In vitro diagnosis of cypress pollen allergy by using cytofluorimetric analysis of basophils (Basotest),☆☆,

https://doi.org/10.1016/S0091-6749(00)90085-XGet rights and content

Abstract

Background: Cupressaceae pollen allergy is a worldwide pollinosis, but its in vitro diagnosis is notoriously difficult. The Basotest is a newly available in vitro test for the detection of allergen-specific IgE based on the level of cellular activation of basophils by using flow cytometry. Objectives: The Basotest was compared with the measurement of cypress pollen–specific IgE in highly selected patients. Methods: We analyzed 34 patients allergic to cypress pollen selected on the basis of a suggestive clinical history and positive skin test and nasal challenge responses to cypress pollen extract. We also analyzed 8 patients with positive skin test responses to cypress pollen extract who did not present symptoms during the pollen season (intermediate group) and 33 control subjects. Sensitivity, specificity, and efficiency of the Basotest and serum-specific IgE levels measured by using the CAP System were determined in patients allergic to cypress pollen. Histamine release was studied in a selected group of patients. Results: The Basotest was more sensitive (91.2%) than the CAP System (76%) for the in vitro diagnosis of cypress pollen allergy. A dose-response curve was observed in basophils obtained from patients allergic to cypress pollen. There were no false-positive results with either test (specificity 100%). The results of the Basotest or those of the CAP System did not correlate with the patients’ in vivo threshold sensitivity assessed by skin tests and nasal challenge. Conclusions: The Basotest was found to be an effective diagnostic test in patients allergic to cypress pollen. (J Allergy Clin Immunol 2000;105:339-45.)

Section snippets

Subjects

Thirty-four patients allergic to cypress pollen (17 men and 17 women, 19 to 64 years [mean ± SD, 36 ± 11 years]) were enrolled by using the following criteria. All patients had exhibited symptoms of rhinitis between January and March during the peak of the cypress pollen season for at least the past 2 years and demonstrated a positive skin prick test response and a positive nasal challenge response to cypress pollen extract, as described below. Patients were excluded if they had taken

Clinical characteristics of the subjects

All 34 patients allergic to cypress pollen presented nasal symptoms during the cypress pollen season. Conjunctivitis was present in 23 allergic patients, and 1 patient had asthma. Five patients were monosensitized (Table I).

. Individual data of in vivo and in vitro test in allergic patients

Patient numberAge (y)Time (mo)MSPSNPT*Skin prick test*Specific IgE (kUA /L)Basotest (%)
No. 1593+320.9750.27
No. 2213+319.3459.35
No. 3353+52<0.351.33
No. 4276+53<0.3585.88
No. 53412+43<0.3515.44
No. 64612+44

DISCUSSION

In this study a selected group of patients with a positive skin prick test response and clinical history of cypress allergy were studied, and it was found that the Basotest was more efficient than the CAP System for the in vitro diagnosis of cypress pollen allergy. However, neither the results of the Basotest nor those of the CAP System were correlated with the threshold in vivo patient sensitivity, as assessed by skin tests or nasal challenge.

The clinical diagnosis of cypress pollen allergy is

References (40)

  • J Bousquet et al.

    Comparison between RAST and Pharmacia CAP system: a new automated specific IgE assay

    J Allergy Clin Immunol

    (1990)
  • H Nolte et al.

    Performance characteristics of a new automated enzyme immunoassay for the measurement of allergen-specific IgE. Summary of the probability outcomes comparing results of allergen skin testing to results obtained with the HYTEC system and CAP system

    Ann Allergy Asthma Immunol

    (1997)
  • EA Pastorello et al.

    Studies on the relationship between the level of specific IgE antibodies and the clinical expression of allergy. I. Definition of levels distinguishing patients with symptomatic from patients with asymptomatic allergy to common aeroallergens

    J Allergy Clin Immunol

    (1995)
  • JP Corey et al.

    Comparison of modified PhadezymRAST, ImmunoCAP, and serial dilution titration skin testing by receiver operating curve analysis

    Otolaryngol Head Neck Surg

    (1995)
  • A Mari et al.

    Cypress allergy: an underestimated pollinosis

    Allergy

    (1997)
  • J Bousquet et al.

    Allergy in the Mediterranean area. I. Pollen counts and pollinosis of Montpellier

    Clin Allergy

    (1984)
  • J Bousquet et al.

    Heterogeneity of atopy. I. Clinical and immunologic characteristics of patients allergic to cypress pollen

    Allergy

    (1993)
  • NH Pham et al.

    Allergenic relationship between taxonomically diverse pollens

    Clin Exp Allergy

    (1995)
  • G Di-Felice et al.

    Allergens of Arizona cypress (Cupressus arizonica) pollen: characterization of the pollen extract and identification of the allergenic components

    J Allergy Clin Immunol

    (1994)
  • MJ Reid et al.

    Mountain cedar pollinosis: can it occur in non-atopics?

    N Engl Reg Allergy Proc

    (1988)
  • Cited by (98)

    • Basophil activation test for inhalant allergens in pediatric patients with allergic rhinitis

      2017, International Journal of Pediatric Otorhinolaryngology
      Citation Excerpt :

      Additionally, corresponding PPV and NPV to determine grass pollen sensitization in children with allergic rhinitis were resulted as 0.98 and 0.88, respectively. Two studies investigating the flow cytometric analysis of in vitro-activated basophils in the diagnosis of HDM allergy resulted that the overall sensitivity and specificity equaled or exceeded 90% [18,21]. Additionally, Cozon et al. also determined sensitivity and specificity of basophil CD63 surface expression with IL-3 pre-incubation induced by HDM and concluded as 78% and 81%, respectively for the diagnosis of atopic patients [19].

    • BATting above average: Basophil activation testing for peanut allergy

      2014, Journal of Allergy and Clinical Immunology
    • Assessment of allergen sensitization in a general population-based survey (European Community Respiratory Health Survey I)

      2010, Annals of Epidemiology
      Citation Excerpt :

      This is particularly true in the Mediterranean area in which cypress pollen was not tested. It was decided not to test this particular pollen because it was not standardized at the time of the study and many patients with a clinically-evident allergy had negative skin tests and serum-specific IgE (28). Bermuda grass might have been tested (27), but it does not seem to represent major allergens in most of the centers.

    • Antigen-driven basophil activation is indicative of early Necator americanus infection in IgE-seronegative patients

      2009, Journal of Allergy and Clinical Immunology
      Citation Excerpt :

      The supernatant was discarded, and the cells were fixed in 0.5% formaldehyde/DPBS. Because identification of basophils in whole blood relied solely on CD203c expression (in combination with side-scatter/forward-scatter gating), the incubation time was chosen as 10 minutes, which allows optimal detection of CD203c,10,11 rather than longer incubation times, which might have been more suitable for CD63 and have been shown by some authors to peak after 20 to 25 minutes.10,12 The stained blood samples were measured on an EPICS Altra sorter (Coulter, High Wycombe, United Kingdom), and data were analyzed with WinMDI version 2.8 (The Scripps Research Institute, La Jolla, Calif).

    • Introduction

      2022, Manual of Molecular and Clinical Laboratory Immunology: 7th edition
    View all citing articles on Scopus

    Supported by INSERM. Aurélie Pâris-Koëhler is supported by the Fondation de la Recherche Médicale.

    ☆☆

    Reprint requests: Bernard Arnoux, PhD, INSERM U454-IFR3, Hopital Arnaud de Villeneuve, 34295 Montpellier CEDEX 5, France.

    0091-6749/2000 $12.00 + 0  1/1/103175

    View full text