Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Opinion Article Int Arch Allergy Immunol 2008;146:177–189 DOI: 10.1159/000115885 Diagnostic Tests Based on Human Basophils: More Potentials and Perspectives than Pitfalls A.L. de Weck a M.L. Sanz a P.M. Gamboa b W. Aberer d J. Bienvenu e M. Blanca c P. Demoly f D.G. Ebo h L. Mayorga c G. Monneret e J. Sainte-Laudy g a University of Navarra, Pamplona, b Hopital Basurto, Bilbao, and c Carlos Haya Hospital, Malaga, Spain; d University of Graz, Graz, Austria; Centres Hospitaliers Universitaires, e Lyon, f Montpellier and g Limoges, France; h Department of Immunology, University of Antwerp, Antwerp, Belgium sons to deprive allergic patients of clinically indicated BAT, which can be performed reliably by any laboratory with al- lergy and flow-cytometric capacity and expertise. Copyright © 2008 S. Karger AG, Basel Introduction In a recent issue of this Journal an opinion paper was devoted to diagnostic tests in allergy based on human basophils [1]. Although reviewing first many publica- tions about histamine release as an outcome of basophil activation, the main discussion and criticisms of this pa- per focus on the flow-cytometric basophil activation test (BAT), which has recently attracted increased attention. The overall picture is strongly influenced by the expe- rience gained with anti-IgE- and allergen-induced hista- mine release. In a number of ways, expression of basophil activation markers, particularly when applied to diag- nostic clinical evaluation of basophil activation, obeys different rules, and a number of pitfalls are simply coun- teracted by our long clinical experience with such tests. The above-mentioned opinion paper [1] also nourishes the general impression that the diagnostic use of flow- cytometric BAT is plagued with many unresolved ques- Key Words Basophil activation  Drug allergy  Flow cytometry  Food allergy  Insect venoms  -Lactams  Latex  Myorelaxants  NSAID Abstract For the diagnosis of allergy, cellular basophil activation tests (BAT), e.g. histamine or sulfidoleukotriene release tests, have long been introduced, but the expression of basophil acti- vation markers such as CD63 and CD203c detected by flow cytometry has attracted more recent attention. A recent opinion paper in this Journal has stressed not only the po- tential but also the possible pitfalls of flow-cytometric BAT. We have applied clinical validation of various BAT in various ways for several years, and our experience shows that these new technologies have more potentials and perspectives than pitfalls. A comprehensive review of clinically validated studies on allergy to aeroallergens, insect venoms, latex, food allergens and drugs, e.g. myorelaxants, -lactams, pyr- azolones and non-steroidal anti-inflammatory drugs, as well as chronic urticaria shows clearly that even with different protocols, reproducible and meaningful results can be ob- tained. Although the available technologies may still be op- timized and better standardized, there are no serious rea- Received: June 25, 2007 Accepted after revision: October 18, 2007 Published online: February 11, 2008 Correspondence to: Prof. Alain de Weck Beaumont 18 CH–1700 Fribourg (Switzerland) Tel. +41 26 424 6910, Fax +41 26 424 6911 E-Mail alain.dew@bluewin.ch © 2008 S. Karger AG, Basel 1018–2438/08/1463–0177$24.50/0 Accessible online at: www.karger.com/iaa