond, cashew, hazelnut, pistachio, walnut) allergy or sensitization from Canadian (n = 150) and Austrian (n = 50) tertiary pediatric centers. BAT using %CD63+ basophils (SSClow/CCR3pos) as outcome was performed with whole blood samples stimulated with allergen extracts of each nut (0.001‐1000 ng/mL protein). BAT results were assessed against confirmed allergic status in a blinded fashion to develop a generalizable statistical model for comparison to extract and marker allergen‐specific IgE.
Results
A mixed effect model integrating BAT results for 10 and 100 ng/mL of peanut and individual tree nut extracts was optimal. The area under the ROC curve (AUROC) was 0.98 for peanut, 0.97 for cashew, 0.92 for hazelnut, 0.95 for pistachio, and 0.97 for walnut. The BAT outperformed sIgE testing for peanut or hazelnut and was comparable for walnut (AUROC 0.95, 0.94, 0.92) in a sub‐analysis in sensitized patients undergoing OFC.
Conclusions
Basophil activation test can predict allergic clinical status to peanut and tree nuts in multi‐nut‐sensitized children and may reduce the need for high‐risk OFCs in patients.
BAT can predict allergic clinical status to peanut and individual tree nuts in multi‐nut‐sensitized children from Austria and Canada.
Mixed effect model integrating 10 and 100 ng/mL of peanut and individual tree nut stimulation is effective in diagnosing allergy.
BAT separates allergic from non‐allergic status in patients who underwent clinically indicated OFCs to peanut and individual tree nuts.
Abbreviations: BAT, basophil activation test; OFC, oral food challenge; sIgE, specific IgE.</abstract><cop>Denmark</cop><pub>Blackwell Publishing Ltd</pub><pmid>33300157</pmid><doi>10.1111/all.14695</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0002-0560-583X</orcidid><orcidid>https://orcid.org/0000-0002-2146-2955</orcidid><orcidid>https://orcid.org/0000-0003-2022-8689</orcidid><orcidid>https://orcid.org/0000-0001-5320-4232</orcidid><orcidid>https://orcid.org/0000-0001-9620-0303</orcidid><orcidid>https://orcid.org/0000-0003-4852-3102</orcidid><orcidid>https://orcid.org/0000-0003-2467-4256</orcidid><orcidid>https://orcid.org/0000-0002-2914-7829</orcidid><orcidid>https://orcid.org/0000-0001-9264-1881</orcidid><orcidid>https://orcid.org/0000-0001-5736-5340</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0105-4538 |
| ispartof | Allergy (Copenhagen), 2021-06, Vol.76 (6), p.1800-1812 |
| issn | 0105-4538 1398-9995 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8608143 |
| source | Wiley Free Content; MEDLINE; Wiley Online Library Journals Frontfile Complete; EZB-FREE-00999 freely available EZB journals |
| subjects | Allergens Allergies allergy diagnosis Anacardiaceae Anaphylaxis Arachis Austria basophil Basophils Canada CD63 antigen challenge tests Child Diagnostic tests Food allergies food allergy Humans Immunoglobulin E Leukocytes (basophilic) Mathematical models Medical diagnosis molecular allergology multiple nut allergy Nut Hypersensitivity - diagnosis Nuts Patients Peanut Hypersensitivity - diagnosis Pediatrics Skin Tests |
| title | Basophil activation test shows high accuracy in the diagnosis of peanut and tree nut allergy: The Markers of Nut Allergy Study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-08T13%3A34%3A47IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Basophil%20activation%20test%20shows%20high%20accuracy%20in%20the%20diagnosis%20of%20peanut%20and%20tree%20nut%20allergy:%20The%20Markers%20of%20Nut%20Allergy%20Study&rft.jtitle=Allergy%20(Copenhagen)&rft.au=Duan,%20Lucy&rft.date=2021-06&rft.volume=76&rft.issue=6&rft.spage=1800&rft.epage=1812&rft.pages=1800-1812&rft.issn=0105-4538&rft.eissn=1398-9995&rft_id=info:doi/10.1111/all.14695&rft_dat=%3Cproquest_pubme%3E2469092292%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2540680568&rft_id=info:pmid/33300157&rfr_iscdi=true |