Basophil Activation Test useful Alternative to Nasal Allergen Challenge Test for Allergic Rhinitis, suggests study

Written By : Dr.Niharika Harsha B |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2024-11-27T00:30:27+05:30 | Updated On 27 Nov 2024 12:23 PM IST

A recent groundbreaking study confirmed that the basophil activation test (BAT) is a useful tool instead of nasal allergen challenges to confirm allergies as per results published in the journal Allergy.

Allergic rhinitis (AR) is an inflammatory condition of the nasal mucosa associated with increased morbidity and reduced quality of life. Skin prick test (SPT) and serum allergen-specific (sIgE) are some of the tests for AR after a thorough clinical examination. nasal allergen challenge (NAC) is advised to individuals whose clinical history is not sufficiently clarifying regarding the relevance of the sensitizations detected. Some individuals have negative SPT tests but positive NAC which is called local allergic rhinitis (LAR). Some may have a combination of allergies with and without SPT positivity called dual allergic rhinitis (DAR). Research shows that BAT can be used as a standard test for AR. Research shows that BAT can be an alternative to NAC for allergic patients with an IgE-dependent endotype. Hence, researchers conducted a study to investigate the diagnostic performance of BAT for allergic phenotypes of rhinitis.

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A prospective study included patients ≥18 years with chronic rhinitis for ≥2 years. They were subjected to NAC with the allergens from Dermatophagoides pteronyssinus (DP), Alternaria alternata (AA), Grass pollen (GP), and Olea europaea pollen (OP). Rhinitis subjects underwent a 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, de-fined as AR for ≥1 allergen and LAR for ≥1 allergen), and non-allergic rhinitis (NAR, negative NAC and SPT) phenotypes. BAT was used to measure allergic reactions in various samples. Shapiro-Wilk tests were used to assess data normality, ROC curves were used to assess the diagnostic accuracy of BAT.

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 from 43.5%(AA)-83.3%(OP), 88.9%(GP)-100%(AA), 87%(GP)-100%(AA), and61.1%(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 was associated with conjunctivitis (p = 0.015) in allergic subjects.

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Thus, the study concluded that BAT can be effectively used for various rhinitis phenotypes. This comes after BAT positivity was linked to severe rhinitis in LAR and conjunctivitis in allergic individuals. As BAT can widely discriminate between allergic and non-allergic rhinitis with high sensitivity and specificity this can be used for early diagnosis and a tailored treatment plan.

Further reading: Testera-Montes A, Ariza A, Sola-Martinez RA, et al. Investigation of the diagnostic accuracy of basophil activation test for allergic phenotypes of rhinitis. Allergy. Published online November 5, 2024. doi:10.1111/all.16390

Allergybasophil activation testAlmudena Testera-Montesnasal allergen challengeAllergic Rhinitis

Source : Allergy

Dr.Niharika Harsha B

BDS, MDS

Dr.Niharika Harsha B (BDS,MDS) completed her BDS from Govt Dental College, Hyderabad and MDS from Dr.NTR University of health sciences(Now Kaloji Rao University). She has 4 years of private dental practice and worked for 2 years as Consultant Oral Radiologist at a Dental Imaging Centre in Hyderabad. She worked as Research Assistant and scientific writer in the development of Oral Anti cancer screening device with her seniors. She has a deep intriguing wish in writing highly engaging, captivating and informative medical content for a wider audience. She can be contacted at editorial@medicaldialogues.in.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751