@article{97d5e9ad55d94eff925a00e0e88c112b,
title = "Basophil activation test shows high accuracy in the diagnosis of peanut and tree nut allergy: The Markers of Nut Allergy Study",
abstract = "BACKGROUND: Peanut and tree nut allergies are the most important causes of anaphylaxis. Co-reactivity to more than one nut is frequent, and co-sensitization in the absence of clinical data is often obtained. Confirmatory oral food challenges (OFCs) are inconsistently performed.OBJECTIVE: To investigate the utility of the basophil activation test (BAT) in diagnosing peanut and tree nut allergies.METHODS: The Markers Of Nut Allergy Study (MONAS) prospectively enrolled patients aged 0.5-17 years with confirmed peanut and/or tree nut (almond, cashew, hazelnut, pistachio, walnut) allergy or sensitization from Canadian (n = 150) and Austrian (n = 50) tertiary pediatric centers. BAT using %CD63+ basophils (SSClow/CCR3pos) as outcome was performed with whole blood samples stimulated with allergen extracts of each nut (0.001-1000 ng/mL protein). BAT results were assessed against confirmed allergic status in a blinded fashion to develop a generalizable statistical model for comparison to extract and marker allergen-specific IgE.RESULTS: A mixed effect model integrating BAT results for 10 and 100 ng/mL of peanut and individual tree nut extracts was optimal. The area under the ROC curve (AUROC) was 0.98 for peanut, 0.97 for cashew, 0.92 for hazelnut, 0.95 for pistachio, and 0.97 for walnut. The BAT outperformed sIgE testing for peanut or hazelnut and was comparable for walnut (AUROC 0.95, 0.94, 0.92) in a sub-analysis in sensitized patients undergoing OFC.CONCLUSIONS: Basophil activation test can predict allergic clinical status to peanut and tree nuts in multi-nut-sensitized children and may reduce the need for high-risk OFCs in patients.",
keywords = "Allergens, Arachis, Austria, Basophils, Canada, Child, Humans, Nut Hypersensitivity/diagnosis, Nuts, Peanut Hypersensitivity/diagnosis, Skin Tests",
author = "Lucy Duan and Alper Celik and Hoang, {Jennifer A} and Klara Schmidthaler and Delvin So and Xiaojun Yin and Ditlof, {Christina M} and Marta Ponce and Upton, {Julia E M} and Jean-Soo Lee and Lisa Hung and Heimo Breiteneder and Chiara Palladino and Atkinson, {Adelle R} and Kim, {Vy H D} and Alireza Berenjy and Maria Asper and David Hummel and Samantha Wong and Mara Alexanian-Farr and Ahuva Magder and Chinthrajah, {Sharon R} and Kaori Mukai and Mindy Tsai and Kari Nadeau and Galli, {Stephen J} and Ramani, {Arun K} and Zsolt Szepfalusi and Thomas Eiwegger",
note = "Funding Information: Lucy Duan has nothing to disclose. Alper Celik has nothing to disclose. Jennifer A. Hoang has nothing to disclose. Klara Schmidthaler has nothing to disclose. Delvin So has nothing to disclose. Xiaojun Yin has nothing to disclose. Christina M. Ditlof has nothing to disclose. Marta Ponce has nothing to disclose. Julia Upton reports grants and personal fees from ALK‐Abell{\'o} A/S, personal fees from Bausch Health, personal fees from Kaleo, grants from DBV Technologies, grants from Regeneron, and grants from Food Allergy Anaphylaxis Programme (SickKids), outside the submitted work; and Section Chair of Food Allergy and Anaphylaxis, Canadian Society of Allergy and Clinical Immunology; Healthcare Advisory Board, Food Allergy Canada. Jean‐Soo Lee has nothing to disclose. Lisa Hung has nothing to disclose. Heimo Breiteneder has nothing to disclose. Chiara Palladino has nothing to disclose. Adelle R. Atkinson has nothing to disclose. Vy H.D. Kim has nothing to disclose. Alireza Berenjy has nothing to disclose. Maria Asper has nothing to disclose. David Hummel has nothing to disclose. Samantha Wong has nothing to disclose. Mara Alexanian‐Farr has nothing to disclose. Ahuva Magder has nothing to disclose. Sharon Chinthrajah reports grants from NIAID, grants from Aimmune, grants from DBV Technologies, grants from Astellas, grants from AnaptysBio, grants from Regeneron, grants from CoFAR, personal fees from Alladapt Therapeutics, personal fees from Genetech, personal fees from Novartis, personal fees from Before Brands, and personal fees from Nutricia, during the conduct of the study; grants from NIAID, grants and other from Aimmune, grants from DBV Technologies, grants from Astellas, grants from AnaptysBio, grants from Regeneron, grants from CoFAR, grants and other from All Adapt, grants and other from Genentech, grants and other from Novartis, grants and other from Before Brands, grants and other from Nutricia, and other from Guidepoint Global, outside the submitted work. Kaori Mukai has nothing to disclose. Mindy Tsai reports grants from NIAID/NIH during the conduct of the study. Kari Nadeau reports grants and other from NIAID, other from Novartis, personal fees and other from Regeneron, grants and other from FARE, grants from EAT, other from Sanofi, other from Astellas, other from Nestle, other from Before Brands, other from Alladapt, other from Fortra, other from Genentech, other from Aimmune Therapeutics, other from DBV Technologies, personal fees from AstraZeneca, personal fees from ImmuneWorks, personal fees from Cour Pharmaceuticals, grants from AllerGenis, grants from Ukko Pharma, other from AnaptysBio, other from Adare Pharmaceuticals, other from Stallergenes Greer, other from NHLBI, other from NIEHS, other from EPA, other from WAO Center of Excellence, other from IgGenix, other from ProBio, other from Vedanta, other from Centecor, other from Seed, other from Immune Tolerance Network, and other from NIH, outside the submitted work. In addition, Dr. Nadeau has a patent Inhibition of Allergic Reaction to Peanut Allergen using an IL‐33 Inhibitor pending, a patent Special Oral Formula for Decreasing Food Allergy Risk and Treatment for Food Allergy pending, a patent Basophil Activation Based Diagnostic Allergy Test pending, a patent Granulocyte‐based methods for detecting and monitoring immune system disorders pending, a patent Methods and Assays for Detecting and Quantifying Pure Subpopulations of White Blood Cells in Immune System Disorders pending, a patent Mixed Allergen Compositions and Methods for Using the Same pending, and a patent Microfluidic Device and Diagnostic Methods for Allergy Testing Based on Detection of Basophil Activation pending. Stephen Galli reports grants from NIAID/NIH during the conduct of the study. Arun K. Ramani has nothing to disclose. Zsolt Szepfalusi has nothing to disclose. Thomas Eiwegger reports other from DBV, grants from Innovation fund Denmark and CIHR, and other from Regeneron. He is the Co‐I or scientific lead in three investigator initiated oral immunotherapy trials including the usage of biologicals supported by the Allergy and Anaphylaxis Program SickKids and CIHR. He serves as associate editor for Allergy. He is on advisory boards for ALK. Publisher Copyright: {\textcopyright} 2020 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.",
year = "2021",
month = jun,
doi = "10.1111/all.14695",
language = "English",
volume = "76",
pages = "1800--1812",
journal = "Allergy: European Journal of Allergy and Clinical Immunology",
issn = "0105-4538",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "6",
}