Evaluation of basophil activation in food allergy: present and future applications

Purpose of review: The diagnoses of immediate hypersensitivity relies on specific IgE and history. Because of low specificity, howver, provocation challenges are often necfessary. Furthermore, IgE testing does not predict features such as reaction severity; nor can it ediscriminate cross-reactivity from multiple sensitizationa. Direct and passive basophil activation tests may address these needs. In addition, measuring basophil activation ex vio may be useful for monitering patients with food allergies. Recent findings: Several papers using basophil activation tests demonstate comparable sensitivity and specificity to current testing for foood allergy. Flow-based basophil activation phenotypes have been identified as markeres of allergic inflammation in vivo; these phenotypes appear to correspond to earlier reports of spontaneous histamine-releasing basophils in patients with active allergic inflammation. Summary: Although in thier early stages, direct basophil activation tests may prove to be useful in the clinic. Indirect basophil activation studies are useful when applied to compare functional aspects of IgE. Identification of basophil activation ex vivo is a promising approach for monitering allergic inflammation.