Abstract
BackgroundMost of the peanut-sensitized children do not have clinical peanut allergy. In equivocal cases, oral food challenges (OFCs) are required. However, OFCs are laborious and not without risk; thus, a test that could accurately diagnose peanut allergy and reduce the need for OFCs is desirable.ObjectiveTo assess the performance of basophil activation test (BAT) as a diagnostic marker for peanut allergy.MethodsPeanut-allergic (n = 43), peanut-sensitized but tolerant (n = 36) and non–peanut-sensitized nonallergic (n = 25) children underwent skin prick test (SPT) and specific IgE (sIgE) to peanut and its components. BAT was performed using flow cytometry, and its diagnostic performance was evaluated in relation to allergy versus tolerance to peanut and validated in an independent population (n = 65).ResultsBAT in peanut-allergic children showed a peanut dose-dependent upregulation of CD63 and CD203c while there was no significant response to peanut in peanut-sensitized but tolerant (P < .001) and non–peanut-sensitized nonallergic children (P < .001). BAT optimal diagnostic cutoffs showed 97% accuracy, 95% positive predictive value, and 98% negative predictive value. BAT allowed reducing the number of required OFCs by two-thirds. BAT proved particularly useful in cases in which specialists could not accurately diagnose peanut allergy with SPT and sIgE to peanut and to Arah2. Using a 2-step diagnostic approach in which BAT was performed only after equivocal SPT or Arah2-sIgE, BAT had a major effect (97% reduction) on the number of OFCs required.ConclusionsBAT proved to be superior to other diagnostic tests in discriminating between peanut allergy and tolerance, particularly in difficult cases, and reduced the need for OFCs.
Highlights
Most of the peanut-sensitized children do not have clinical peanut allergy
Citing this paper Please note that where the full-text provided on King's Research Portal is the Author Accepted Manuscript or Post-Print version this may differ from the final Published version
The combination of basophil activation test (BAT) with other diagnostic tests We evaluated the diagnostic performance of different tests in the primary study population (n 5 104), including BAT
Summary
Most of the peanut-sensitized children do not have clinical peanut allergy. In equivocal cases, oral food challenges (OFCs) are required. Methods: Peanut-allergic (n 5 43), peanut-sensitized but tolerant (n 5 36) and non–peanut-sensitized nonallergic (n 5 25) children underwent skin prick test (SPT) and specific. From athe Division of Asthma, Allergy & Lung Biology, Department of Pediatric Allergy, King’s College London; bMRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London; cthe Immunoallergology Department, Coimbra University Hospital, Coimbra; dGulbenkian Programme for Advanced Medical Education, Lisbon; ethe Department of Public Health Science, School of Medicine, King’s College London, London; and fthe National Institute for Health Research, Biomedical Research Centre, Guy’s and St Thomas’ Hospital NHS Foundation Trust, London.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
