Cellular Antigen Stimulation Test Research Articles

Case Report. Monascus purpureus—a new fungus of allergologic relevance

Anaphylactic reactions to food containing allergens in the consumption or preparation of food are well known. However, allergy in the preparation of sausages has rarely been described. In the present study a 26-year-old-butcher was investigated who had a severe anaphylactic reaction developing sneezing, rhinitis, conjunctivitis, generalised pruritus, followed by widespread urticaria, Quincke's oedema and dyspnoe after starting to prepare sausages containing red yield rice. Red yield rice is produced by the fungus Monascus purpureus. It was the first time that Monascus purpureus could be shown as allergic agent by means of prick-to-prick test, Cellular Antigen Stimulation Test (CAST) and different immunoblots.

Adverse drug reaction diagnosis by cellular antigen stimulation test (CAST-ELISA): Correaltion with oral drug challenge

Adverse drug reaction diagnosis by cellular antigen stimulation test (CAST-ELISA): Correaltion with oral drug challenge

Die Diagnostik von Allergien und Intoleranzreaktionen auf Hymenopterengifte mit Hilfe des Zellantigenstimulationstests (CAST)

Der Zellantigenstimulationstest (CAST) stellt ein neues Verfahren in der In-vitro-Diagnostik von allergischen Reaktionen dar. Dieser Test beruht auf der Stimulierung von Blutleukozyten mit anschließender Bestimmung der produzierten Sulfidoleukotriene LTC4 und deren Metaboliten LTD4 und LTE4. Die Sulfidoleukotriene werden mittels ELISA-Technik (Enzyme Linked Immunosorbent Assay) gemessen. 84 Patienten mit Verdacht auf Hymenopterengiftallergie wurden mit Hilfe des CAST, des CAP-Systems und der klassischen Hauttests untersucht. Beim vorliegenden Untersuchungsmaterial wurden allergische Reaktionen aller Schweregrade (Grad I-IV nach Mueller) diagnostiziert. Die allergologische Abklärung umfasste nach einer gründlichen Anamnese den Hauttest (Schwellenwertbestimmung bis 1 µg/mL), die spezifische IgE-Antikörper-Bestimmung mit dem CAP-System und den zellulären Antigenstimulationstest. Der CAST wurde mit einer Konzentration von jeweils 0,2 µg/mL Bienen- und Wespengift (Apis mellifera et Vespula spec.) durchgeführt. Als Vergleich diente eine Kontrollgruppe von 10 nicht-allergischen CAP-negativen Personen. Zur Evaluation der diagnostischen Wertigkeiten des CAST wurden sowohl Vergleiche mit dem Hauttest als auch mit den Ergebnissen des CAP-Systems herangezogen. Die Sensitivität und Spezifität erreichten mit 93/67 % für Bienengift und 96/63 % für Wespengift sehr gute Werte und war den CAP-Ergebnissen überlegen. Durch Inkubation mit C 5a war es möglich, in einigen Fällen eine pseudoallergische Reaktion nachzuweisen.

Le test de stimulation leucocytaire ou CAST (cellular antigen stimulation test) dans le diagnostic in vitro des réactions allergiques et des réactions d'intolérance : faisabilité et évaluaton technique

Cellular antigen stimulation test (CAST-ELISA) in the diagnosis of allergic and intolerance reactions : feasibility and technical evaluation. In order to evaluate the feasibility of the CAST-ELISA we tested 155 patients aged 5 to 86 years for antigens where classical in vitro tests are not available, not enough reliable or difficult to perform in routine : dyes and preservatives (419 tests), antibiotics (101 tests) and non steroidal anti-inflammatory drugs including acetylsalicyclic acid (76 tests). This test is easy to perform within a hospital based laboratory trained to operate on living cells. It offers a new and scientifically attractive approach of allergic and intolerance reactions by studying their pathophysiological mechanisms on a cellular level. It allows objective and quantified exploration of antigenic challenged leukocytes reactivity by the quantitaif measurement of leukotrienes they produce and wich are potent inflammatory mediators. This in vitro safe challenge test is a promising tool for the diagnosis of IgE-dependent allergic reactions and IgE-non dependent intolrance reactions. Since this study was achieved, CAST-ELISA is performed routinely within our laboratory.

Diagnosis of oral allergy syndrome to apple using the cellular antigen stimulation test (cast®) with native apple extract despite negative specific IgE results

Diagnosis of oral allergy syndrome to apple using the cellular antigen stimulation test (cast®) with native apple extract despite negative specific IgE results

Sulfidoleukotriene release test (CAST) in hypersensitivity to nonsteroidal anti-inflammatory drugs.

There is a great need to develop a method for making an accurate and reliable in vitro diagnosis of adverse hypersensitivity reactions to drugs. We measured the amount of sulfidoleukotriene (sLT) released from the peripheral blood leukocytes obtained from 25 patients who developed hypersensitivity reactions following the administration of nonsteroidal anti-inflammatory drugs (NSAIDs); 12 patients demonstrated reactions to Voltaren, 8 patients to Bufferin, and 5 patients to Sedes G. The stimulation index, the ratio of the amounts of sLT (pg/ml) incubated with and without drugs, was considerably higher in the patients than in the controls, which consisted of 5 nonallergic healthy subjects. The sensitivity of the CAST (cellular antigen stimulation test) was evaluated to range from 62.5 to 80%, while the specificity was 70-100%. The CAST may thus be useful as a novel in vitro test system in order to screen for possible hypersensitive reactions to NSAIDs with both reliability and safety.