Influence of Antihistamines on Basophil Activation Test in Food Allergy to Milk and Egg.

Eleonora Nucera,Riccardo Inchingolo,Anna Giulia Ricci,Marilena La Sorda,Maurizio Sanguinetti,Giuseppe Parrinello,Angela Rizzi,Rosario Nicotra,Antonio Gasbarrini,Manuela Ferraironi

doi:10.3390/diagnostics11010044

Abstract

Background: The basophil activation test (BAT) is used to improve the accuracy of food allergy diagnosis. To date, the influence of antiallergic drugs on BAT reactivity is poorly investigated. The aim of the study was to investigate if BAT results were influenced by antihistamine intake for 3 months in a cohort of patients with IgE-mediated food allergy to milk or egg. Methods: A retrospective, single-center, observational study was performed. We enrolled subjects with history of hypersensitivity reaction after specific food ingestion, positive skin prick tests and specific IgEs, concomitant allergic rhinitis, and, contraindication to the double-blind, placebo-controlled food challenge due to personal history of systemic reactions related to the ingestion of culprit food. Validated allergens (α-lactoalbumin, β-lactoglobulin, casein, egg white, and yolk) for BAT were used. Results: Thirty-nine patients with well-documented food symptoms and positive allergological workup were included in the study. BAT was positive in 29 patients. The mean percentages of CD63+ expression to specific culprit allergen did not change after the administration of drugs. Conclusions: This was the first study assessing the effects of oral antihistamines on basophil reactivity in cow’s milk and egg food allergy. Antihistamines do not interfere with BAT results.

Highlights

IgE-mediated food allergy is increasingly recognized as a growing public health burden with a prevalence ranging from 0.1% to 6.0% in Europe [1] and high morbidity and mortality rates [2]
In order to explore if basophil CD63+ expression was influenced by the use of antihistamines, the median percentages of basophil activation test (BAT) results for each specific culprit allergens (α-lactoalbumin, β-lactoglobulin and casein for cow’s milk, and egg white and yolk, respectively), before and after the administration of drugs, were compared with Wilcoxon signed-rank test, because of the heterogeneous distribution of the sample
To the best of our knowledge, this was the first study, which focused on the influence of antihistamines on BAT results in cow’s milk and egg food allergy

Summary

Introduction

IgE-mediated food allergy is increasingly recognized as a growing public health burden with a prevalence ranging from 0.1% to 6.0% in Europe [1] and high morbidity and mortality rates [2]. The gold standard to diagnose IgE-mediated food allergy remains the double blind, placebo-controlled food challenge (DBPCFC). The aim of the study was to investigate if BAT results were influenced by antihistamine intake for 3 months in a cohort of patients with IgE-mediated food allergy to milk or egg. Methods: A retrospective, single-center, observational study was performed. We enrolled subjects with history of hypersensitivity reaction after specific food ingestion, positive skin prick tests and specific IgEs, concomitant allergic rhinitis, and, contraindication to the double-blind, placebo-controlled food challenge due to personal history of systemic reactions related to the ingestion of culprit food.

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