1
|
Ebo DG, Bahri R, Tontini C, Van Gasse AL, Mertens C, Hagendorens MM, Sabato V, Elst J. Mast cell versus basophil activation test in allergy: Current status. Clin Exp Allergy 2024. [PMID: 38686464 DOI: 10.1111/cea.14487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 05/02/2024]
Abstract
In the past two decades, we witnessed the evolution of the basophil activation test (BAT) from mainly research applications to a potential complementary diagnostic tool to document IgE-dependent allergies. However, BAT presents some technical weaknesses. Around 10%-15% of tested patients are non-responders, BAT can be negative immediately post-reaction and the use of fresh basophils, ideally analysed within 4 h of collection, restricts the number of tests that can be performed per sample. The need for fresh basophils is especially limiting when conducting batch analyses and interlaboratory comparisons to harmonize BAT methodology. These limitations significantly hinder the wider application of BAT and urge the development of alternative testing, such as the mast cell activation test (MAT). The essential difference between BAT and MAT is the heterogeneity of the starting material used to perform the assays. Mast cells are tissue-resident, so cannot be easily accessed. Current alternative sources for functional studies are generating primary human mast cells, differentiated from donor progenitor cells, or using immortalized mast cell lines. Hence, the methodological approaches for MAT are not only vastly different from BAT, but also different among MAT protocols. This review summarizes the advantages and disadvantages of BAT and MAT assays, dedicating special attention to elucidating the key differences between the cellular sources used and provides an overview of studies hitherto performed comparing BAT and MAT in the diagnosis of IgE-mediated food and drug allergies.
Collapse
Affiliation(s)
- Didier G Ebo
- Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp University Hospital and Infla-Med Centre of Excellence Antwerp University, Antwerpen, Belgium
- Immunology - Allergology AZ Jan Palfijn, Ghent, Belgium
| | - Rajia Bahri
- Lydia Becker Institute of Immunology and Inflammation, Division of Musculo-skeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Core Technology Facility, University of Manchester, Manchester, UK
| | - Chiara Tontini
- Lydia Becker Institute of Immunology and Inflammation, Division of Musculo-skeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Core Technology Facility, University of Manchester, Manchester, UK
| | - Athina L Van Gasse
- Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp University Hospital and Infla-Med Centre of Excellence Antwerp University, Antwerpen, Belgium
- Paediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp University Hospital and Infla-Med Centre of Excellence Antwerp University, Antwerpen, Belgium
| | - Christel Mertens
- Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp University Hospital and Infla-Med Centre of Excellence Antwerp University, Antwerpen, Belgium
| | - Margo M Hagendorens
- Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp University Hospital and Infla-Med Centre of Excellence Antwerp University, Antwerpen, Belgium
- Paediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp University Hospital and Infla-Med Centre of Excellence Antwerp University, Antwerpen, Belgium
| | - Vito Sabato
- Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp University Hospital and Infla-Med Centre of Excellence Antwerp University, Antwerpen, Belgium
| | - Jessy Elst
- Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp University Hospital and Infla-Med Centre of Excellence Antwerp University, Antwerpen, Belgium
| |
Collapse
|
2
|
Ebo DG, Rihs HP, Mertens CH, Van Gasse AL, van der Poorten ML, Hagendorens MM, Sabato V, Elst J. Exploring the thaumatin-like protein (TLP) as a candidate cannabis allergen in North-Western Europe. Allergy 2024; 79:257-259. [PMID: 37984436 DOI: 10.1111/all.15953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/25/2023] [Accepted: 11/07/2023] [Indexed: 11/22/2023]
Affiliation(s)
- D G Ebo
- Department of Immunology-Allergology-Rheumatology and the Infla-med Centre of Excellence, University of Antwerp-University Hospital of Antwerp, Antwerp University, Antwerp, Belgium
- Department of Immunology-Allergology, AZ Jan Palfijn Ghent, Ghent, Belgium
| | - H P Rihs
- Ruhr-University Bochum, IPA-Institute for Prevention and Occupational Medicine, German Social Accident Insurance, Bochum, Germany
| | - C H Mertens
- Department of Immunology-Allergology-Rheumatology and the Infla-med Centre of Excellence, University of Antwerp-University Hospital of Antwerp, Antwerp University, Antwerp, Belgium
| | - A L Van Gasse
- Department of Immunology-Allergology-Rheumatology and the Infla-med Centre of Excellence, University of Antwerp-University Hospital of Antwerp, Antwerp University, Antwerp, Belgium
- Pediatrics, University of Antwerp-University Hospital of Antwerp, Antwerp, Belgium
| | - M L van der Poorten
- Department of Immunology-Allergology-Rheumatology and the Infla-med Centre of Excellence, University of Antwerp-University Hospital of Antwerp, Antwerp University, Antwerp, Belgium
- Pediatrics, University of Antwerp-University Hospital of Antwerp, Antwerp, Belgium
| | - M M Hagendorens
- Department of Immunology-Allergology-Rheumatology and the Infla-med Centre of Excellence, University of Antwerp-University Hospital of Antwerp, Antwerp University, Antwerp, Belgium
- Pediatrics, University of Antwerp-University Hospital of Antwerp, Antwerp, Belgium
| | - V Sabato
- Department of Immunology-Allergology-Rheumatology and the Infla-med Centre of Excellence, University of Antwerp-University Hospital of Antwerp, Antwerp University, Antwerp, Belgium
| | - J Elst
- Department of Immunology-Allergology-Rheumatology and the Infla-med Centre of Excellence, University of Antwerp-University Hospital of Antwerp, Antwerp University, Antwerp, Belgium
| |
Collapse
|
3
|
Elst J, van der Poorten MLM, Toscano A, Van Gasse AL, Mertens C, Beyens M, Hagendorens MM, Ebo DG, Sabato V. Correspondence to "Diagnosis of immediate reactions to amoxicillin: Comparison of basophil activation markers CD63 and CD203c in a prospective study". Allergy 2023; 78:2808-2809. [PMID: 36995969 DOI: 10.1111/all.15686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/06/2023] [Accepted: 02/17/2023] [Indexed: 03/31/2023]
Affiliation(s)
- Jessy Elst
- Department of Immunology, Allergology, Rheumatology, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
| | - Marie-Line M van der Poorten
- Department of Immunology, Allergology, Rheumatology, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
- Department of Paediatrics, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerpen, Belgium
| | - Alessandro Toscano
- Department of Immunology, Allergology, Rheumatology, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
| | - Athina L Van Gasse
- Department of Immunology, Allergology, Rheumatology, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
- Department of Paediatrics, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerpen, Belgium
| | - Christel Mertens
- Department of Immunology, Allergology, Rheumatology, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
| | - Michiel Beyens
- Department of Immunology, Allergology, Rheumatology, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
| | - Margo M Hagendorens
- Department of Immunology, Allergology, Rheumatology, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
- Department of Paediatrics, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerpen, Belgium
| | - Didier G Ebo
- Department of Immunology, Allergology, Rheumatology, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
- Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| | - Vito Sabato
- Department of Immunology, Allergology, Rheumatology, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
- Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| |
Collapse
|
4
|
Ebo DG, Elst J, Mertens C, van der Poorten MLM, Van Gasse AL, Van Houdt M, Hagendorens MM, Sabato V. Dual intracellular staining of CD154 (CD40L) and cytokines at single-cell level: A novel aid to document immediate hypersensitivity to amoxicillin. Clin Exp Allergy 2023. [PMID: 37057758 DOI: 10.1111/cea.14313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/23/2023] [Accepted: 03/16/2023] [Indexed: 04/15/2023]
Affiliation(s)
- Didier G Ebo
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
- Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| | - Jessy Elst
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
| | - Christel Mertens
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
| | - Marie-Line M van der Poorten
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
- Faculty of Medicine and Health Sciences, Department of Paediatrics and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
| | - Athina L Van Gasse
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
- Faculty of Medicine and Health Sciences, Department of Paediatrics and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
| | - Michel Van Houdt
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
| | - Margo M Hagendorens
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
- Faculty of Medicine and Health Sciences, Department of Paediatrics and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
| | - Vito Sabato
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
- Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| |
Collapse
|
5
|
Ebo DG, Vlaeminck N, van der Poorten MLM, Elst J, Toscano A, Van Gasse AL, Hagendorens MM, Aerts S, Adriaensens I, Saldien V, Sabato V. A quarter of a century fundamental and translational research in perioperative hypersensitivity and anaphylaxis at the Antwerp university hospital, a Belgian Centre of Excellence of the World Allergy Organization. World Allergy Organ J 2023; 16:100759. [PMID: 37025251 PMCID: PMC10070178 DOI: 10.1016/j.waojou.2023.100759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/20/2023] [Accepted: 03/05/2023] [Indexed: 04/03/2023] Open
Abstract
Perioperative hypersensitivity constitutes an important health issue, with potential dramatic consequences of diagnostic mistakes. However, safe and correct diagnosis is not always straightforward, mainly because of the application of incorrect nomenclature, absence of easy accessible in-vitro/ex-vivo tests and uncertainties associated with the non-irritating skin test concentrations. In this editorial we summarize the time line, seminal findings, and major realizations of 25 years of research on the mechanisms, diagnosis, and management of perioperative hypersensitivity.
Collapse
|
6
|
Heremans K, Toscano A, Elst J, Van Gasse AL, Mertens C, Beyens M, van der Poorten MLM, Hagendorens MM, Ebo DG, Sabato V. Basophil Activation Test Shows Poor Sensitivity in Immediate Amoxicillin Allergy. J Allergy Clin Immunol Pract 2023; 11:500-505. [PMID: 36402397 DOI: 10.1016/j.jaip.2022.10.050] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/13/2022] [Accepted: 10/30/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND In light of the pandemic of spurious penicillin allergy, correct diagnosis of amoxicillin (AX) allergy is of great importance. The diagnosis of immediate hypersensitivity reactions relies on skin tests and specific IgE, and although reliable, these are not absolutely predictive. Therefore, drug challenges are needed in some cases, which contain the risk of severe reactions. Safe in vitro diagnostics as an alternative for the drug challenge in the diagnostic workup of AX allergy would be more than welcome to fill this gap. In this respect, the basophil activation test (BAT) has shown potential, but its clinical reliability is doubtful. OBJECTIVE To investigate the reliability of the BAT to AX and determining its exact place in the diagnostic algorithm of AX allergy. METHODS BAT for AX was performed in 70 exposed control individuals and 66 patients diagnosed according to the European Academy of Allergy and Clinical Immunology guidelines for AX allergy. Upregulation of both CD63 and CD203c was flow-cytometrically assessed. RESULTS Analyses revealed that 1370 μmol/L and 685 μmol/L were the most discriminative stimulation concentrations for CD63 and CD203c upregulation, respectively, and a diagnostic threshold of 9% for positivity for both markers was identified. At these concentrations, sensitivity and specificity for CD63 upregulation were 13% and 100%, respectively, and for CD203c upregulation, 23% and 98%. CONCLUSIONS BAT with dual analysis of CD63 and CD203c is of poor performance to document AX allergy. The sensitivity is too low to let it occupy a prominent role in the diagnostic algorithm.
Collapse
Affiliation(s)
- Kevin Heremans
- Faculty of Medicine and Health Science, Department of Immunology - Allergology - Rheumatology, University of Antwerp, Antwerp University Hospital, Antwerpen, Belgium
| | - Alessandro Toscano
- Faculty of Medicine and Health Science, Department of Immunology - Allergology - Rheumatology, University of Antwerp, Antwerp University Hospital, Antwerpen, Belgium
| | - Jessy Elst
- Faculty of Medicine and Health Science, Department of Immunology - Allergology - Rheumatology, University of Antwerp, Antwerp University Hospital, Antwerpen, Belgium; The Infla-Med Centre of Excellence, Antwerp University, Antwerpen, Belgium
| | - Athina L Van Gasse
- Faculty of Medicine and Health Science, Department of Immunology - Allergology - Rheumatology, University of Antwerp, Antwerp University Hospital, Antwerpen, Belgium; Faculty of Medicine and Health Science, Department of Pediatrics, University of Antwerp, Antwerp University Hospital, Antwerpen, Belgium
| | - Christel Mertens
- Faculty of Medicine and Health Science, Department of Immunology - Allergology - Rheumatology, University of Antwerp, Antwerp University Hospital, Antwerpen, Belgium; The Infla-Med Centre of Excellence, Antwerp University, Antwerpen, Belgium
| | - Michiel Beyens
- Faculty of Medicine and Health Science, Department of Immunology - Allergology - Rheumatology, University of Antwerp, Antwerp University Hospital, Antwerpen, Belgium
| | - Marie-Line M van der Poorten
- Faculty of Medicine and Health Science, Department of Immunology - Allergology - Rheumatology, University of Antwerp, Antwerp University Hospital, Antwerpen, Belgium; Faculty of Medicine and Health Science, Department of Pediatrics, University of Antwerp, Antwerp University Hospital, Antwerpen, Belgium
| | - Margo M Hagendorens
- Faculty of Medicine and Health Science, Department of Immunology - Allergology - Rheumatology, University of Antwerp, Antwerp University Hospital, Antwerpen, Belgium; The Infla-Med Centre of Excellence, Antwerp University, Antwerpen, Belgium; Faculty of Medicine and Health Science, Department of Pediatrics, University of Antwerp, Antwerp University Hospital, Antwerpen, Belgium
| | - Didier G Ebo
- Faculty of Medicine and Health Science, Department of Immunology - Allergology - Rheumatology, University of Antwerp, Antwerp University Hospital, Antwerpen, Belgium; The Infla-Med Centre of Excellence, Antwerp University, Antwerpen, Belgium; Faculty of Medicine and Health Science, Department of Pediatrics, University of Antwerp, Antwerp University Hospital, Antwerpen, Belgium; Department of Immunology and Allergology, AZ Jan Palfijn Ghent, Ghent, Belgium.
| | - Vito Sabato
- Faculty of Medicine and Health Science, Department of Immunology - Allergology - Rheumatology, University of Antwerp, Antwerp University Hospital, Antwerpen, Belgium; The Infla-Med Centre of Excellence, Antwerp University, Antwerpen, Belgium; Faculty of Medicine and Health Science, Department of Pediatrics, University of Antwerp, Antwerp University Hospital, Antwerpen, Belgium; Department of Immunology and Allergology, AZ Jan Palfijn Ghent, Ghent, Belgium
| |
Collapse
|
7
|
Toscano A, Elst J, Van Gasse AL, Beyens M, van der Poorten ML, Bridts CH, Mertens C, Van Houdt M, Hagendorens MM, Van Remoortel S, Timmermans JP, Ebo DG, Sabato V. Mas-related G protein-coupled receptor MRGPRX2 in human basophils: Expression and functional studies. Front Immunol 2023; 13:1026304. [PMID: 36726977 PMCID: PMC9885256 DOI: 10.3389/fimmu.2022.1026304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 12/30/2022] [Indexed: 01/18/2023] Open
Abstract
Background Occupancy of MRGPRX2 heralds a new era in our understandings of immediate drug hypersensitivity reactions (IDHRs), but a constitutive expression of this receptor by basophils is debated. Objective To explore the expression and functionality of MRGPRX2 in and on basophils. Methods Basophils from patients with birch pollen allergy, IDHRs to moxifloxacin, and healthy controls were studied in different conditions, that is, in rest, after stimulation with anti-IgE, recombinant major birch pollen allergen (rBet v 1), moxifloxacin, fMLP, substance P (SP), or other potential basophil secretagogues. In a separate set of experiments, basophils were studied after purification and resuspension in different media. Results Resting whole blood basophils barely express MRGPRX2 on their surface and are unresponsive to SP or moxifloxacin. However, surface MRGPRX2 is quickly upregulated upon incubation with anti-IgE or fMLP. Pre-stimulation with anti-IgE can induce a synergic effect on basophil degranulation in IgE-responsive subjects after incubation with SP or moxifloxacin, provided that basophils have been obtained from patients who experienced an IDHR to moxifloxacin. Cell purification can trigger a "spontaneous" and functional upregulation of MRGPRX2 on basophils, not seen in whole blood cells, and its surface density can be influenced by distinct culture media. Conclusion Basophils barely express MRGPRX2 in resting conditions. However, the receptor can be quickly upregulated after stimulation with anti-IgE, fMLP, or after purification, making cells responsive to MRGPRX2 occupation. We anticipate that such "conditioned" basophils constitute a model to explore MRGPRX2 agonism or antagonism, including IDHRs originating from the occupation of this receptor.
Collapse
Affiliation(s)
- Alessandro Toscano
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium,Post-Graduate School of Allergology and Clinical Immunology, University of Milan, Milan, Italy
| | - Jessy Elst
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Athina L. Van Gasse
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium,Department of Pediatrics and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium,Pediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Michiel Beyens
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Marie-Line van der Poorten
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium,Department of Pediatrics and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium,Pediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Chris H. Bridts
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Christel Mertens
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Michel Van Houdt
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Margo M. Hagendorens
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium,Department of Pediatrics and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium,Pediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Samuel Van Remoortel
- Laboratory of Cell Biology and Histology, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Antwerp, Belgium
| | - Jean-Pierre Timmermans
- Laboratory of Cell Biology and Histology, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Antwerp, Belgium
| | - Didier G. Ebo
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium,Algemeen Ziekenhuis (AZ) Jan Palfijn Gent, Department of Immunology and Allergology, Ghent, Belgium,*Correspondence: Didier G. Ebo,
| | - Vito Sabato
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium,Algemeen Ziekenhuis (AZ) Jan Palfijn Gent, Department of Immunology and Allergology, Ghent, Belgium
| |
Collapse
|
8
|
Ebo DG, Elst J, Moonen N, van der Poorten MLM, Van Gasse AL, Garvey LH, Bridts CH, Mertens C, Hagendorens MM, Sabato V. Mast cell activation test: A new asset in the investigation of the chlorhexidine cross-sensitization profile. Clin Exp Allergy 2022; 52:1311-1320. [PMID: 35305051 DOI: 10.1111/cea.14129] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/24/2022] [Accepted: 03/01/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Insights into the IgE cross-sensitization and possible cross-reactivity patterns of sera reactive to chlorhexidine (CHX) are still incomplete and are likely to benefit from a functional exploration using a passive mast cell activation test (pMAT). Therefore, we want to study whether the pMAT with CHX-specific IgE (sIgE) enables to depict effector cell degranulation in response to alexidine (ALX), octenidine (OCT) and/or polyhexamethylene biguanide (PHMB) indicative of cross-reactivity between these compounds and CHX. METHODS Serum of 10 CHX-allergic patients, nine individuals with an isolated sIgE CHX and five healthy controls were included. Human cultured mast cells (MCs) were, before and after sensitization, challenged with CHX, ALX, OCT or PHMB. Degranulation was measured via quantification of upregulation of CD63. RESULTS Mast cell responsiveness to ALX and OCT was demonstrable with 4/10 and 3/10 of the sera of CHX-allergic patients respectively. Percentage of degranulation varied between 12 and 34% for ALX-reactive MCs and between 4 and 22% for OCT-reactive MCs. No reactivity to ALX or OCT was demonstrable when using sera obtained from individuals with an isolated sIgE CHX or from healthy controls. Unlike CHX, ALX and OCT, PHMB turned out to be a direct MC activator via occupation of MRGPRX2. PHMB-reactive sIgEs were demonstrable in some patients with an isolated sIgE CHX but were unable to trigger PHMB-induced degranulation in MRGPRX2 knockdown MCs. CONCLUSION Mast cells constitute an attractive tool to explore cross-reactivity between structurally similar compounds. Along with the identification of safe alternatives for the individual patient, the pMAT can advance our insights into sIgE cross-reactivity patterns including assessment of molecules not yet approved for human use.
Collapse
Affiliation(s)
- Didier G Ebo
- Department of Immunology, Allergology, Rheumatology, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| | - Jessy Elst
- Department of Immunology, Allergology, Rheumatology, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Nele Moonen
- Department of Immunology, Allergology, Rheumatology, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Marie-Line M van der Poorten
- Department of Immunology, Allergology, Rheumatology, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Department of Paediatrics, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Paediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Athina L Van Gasse
- Department of Immunology, Allergology, Rheumatology, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Department of Paediatrics, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Paediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Lene H Garvey
- Allergy Clinic, Department of Dermatology and Allergy, Gentofte Hospital, Hellerup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Chris H Bridts
- Department of Immunology, Allergology, Rheumatology, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Christel Mertens
- Department of Immunology, Allergology, Rheumatology, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Margo M Hagendorens
- Department of Immunology, Allergology, Rheumatology, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Department of Paediatrics, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Paediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Vito Sabato
- Department of Immunology, Allergology, Rheumatology, The Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| |
Collapse
|
9
|
van der Poorten MLM, Vlaeminck N, Van Pée J, Thiele N, Smout K, Elst J, Toscano A, Van Gasse AL, Hagendorens MM, Aerts S, Adriaensens I, Sermeus LA, Garvey LH, Sabato V, Ebo DG. Drug provocation tests with hypnotics, opioids, and neuromuscular blocking agents in the diagnosis of suspected perioperative hypersensitivity. Br J Anaesth 2022; 129:e119-e122. [DOI: 10.1016/j.bja.2022.07.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 07/26/2022] [Indexed: 11/16/2022] Open
|
10
|
Toscano A, Elst J, van der Poorten ML, Beyens M, Heremans K, Decuyper II, Van Gasse AL, Mertens C, Van Houdt M, Hagendorens MM, Sabato V, Ebo DG. Establishing diagnostic strategies for cannabis allergy. Expert Rev Clin Immunol 2022; 18:1015-1022. [PMID: 35912836 DOI: 10.1080/1744666x.2022.2108791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Cannabis is the most widely consumed illicit drug in the world and carries a risk of severe IgE-mediated allergic reactions, requiring appropriate diagnostic management. Currently available diagnostics are still relatively limited and require careful interpretation of results to avoid harmful over- and underdiagnosis. AREAS COVERED This review focuses on the most up-to-date understandings of cannabis allergy diagnosis, starting with the main clinical features of the disease and the allergenic characteristics of Cannabis sativa, and then providing insights into in vivo, in vitro, and ex vivo diagnostic tests. EXPERT OPINION At present, the diagnosis of IgE-mediated cannabis allergy is based on a three-step approach that starts with accurate history taking and ends with a confirmation of sensitization to the whole extract and, finally, molecular components. Although much has been discovered since its first description in 1971, the diagnosis of cannabis allergy still has many unmet needs. The lack of commercial standardized and validated extracts and in vitro assays makes a harmonized workup of cannabis allergy difficult. Furthermore, the epidemiological characteristics, and clinical implications of sensitization to different molecular components are not yet fully known. Future research will complete the picture and likely result in an individualized and standardized approach.
Collapse
Affiliation(s)
- Alessandro Toscano
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Post-Graduate School of Allergology and Clinical Immunology, University of Milan, Milan, Italy
| | - Jessy Elst
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Marie-Line van der Poorten
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Department of Pediatrics and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Michiel Beyens
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Kevin Heremans
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Ine I Decuyper
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Department of Pediatrics and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Athina L Van Gasse
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Christel Mertens
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Michel Van Houdt
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Margo M Hagendorens
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Department of Pediatrics and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Vito Sabato
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| | - Didier G Ebo
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| |
Collapse
|
11
|
Elst J, De Puysseleyr LP, Ebo DG, Faber MA, Van Gasse AL, van der Poorten MLM, Decuyper II, Bridts CH, Mertens C, Van Houdt M, Hagendorens MM, De Clerck LS, Verlinden A, Vermeulen K, Maes MB, Berneman ZN, Valent P, Sabato V. Overexpression of FcεRI on Bone Marrow Mast Cells, but Not MRGPRX2, in Clonal Mast Cell Disorders With Wasp Venom Anaphylaxis. Front Immunol 2022; 13:835618. [PMID: 35281031 PMCID: PMC8914951 DOI: 10.3389/fimmu.2022.835618] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/04/2022] [Indexed: 12/17/2022] Open
Abstract
Background Uncertainties remain about the molecular mechanisms governing clonal mast cell disorders (CMCD) and anaphylaxis. Objective This study aims at comparing the burden, phenotype and behavior of mast cells (MCs) and basophils in patients with CMCD with wasp venom anaphylaxis (CMCD/WVA+), CMCD patients without anaphylaxis (CMCD/ANA-), patients with an elevated baseline serum tryptase (EBST), patients with wasp venom anaphylaxis without CMCD (WVA+) and patients with a non-mast cell haematological pathology (NMHP). Methods This study included 20 patients with CMCD/WVA+, 24 with CMCD/ANA-, 19 with WVA+, 6 with EBST and 5 with NMHP. We immunophenotyped MCs and basophils and compared baseline serum tryptase (bST) and both total and venom specific IgE in the different groups. For basophil studies, 13 healthy controls were also included. Results Higher levels of bST were found in CMCD patients with wasp venom anaphylaxis, CMCD patients without anaphylaxis and EBST patients. Total IgE levels were highest in patients with wasp venom anaphylaxis with and without CMCD. Bone marrow MCs of patients with CMCD showed lower CD117 expression and higher expression of CD45, CD203c, CD63, CD300a and FcεRI. Within the CMCD population, patients with wasp venom anaphylaxis showed a higher expression of FcεRI as compared to patients without anaphylaxis. Expression of MRGPRX2 on MCs did not differ between the study populations. Basophils are phenotypically and functionally comparable between the different patient populations. Conclusion Patients with CMCD show an elevated burden of aberrant activated MCs with a significant overexpression of FcεRI in patients with a wasp venom anaphylaxis.
Collapse
Affiliation(s)
- Jessy Elst
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Leander P De Puysseleyr
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Didier G Ebo
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| | - Margaretha A Faber
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Athina L Van Gasse
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Department of Paediatrics and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Paediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Marie-Line M van der Poorten
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Department of Paediatrics and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Paediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Ine I Decuyper
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Department of Paediatrics and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Paediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Chris H Bridts
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Christel Mertens
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Michel Van Houdt
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Margo M Hagendorens
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Department of Paediatrics and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Paediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Luc S De Clerck
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Anke Verlinden
- Department of Haematology, Antwerp University Hospital, Antwerp, Belgium
| | - Katrien Vermeulen
- Department of Clinical Biology, Antwerp University Hospital, Antwerp, Belgium
| | - Marie-Berthe Maes
- Department of Clinical Biology, Antwerp University Hospital, Antwerp, Belgium
| | - Zwi N Berneman
- Department of Haematology, Antwerp University Hospital, Antwerp, Belgium
| | - Peter Valent
- Division of Hematology and Hemostaseology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.,Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Vito Sabato
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| |
Collapse
|
12
|
van der Poorten MLM, Walschot M, Faber M, Elst J, Van Gasse AL, De Puysseleyr L, Mertens CM, Hagendorens MM, Garvey LH, Sabato V, Ebo DG. Reliability of Early and Late Testing for Suspected Perioperative Hypersensitivity. J Allergy Clin Immunol Pract 2022; 10:1057-1062.e2. [PMID: 34767998 DOI: 10.1016/j.jaip.2021.10.066] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 10/26/2021] [Accepted: 10/26/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The optimal timing of diagnostic testing for perioperative hypersensitivity (POH) remains unknown. It has been recommended that investigation is best carried out at least 4 to 6 weeks after the event. On the other hand, guidelines discourage the use of in vitro tests later than 3 years after the index reaction. OBJECTIVE This retrospective study aimed to assess the reliability of early and late skin tests (STs). It also attempted to verify whether discouraging late ex vivo and in vitro tests is substantiated. METHODS For the first aim, patients were stratified over three epochs: an early timing group, with investigations performed within 6 weeks; a recommended timing group, with tests performed between 6 weeks and 6 months; and a late timing group, tested later than 6 months after the event. For the second study purpose, we studied the reliability of specific IgE quantification and basophil activation test rocuronium within 6 weeks and after 3 years in patients who experienced an ST-proven POH to rocuronium. RESULTS A total of 677 patients were included. Based on a positive ST result, a causative agent was found in 74.2% of the early timing group, 62.6% of the recommended timing group, and 50% of the late timing group. A positive specific IgE for rocuronium or morphine was found in 80% of patients tested within 6 weeks, 63% of patients tested between 6 weeks and 3 years, and 50% of patients tested more than 3 years after the event. A positive basophil activation test was found in 83.3%, 51%, and 20%, respectively, of patients. CONCLUSIONS Our data confirm that evaluation of drug allergy for suspected POH can be performed before 6 weeks after the event, and there is no maximal upper time limit disclosing ex vivo and in vitro testing.
Collapse
Affiliation(s)
- Marie-Line M van der Poorten
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, and Rheumatology, Antwerp University Hospital, and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium; Faculty of Medicine and Health Science, Department of Paediatrics, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Mark Walschot
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, and Rheumatology, Antwerp University Hospital, and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
| | - Margaretha Faber
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, and Rheumatology, Antwerp University Hospital, and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
| | - Jessy Elst
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, and Rheumatology, Antwerp University Hospital, and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
| | - Athina L Van Gasse
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, and Rheumatology, Antwerp University Hospital, and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium; Faculty of Medicine and Health Science, Department of Paediatrics, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Leander De Puysseleyr
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, and Rheumatology, Antwerp University Hospital, and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
| | - Christel M Mertens
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, and Rheumatology, Antwerp University Hospital, and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium
| | - Margo M Hagendorens
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, and Rheumatology, Antwerp University Hospital, and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium; Faculty of Medicine and Health Science, Department of Paediatrics, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Lene H Garvey
- Allergy Clinic, Department of Dermatology and Allergy, Gentofte Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Vito Sabato
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, and Rheumatology, Antwerp University Hospital, and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium; Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| | - Didier G Ebo
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, and Rheumatology, Antwerp University Hospital, and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium; Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium.
| |
Collapse
|
13
|
Elst J, van der Poorten MLM, Van Gasse AL, Mertens C, Hagendorens MM, Ebo DG, Sabato V. Tryptase release does not discriminate between IgE- or MRGPRX2-mediated activation in human mast cells. Clin Exp Allergy 2022; 52:797-800. [PMID: 35152504 DOI: 10.1111/cea.14110] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/01/2022] [Accepted: 02/10/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Jessy Elst
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Marie-Line M van der Poorten
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,University of Antwerp, Faculty of Medicine and Health Sciences, Department of Paediatrics and the Infla-Med Centre of Excellence, Paediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Athina L Van Gasse
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,University of Antwerp, Faculty of Medicine and Health Sciences, Department of Paediatrics and the Infla-Med Centre of Excellence, Paediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Christel Mertens
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Margo M Hagendorens
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,University of Antwerp, Faculty of Medicine and Health Sciences, Department of Paediatrics and the Infla-Med Centre of Excellence, Paediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Didier G Ebo
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| | - Vito Sabato
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| |
Collapse
|
14
|
Elst J, Sabato V, Faber MA, Bridts CH, Mertens C, Van Houdt M, Van Gasse AL, Hagendorens MM, Van Tendeloo V, Maurer M, Campillo-Davo D, Timmermans JP, Pintelon I, Ebo DG. MRGPRX2 and Immediate Drug Hypersensitivity: Insights From Cultured Human Mast Cells. J Investig Allergol Clin Immunol 2021; 31:489-499. [PMID: 32732181 DOI: 10.18176/jiaci.0557] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Mast cell (MC) degranulation via activation of the Mas-related G protein-coupled receptor X2 (MRGPRX2) plays a key role in immediate drug hypersensitivity (IDH). However, data in humans are limited to observations in specific cell lines. Objective: To study the usefulness of silencing MRGPRX2 in human MCs with the aim of further unveiling the MRGPRX2 pathway in IDH. METHODS MCs were cultured from CD34+ progenitor cells obtained from peripheral blood (PBCMCs) and incubated with substance P (as a positive control), rocuronium, moxifloxacin, morphine, or amoxicillin. Immunophenotyping of the cells included flow cytometry and microscopy analyses of the expression of CD117, CD203c, and MRGPRX2. Intracellular calcium was measured using Fluo-4. Degranulation was analyzed by quantifying CD63 expression. For MRGPRX2 silencing, MCs were electroporated with Dicer small interference RNAs. RESULTS Incubation of MCs with substance P, morphine, and moxifloxacin increased intracellular calcium levels and triggered MC degranulation, which, for the drugs, is almost completely abolished by selective MRGPRX2 silencing. Despite an increase in intracellular calcium in MRGPRX2+ cells, incubation with nontoxic concentrations of rocuronium does not result in degranulation of PBCMCs. Amoxicillin has no effect on PBCMCs. CONCLUSION The use of MRGPRX2 silencing in human MCs can provide important insights into the role of MRGPRX2 in the pathogenesis of IDH. As induction of calcium signals does not necessarily translate into a secretory response, measurement of the degranulation reaction seems more meaningful in the context of drug testing.
Collapse
Affiliation(s)
- J Elst
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium and Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, B
| | - V Sabato
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium and Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, B.,Department of Immunology, AZ Jan Palfijn Hospital Gent, Ghent, Belgium
| | - M A Faber
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium and Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, B
| | - C H Bridts
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium and Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, B
| | - C Mertens
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium and Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, B
| | - M Van Houdt
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium and Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, B
| | - A L Van Gasse
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium and Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, B.,Department of Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - M M Hagendorens
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium and Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, B.,Department of Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - V Van Tendeloo
- Laboratory of Experimental Haematology, Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
| | - M Maurer
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - D Campillo-Davo
- Laboratory of Experimental Haematology, Vaccine & Infectious Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
| | - J P Timmermans
- Laboratory of Cell Biology and Histology, Department of Veterinary Sciences, University of Antwerp, Antwerp, Belgium
| | - I Pintelon
- Laboratory of Cell Biology and Histology, Department of Veterinary Sciences, University of Antwerp, Antwerp, Belgium
| | - D G Ebo
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium and Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, B.,Department of Immunology, AZ Jan Palfijn Hospital Gent, Ghent, Belgium
| |
Collapse
|
15
|
van der Poorten MLM, Hagendorens MM, Faber MA, De Puysseleyr L, Elst J, Mertens CM, Romano A, Ebo DG, Sabato V. Nonirritant concentrations and performance of ceftaroline skin tests in patients with an immediate β-lactam hypersensitivity. J Allergy Clin Immunol Pract 2021; 9:4486-4488.e2. [PMID: 34454097 DOI: 10.1016/j.jaip.2021.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Marie-Line M van der Poorten
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; Faculty of Medicine and Health Sciences, Department of Paediatrics, University of Antwerp, and Antwerp University Hospital, Antwerp, Belgium
| | - Margo M Hagendorens
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; Faculty of Medicine and Health Sciences, Department of Paediatrics, University of Antwerp, and Antwerp University Hospital, Antwerp, Belgium
| | - Margaretha A Faber
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Leander De Puysseleyr
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Jessy Elst
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Christel M Mertens
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | | | - Didier G Ebo
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium.
| | - Vito Sabato
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| |
Collapse
|
16
|
Decuyper II, Rihs H, Mertens CH, Van Gasse AL, Elst J, Faber MA, Hagendorens MM, Sabato V, Ebo DG. In search of the golden ratio for cannabis allergy: Utility of specific allergen-to-total IgE ratios. Allergy 2021; 76:3522-3525. [PMID: 34324720 DOI: 10.1111/all.15028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/21/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Ine I. Decuyper
- Faculty of Medicine and Health Sciences Department of Immunology, Allergology Rheumatology and the Infla‐Med Centre of Excellence, and Immunology, Allergology, Rheumatology Antwerp University Hospital University of Antwerp Antwerp Belgium
- Faculty of Medicine and Health Sciences Department of Paediatrics and the Infla‐Med Centre of Excellence, and Paediatrics Antwerp University Hospital University of Antwerp Antwerp Belgium
| | - Hans‐Peter Rihs
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA) Institute of the Ruhr‐University Bochum Bochum Germany
| | - Christel H. Mertens
- Faculty of Medicine and Health Sciences Department of Immunology, Allergology Rheumatology and the Infla‐Med Centre of Excellence, and Immunology, Allergology, Rheumatology Antwerp University Hospital University of Antwerp Antwerp Belgium
| | - Athina Ludovica Van Gasse
- Faculty of Medicine and Health Sciences Department of Immunology, Allergology Rheumatology and the Infla‐Med Centre of Excellence, and Immunology, Allergology, Rheumatology Antwerp University Hospital University of Antwerp Antwerp Belgium
- Faculty of Medicine and Health Sciences Department of Paediatrics and the Infla‐Med Centre of Excellence, and Paediatrics Antwerp University Hospital University of Antwerp Antwerp Belgium
| | - Jessy Elst
- Faculty of Medicine and Health Sciences Department of Immunology, Allergology Rheumatology and the Infla‐Med Centre of Excellence, and Immunology, Allergology, Rheumatology Antwerp University Hospital University of Antwerp Antwerp Belgium
| | - Margaretha A. Faber
- Faculty of Medicine and Health Sciences Department of Immunology, Allergology Rheumatology and the Infla‐Med Centre of Excellence, and Immunology, Allergology, Rheumatology Antwerp University Hospital University of Antwerp Antwerp Belgium
| | - Margo M. Hagendorens
- Faculty of Medicine and Health Sciences Department of Immunology, Allergology Rheumatology and the Infla‐Med Centre of Excellence, and Immunology, Allergology, Rheumatology Antwerp University Hospital University of Antwerp Antwerp Belgium
- Faculty of Medicine and Health Sciences Department of Paediatrics and the Infla‐Med Centre of Excellence, and Paediatrics Antwerp University Hospital University of Antwerp Antwerp Belgium
| | - Vito Sabato
- Faculty of Medicine and Health Sciences Department of Immunology, Allergology Rheumatology and the Infla‐Med Centre of Excellence, and Immunology, Allergology, Rheumatology Antwerp University Hospital University of Antwerp Antwerp Belgium
- Department of Immunology and Allergology AZ Jan Palfijn Gent Ghent Belgium
| | - Didier G. Ebo
- Faculty of Medicine and Health Sciences Department of Immunology, Allergology Rheumatology and the Infla‐Med Centre of Excellence, and Immunology, Allergology, Rheumatology Antwerp University Hospital University of Antwerp Antwerp Belgium
- Department of Immunology and Allergology AZ Jan Palfijn Gent Ghent Belgium
| |
Collapse
|
17
|
Elst J, Maurer M, Sabato V, Faber MA, Bridts CH, Mertens C, Van Houdt M, Van Gasse AL, van der Poorten MLM, De Puysseleyr LP, Hagendorens MM, Van Tendeloo VF, Lion E, Campillo-Davo D, Ebo DG. Novel Insights on MRGPRX2-Mediated Hypersensitivity to Neuromuscular Blocking Agents And Fluoroquinolones. Front Immunol 2021; 12:668962. [PMID: 34385999 PMCID: PMC8353374 DOI: 10.3389/fimmu.2021.668962] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/13/2021] [Indexed: 11/13/2022] Open
Abstract
Neuromuscular blocking agents (NMBAs) like atracurium and rocuronium as well as fluoroquinolones (FQs) cause mast cell-mediated anaphylaxis by activating Mas-related G protein-coupled receptor X2 (MRGPRX2), but many questions remain unanswered. Here, we address three of them, namely whether primary human mast cells show similar activation by these drugs as murine mast cells and mast cell lines, how sugammadex protects from atracurium-induced MRGPRX2-mediated mast cell activation, and why some but not all patients treated with rocuronium develop anaphylaxis. We used peripheral blood-derived cultured mast cells from healthy donors and patients, assessed mast cell activation and degranulation by quantifying intracellular calcium and CD63 expression, respectively, and made use of MRGPRX2-silencing, via electroporation with Dicer-substrate small interfering RNAs, and single cell flow cytometric analyses. Atracurium, ciprofloxacin, and levofloxacin activated and degranulated primary human mast cells, but only MRGPRX2-positive and not MRGPRX2-negative or -silenced mast cells. Sugammadex attenuated the atracurium-induced and MRGPRX2-mediated activation and degranulation of human mast cells by reducing free atracurium levels. The mast cells of patients with IgE-independent anaphylaxis to rocuronium were similar, in their MRGPRX2 expression and function, to those of patients with IgE-mediated anaphylaxis. These findings further improve our understanding of the role and relevance of MRGPRX2-driven mast cell activation in anaphylactic reactions to NMBAs and FQs and may help to improve their prediction, prevention, and treatment.
Collapse
Affiliation(s)
- Jessy Elst
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Marcus Maurer
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin, Berlin, Germany
| | - Vito Sabato
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Department of Immunology, AZ Jan Palfijn Hospital Gent, Ghent, Belgium
| | - Margaretha A Faber
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Chris H Bridts
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Christel Mertens
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Michel Van Houdt
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Athina L Van Gasse
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Department of Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Marie-Line M van der Poorten
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Department of Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Leander P De Puysseleyr
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Margo M Hagendorens
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Department of Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Viggo F Van Tendeloo
- Laboratory of Experimental Hematology, Vaccine & Infectious Disease institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Eva Lion
- Laboratory of Experimental Hematology, Vaccine & Infectious Disease institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Diana Campillo-Davo
- Laboratory of Experimental Hematology, Vaccine & Infectious Disease institute (VAXINFECTIO), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Didier G Ebo
- Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium.,Department of Immunology, AZ Jan Palfijn Hospital Gent, Ghent, Belgium
| |
Collapse
|
18
|
Elst J, van der Poorten MLM, Van Gasse AL, De Puysseleyr L, Hagendorens MM, Faber MA, Van Houdt M, Passante E, Bahri R, Walschot M, Mertens C, Bridts CH, Sabato V, Ebo DG. Mast cell activation tests by flow cytometry: A new diagnostic asset? Clin Exp Allergy 2021; 51:1482-1500. [PMID: 34233046 DOI: 10.1111/cea.13984] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/04/2021] [Indexed: 12/20/2022]
Abstract
Since the late nineties, evidence has accumulated that flow-assisted basophil activation test (BAT) might be an accessible and reliable method to explore the mechanisms governing basophil degranulation and diagnostic allowing correct prediction of the clinical outcome following exposure to the offending allergen(s) and cross-reactive structures for different IgE-dependent allergies and particular forms of autoimmune urticaria. Although the BAT offers many advantages over mediator release tests, it is left with some weaknesses that hinder a wider application. It is preferable to perform the BAT analysis within 4 h of collection, and the technique does not advance diagnosis in patients with non-responsive cells. Besides, the BAT is difficult to standardize mainly because of the difficulty to perform large batch analyses that might span over several days. This article reviews the status of flow cytometric mast cell activation test (MAT) using passively sensitized mast cells (MCs) with patients' sera or plasma (henceforth indicated as passive MAT; pMAT) using both MC lines and cultured MCs in the diagnosis of IgE-dependent allergies. In addition, this paper provides guidance for generating human MCs from peripheral blood CD34+ progenitor cells (PBCMCs) and correct interpretation of flow cytometric analyses of activated and/or degranulating cells. With the recent recognition of the mas-related G protein-coupled receptor X2 (MRGPRX2) occupation as a putative mechanism of immediate drug hypersensitivity reactions (IDHRs), we also speculate how direct activation of MCs (dMAT)-that is direct activation by MRGPRX2 agonists without prior passive sensitization-could advance paradigms for this novel endotype of IDHRs.
Collapse
Affiliation(s)
- Jessy Elst
- Department of Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Science and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Marie-Line M van der Poorten
- Department of Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Science and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium.,Department of Paediatrics, Faculty of Medicine and Health Science, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Athina L Van Gasse
- Department of Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Science and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium.,Department of Paediatrics, Faculty of Medicine and Health Science, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Leander De Puysseleyr
- Department of Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Science and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Margo M Hagendorens
- Department of Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Science and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium.,Department of Paediatrics, Faculty of Medicine and Health Science, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Margaretha A Faber
- Department of Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Science and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Michel Van Houdt
- Department of Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Science and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | | | - Rajia Bahri
- Division of Musculoskeletal & Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Mark Walschot
- Department of Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Science and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Christel Mertens
- Department of Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Science and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Chris H Bridts
- Department of Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Science and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Vito Sabato
- Department of Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Science and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium.,Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| | - Didier G Ebo
- Department of Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Science and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium.,Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| |
Collapse
|
19
|
Elst J, Moonen N, van der Poorten MLM, Faber MA, Van Gasse AL, Garvey LH, Bridts CH, De Puysseleyr LP, Mertens C, Hagendorens MM, Sabato V, Ebo DG. The passively sensitized mast cell activation test is a reliable diagnostic for chlorhexidine allergy. J Allergy Clin Immunol Pract 2021; 9:3826-3828.e2. [PMID: 34182163 DOI: 10.1016/j.jaip.2021.06.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/04/2021] [Accepted: 06/08/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Jessy Elst
- Department of Immunology, Allergology, and Rheumatology, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Nele Moonen
- Department of Immunology, Allergology, and Rheumatology, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Marie-Line M van der Poorten
- Department of Immunology, Allergology, and Rheumatology, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium; Department of Paediatrics, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Margaretha A Faber
- Department of Immunology, Allergology, and Rheumatology, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Athina L Van Gasse
- Department of Immunology, Allergology, and Rheumatology, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium; Department of Paediatrics, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Lene H Garvey
- Allergy Clinic, Department of Dermatology and Allergy, Gentofte Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Chris H Bridts
- Department of Immunology, Allergology, and Rheumatology, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Leander P De Puysseleyr
- Department of Immunology, Allergology, and Rheumatology, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Christel Mertens
- Department of Immunology, Allergology, and Rheumatology, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Margo M Hagendorens
- Department of Immunology, Allergology, and Rheumatology, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium; Department of Paediatrics, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Vito Sabato
- Department of Immunology, Allergology, and Rheumatology, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium; Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| | - Didier G Ebo
- Department of Immunology, Allergology, and Rheumatology, Faculty of Medicine and Health Sciences, Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium; Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium.
| |
Collapse
|
20
|
Ebo DG, Decuyper II, Rihs HP, Mertens C, Van Gasse AL, van der Poorten MLM, De Puysseleyr L, Faber MA, Hagendorens MM, Bridts CH, Sabato V, Elst J. IgE-binding and mast cell–activating capacity of the homologue of the major birch pollen allergen and profilin from Cannabis sativa. The Journal of Allergy and Clinical Immunology: In Practice 2021; 9:2509-2512.e3. [DOI: 10.1016/j.jaip.2021.02.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 02/05/2021] [Accepted: 02/05/2021] [Indexed: 01/01/2023]
|
21
|
De Puysseleyr LP, Ebo DG, Elst J, Faber MA, Poorten MLVD, Van Gasse AL, Bridts CH, Mertens C, Van Houdt M, Hagendorens MM, Verlinden A, Vermeulen K, Maes MB, Berneman ZN, Sabato V. Diagnosis of Primary Mast Cell Disorders in Anaphylaxis: Value of KIT D816V in Peripheral Blood. J Allergy Clin Immunol Pract 2021; 9:3176-3187.e3. [PMID: 33975032 DOI: 10.1016/j.jaip.2021.04.062] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/30/2021] [Accepted: 04/13/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Anaphylaxis is frequent in patients suffering from primary mast cell disorders (PMCDs). In patients without mastocytosis in the skin (MIS) and a baseline serum tryptase (bST) less than 30 ng/mL, the diagnosis of PMCD is challenging. In these patients, detection of the KIT D816V mutation in peripheral blood (PB) has been suggested as screening tool for a PMCD. OBJECTIVE In this study, we investigated whether KIT D816V in PB can contribute to the decision to perform a bone marrow (BM) biopsy in patients with anaphylaxis without MIS and a bST less than 30 ng/mL. METHODS We selected 74 patients with severe anaphylaxis without MIS and a bST less than 30 ng/mL. All underwent a BM biopsy. KIT D816V mutation was quantified in both PB and BM using digital droplet polymerase chain reaction (ddPCR). RESULTS Diagnosis of a PMCD was established in 40 patients (54%). Median bST for patients with and without PMCD was, respectively, 9.5 ng/mL (range 4.2-27 ng/mL) and 4.9 ng/mL (range 2.2-20.3 ng/mL) (P <.001). KIT D816V in PB was detected in 16 out of 40 (40%) patients with PMCD. KIT D816V in BM was detected in 22 out of 40 (55%) patients with PMCD. CONCLUSIONS In patients without MIS and a bST less than < 30 ng/mL who experience anaphylaxis, determination of KIT D816V mutation in PB is of limited help in deciding when to proceed to a BM biopsy. Therefore, KIT D816V in PB mutation analysis should be interpreted together with scoring tools to make a better assessment in identifying patients who should undergo BM biopsy.
Collapse
Affiliation(s)
- Leander P De Puysseleyr
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, and Rheumatology and the Infla-Med Centre of Excellence University of Antwerp; and Department of Immunology, Allergology, and Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Didier G Ebo
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, and Rheumatology and the Infla-Med Centre of Excellence University of Antwerp; and Department of Immunology, Allergology, and Rheumatology, Antwerp University Hospital, Antwerp, Belgium; Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium.
| | - Jessy Elst
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, and Rheumatology and the Infla-Med Centre of Excellence University of Antwerp; and Department of Immunology, Allergology, and Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Margaretha A Faber
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, and Rheumatology and the Infla-Med Centre of Excellence University of Antwerp; and Department of Immunology, Allergology, and Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Marie-Line van der Poorten
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, and Rheumatology and the Infla-Med Centre of Excellence University of Antwerp; and Department of Immunology, Allergology, and Rheumatology, Antwerp University Hospital, Antwerp, Belgium; Faculty of Medicine and Health Sciences, Department of Paediatrics and the Infla-Med Centre of Excellence, University of Antwerp and Department of Paediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Athina L Van Gasse
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, and Rheumatology and the Infla-Med Centre of Excellence University of Antwerp; and Department of Immunology, Allergology, and Rheumatology, Antwerp University Hospital, Antwerp, Belgium; Faculty of Medicine and Health Sciences, Department of Paediatrics and the Infla-Med Centre of Excellence, University of Antwerp and Department of Paediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Chris H Bridts
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, and Rheumatology and the Infla-Med Centre of Excellence University of Antwerp; and Department of Immunology, Allergology, and Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Christel Mertens
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, and Rheumatology and the Infla-Med Centre of Excellence University of Antwerp; and Department of Immunology, Allergology, and Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Michel Van Houdt
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, and Rheumatology and the Infla-Med Centre of Excellence University of Antwerp; and Department of Immunology, Allergology, and Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Margo M Hagendorens
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, and Rheumatology and the Infla-Med Centre of Excellence University of Antwerp; and Department of Immunology, Allergology, and Rheumatology, Antwerp University Hospital, Antwerp, Belgium; Faculty of Medicine and Health Sciences, Department of Paediatrics and the Infla-Med Centre of Excellence, University of Antwerp and Department of Paediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Anke Verlinden
- Department of Haematology, Antwerp University Hospital, Edegem, Belgium
| | - Katrien Vermeulen
- Department of Clinical Biology, Antwerp University Hospital, Edegem, Belgium
| | - Marie-Berthe Maes
- Department of Clinical Biology, Antwerp University Hospital, Edegem, Belgium
| | - Zwi N Berneman
- Department of Haematology, Antwerp University Hospital, Edegem, Belgium
| | - Vito Sabato
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, and Rheumatology and the Infla-Med Centre of Excellence University of Antwerp; and Department of Immunology, Allergology, and Rheumatology, Antwerp University Hospital, Antwerp, Belgium; Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| |
Collapse
|
22
|
Ebo DG, De Puysseleyr LP, Van Gasse AL, Elst J, Poorten MLVD, Faber MA, Mertens C, Van Houdt M, Hagendorens MM, Sermeus L, Vitte J, Moise M, Garvey LH, Castells MC, Tacquard C, Mertes PM, Schwartz LB, Sabato V. Mast Cell Activation During Suspected Perioperative Hypersensitivity: A Need for Paired Samples Analysis. J Allergy Clin Immunol Pract 2021; 9:3051-3059.e1. [PMID: 33862269 DOI: 10.1016/j.jaip.2021.03.050] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/12/2021] [Accepted: 03/27/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Perioperative hypersensitivity (POH) reactions constitute a significant clinical and diagnostic challenge. A transient increase in serum tryptase during POH reflects mast cell activation (MCA) and helps to recognize an underlying hypersensitivity mechanism. OBJECTIVE To determine the diagnostic performance of different tryptase decision thresholds based on single and paired measurements to document MCA in suspected POH. METHODS Acute serum tryptase (aST) and baseline serum tryptase (bST) samples were obtained from patients referred to our outpatients clinic because of clinical POH. Tryptase samples from controls were obtained before induction (Tt0) and 1.5 hours after induction (Tt1) in uneventful anesthesia. Different cutoff points for tryptase increase over bST and the percentage increase in tryptase (%T) were calculated and compared with existing thresholds: aST > [1.2 × (bST) + 2] (consensus formula), aST higher than 11.4 ng/mL, and aST higher than 14 ng/mL. RESULTS Patients with POH had higher bST and aST levels compared with controls (respectively 5.15 vs 2.28 ng/mL for bST and 20.30 vs 1.92 ng/mL for aST). The consensus formula and a tryptase increase over bST of greater than or equal to 3.2 ng/mL held the highest accuracies to document MCA in POH (respectively 81% and 82%). A bST of higher than 8 ng/mL was present in 4% of controls, 5% of patients with grade 1 POH, 24% of patients with grade 2 POH, 15% of patients with grade 3 POH, and 17% of patients with grade 4 POH. CONCLUSIONS Our data endorse the consensus formula for detection of MCA in POH. Furthermore, it shows that a bST of higher than 8 ng/mL was associated with occurrence of anaphylaxis.
Collapse
Affiliation(s)
- Didier G Ebo
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium; Department of Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium; AZ Jan Palfijn Gent, Department of Immunology and Allergology, Ghent, Belgium.
| | - Leander P De Puysseleyr
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium; Department of Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Athina L Van Gasse
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium; Department of Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium; Faculty of Medicine and Health Sciences, Department of Paediatrics and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium; Department of Paediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Jessy Elst
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium; Department of Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Marie-Line van der Poorten
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium; Department of Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium; Faculty of Medicine and Health Sciences, Department of Paediatrics and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium; Department of Paediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Margaretha A Faber
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium; Department of Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Christel Mertens
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium; Department of Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Michel Van Houdt
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium; Department of Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Margo M Hagendorens
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium; Department of Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium; Faculty of Medicine and Health Sciences, Department of Paediatrics and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium; Department of Paediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Luc Sermeus
- Department of Anaesthesia, Antwerp University Hospital, Antwerp, Belgium
| | - Joana Vitte
- Aix-Marseille University, IRD, APHM, MEPHI, IHU Méditerranée Infection, Marseille, France; IDESP, INSERM, University of Montpellier, Montpellier, France; Laboratoire d'Immunologie, CHU de Nîmes, Nîmes, France
| | - Michel Moise
- Aix-Marseille University, IRD, APHM, MEPHI, IHU Méditerranée Infection, Marseille, France; Laboratoire d'Immunologie, CHU de Nîmes, Nîmes, France
| | - Lene H Garvey
- Allergy Clinic, Department of Dermatology and Allergy, Gentofte Hospital, Gentofte, Denmark; Department of Clinical Medicine, Ha, Denmark
| | - Mariana C Castells
- Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Charles Tacquard
- Nouvel Hôpital Civil, hôpitaux universitaires de Strasbourg, service d'anesthésie-réanimation chirurgicale, Strasbourg, France
| | - Paul-Michel Mertes
- Nouvel Hôpital Civil, hôpitaux universitaires de Strasbourg, service d'anesthésie-réanimation chirurgicale, Strasbourg, France
| | - Lawrence B Schwartz
- Department of Internal Medicine, Division of Rheumatology, Allergy & Immunologie, Virginia Commonwealth University, Richmond, Va
| | - Vito Sabato
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium; Department of Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium; AZ Jan Palfijn Gent, Department of Immunology and Allergology, Ghent, Belgium
| |
Collapse
|
23
|
Elst J, Sabato V, van der Poorten MLM, Faber M, Van Gasse AL, De Puysseleyr LP, Bridts CH, Mertens C, Van Houdt M, Maurer M, Hagendorens MM, Ebo DG. Peripheral blood cultured mast cells: Phenotypic and functional outcomes of different culture protocols. J Immunol Methods 2021; 492:113003. [PMID: 33647250 DOI: 10.1016/j.jim.2021.113003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/08/2021] [Accepted: 02/18/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Mast cells (MCs) play a pivotal role in innate and adaptive immune responses. However, MCs are also involved in different pathologic conditions. Studies on the mechanisms that govern human MC functions are impeded by their limited and difficult recovery. Therefore, several research groups have developed protocols to culture human MCs from progenitor cells. These protocols vary with respect to culture duration and used maturation cytokines. How MCs obtained by different protocols differ in phenotype and functionality is currently unknown. OBJECTIVE To compare different protocols for the generation of human MCs from peripheral blood progenitors. METHODS Thirteen paired human MC cultures were investigated. MCs were cultured form CD34+ progenitors cells for 4 or 8 weeks and with or without the addition of IL-6. Phenotyping comprised staining for CD117, CD203c, FcεRI, MRGPRX2, CD300a and CD32. Functional studies included measurements of the up-regulation of CD63 and CD203c after allergen-specific cross-linking of sIgE/FcεRI complexes or ligation of MRGPRX2 with substance P and different drugs. RESULTS Cell cultures for 4 weeks in the presence of IL-6 consistently yielded the highest numbers of MCs. MCs cultured for 8 weeks with IL-6 showed more autofluorescence significantly impeding correct analyses of FcεRI and CD32. The density of FcεRI and CD32 was comparable between the different culture conditions. MRGPRX2 expression was significantly higher in the 8 week cultures. The density of CD300a was increased in the cultures with IL-6. Cells cultured for 8 weeks were more responsive to MRGPRX2 activation. In contrast, the 4-weeks cultures with IL-6 showed significantly higher allergen-specific activation. CONCLUSION Four weeks of culture with IL-6 are sufficient to generate sizeable numbers of human mast cells from blood progenitors, thereby enabling simultaneous exploration of allergen-specific sIgE/FcεRI cross-linking and non-specific activation via MRGPRX2.
Collapse
Affiliation(s)
- Jessy Elst
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Antwerp (Belgium) and Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Vito Sabato
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Antwerp (Belgium) and Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium; Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| | - Marie-Line M van der Poorten
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Antwerp (Belgium) and Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium; University of Antwerp, Faculty of Medicine and Health Sciences, Department of Paediatrics and the Infla-Med Centre of Excellence, Antwerp (Belgium) and Paediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Margaretha Faber
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Antwerp (Belgium) and Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Athina L Van Gasse
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Antwerp (Belgium) and Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium; University of Antwerp, Faculty of Medicine and Health Sciences, Department of Paediatrics and the Infla-Med Centre of Excellence, Antwerp (Belgium) and Paediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Leander P De Puysseleyr
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Antwerp (Belgium) and Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Chris H Bridts
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Antwerp (Belgium) and Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Christel Mertens
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Antwerp (Belgium) and Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Michel Van Houdt
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Antwerp (Belgium) and Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium
| | - Marcus Maurer
- Dermatological Allergology, Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany
| | - Margo M Hagendorens
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Antwerp (Belgium) and Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium; University of Antwerp, Faculty of Medicine and Health Sciences, Department of Paediatrics and the Infla-Med Centre of Excellence, Antwerp (Belgium) and Paediatrics, Antwerp University Hospital, Antwerp, Belgium
| | - Didier G Ebo
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Antwerp (Belgium) and Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium; Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium.
| |
Collapse
|
24
|
Elst J, van der Poorten MLM, Faber MA, Van Gasse AL, Garvey LH, Bridts CH, De Puysseleyr LP, Mertens C, Hagendorens MM, Sabato V, Ebo DG. Mast cell activation test in chlorhexidine allergy: a proof of concept. Br J Anaesth 2020; 125:970-975. [DOI: 10.1016/j.bja.2020.06.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/02/2020] [Accepted: 06/20/2020] [Indexed: 12/20/2022] Open
|
25
|
Van Der Poorten MLM, Molina-Molina G, Van Gasse AL, Hagendorens MM, Faber MA, De Puysseleyr L, Elst J, Mertens CM, Horiuchi T, Sabato V, Ebo DG. Application of specific-to-total IgE ratio does not benefit diagnostic performance of serologic testing for rocuronium allergy. Br J Anaesth 2020; 125:e443-e446. [DOI: 10.1016/j.bja.2020.05.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/14/2020] [Accepted: 05/14/2020] [Indexed: 10/24/2022] Open
|
26
|
van der Poorten MLM, Van Gasse AL, Hagendorens MM, Faber MA, De Puysseleyr L, Elst J, Mertens CM, Chiriac AM, Bridts CH, Ebo DG, Sabato V. The diagnosis of non-life-threatening immediate penicillin allergy should not rest upon low sIgE results between 0.10 kUA/L and 0.35 kUA/L in isolation. Clin Chim Acta 2020; 511:94-96. [PMID: 33035502 DOI: 10.1016/j.cca.2020.09.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/28/2020] [Accepted: 09/28/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Marie-Line M van der Poorten
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; Faculty of Medicine and Health Sciences, Department of Paediatrics, University of Antwerp, and Antwerp University Hospital, Antwerp, Belgium
| | - Athina L Van Gasse
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; Faculty of Medicine and Health Sciences, Department of Paediatrics, University of Antwerp, and Antwerp University Hospital, Antwerp, Belgium
| | - Margo M Hagendorens
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; Faculty of Medicine and Health Sciences, Department of Paediatrics, University of Antwerp, and Antwerp University Hospital, Antwerp, Belgium
| | - Margaretha A Faber
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Leander De Puysseleyr
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Jessy Elst
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Christel M Mertens
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Anca M Chiriac
- Department of Pulmonology, Division of Allergy, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France; UMR-S 1136 INSERM-Sorbonne Université, Equipe EPAR - IPLESP, Paris, France
| | - Chris H Bridts
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Didier G Ebo
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium.
| | - Vito Sabato
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| |
Collapse
|
27
|
van der Poorten MLM, Van Gasse AL, Hagendorens MM, Faber MA, De Puysseleyr L, Elst J, Mertens CM, Romano A, Ebo DG, Sabato V. Nonirritating skin test concentrations for ceftazidime and aztreonam in patients with a documented beta-lactam allergy. J Allergy Clin Immunol Pract 2020; 9:585-588.e1. [PMID: 32889219 PMCID: PMC7462539 DOI: 10.1016/j.jaip.2020.08.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 08/10/2020] [Accepted: 08/13/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Marie-Line M van der Poorten
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology, and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; Faculty of Medicine and Health Sciences, Department of Paediatrics, University of Antwerp, and Antwerp University Hospital, Antwerp, Belgium
| | - Athina L Van Gasse
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology, and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; Faculty of Medicine and Health Sciences, Department of Paediatrics, University of Antwerp, and Antwerp University Hospital, Antwerp, Belgium
| | - Margo M Hagendorens
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology, and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; Faculty of Medicine and Health Sciences, Department of Paediatrics, University of Antwerp, and Antwerp University Hospital, Antwerp, Belgium
| | - Margaretha A Faber
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology, and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Leander De Puysseleyr
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology, and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Jessy Elst
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology, and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Christel M Mertens
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology, and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Antonino Romano
- IRCCS Oasi Maria S.S., Troina, Italy; Fondazione Mediterranea GB Morgagni, Catania, Italy
| | - Didier G Ebo
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology, and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium.
| | - Vito Sabato
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology, and Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| |
Collapse
|
28
|
Van Gasse AL, Oulkadi R, Mousati Z, Ebo DG, Chiriac AM, Van Der Poorten MM, Hagendorens MM, Faber MA, Elst J, Mertens CM, De Puysseleyr L, Coenen S, Sabato V. Prevalence of self-reported and confirmed penicillin allergy in a Belgian outpatient population. Allergy 2020; 75:2111-2115. [PMID: 32243598 DOI: 10.1111/all.14292] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/06/2020] [Accepted: 03/21/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Athina L. Van Gasse
- Faculty of Medicine and Health Sciences Department of Immunology, Allergology, Rheumatology and Infla‐Med Centre of Excellence University of Antwerp and Antwerp University Hospital Antwerp Belgium
- Faculty of Medicine and Health Sciences Department of Paediatrics and the Infla‐Med Centre of Excellence University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Redouane Oulkadi
- Faculty of Medicine and Health Sciences Department of Immunology, Allergology, Rheumatology and Infla‐Med Centre of Excellence University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Zakaria Mousati
- Faculty of Medicine and Health Sciences Department of Immunology, Allergology, Rheumatology and Infla‐Med Centre of Excellence University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Didier G. Ebo
- Faculty of Medicine and Health Sciences Department of Immunology, Allergology, Rheumatology and Infla‐Med Centre of Excellence University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Anca M. Chiriac
- Department of Pulmonology Division of Allergy Hôpital Arnaud de VilleneuveUniversity Hospital of Montpellier Montpellier France
- UMR‐S 1136 INSERM‐Sorbonne Université Equipe EPAR—IPLESP Paris France
| | - Marie‐Line M. Van Der Poorten
- Faculty of Medicine and Health Sciences Department of Immunology, Allergology, Rheumatology and Infla‐Med Centre of Excellence University of Antwerp and Antwerp University Hospital Antwerp Belgium
- Faculty of Medicine and Health Sciences Department of Paediatrics and the Infla‐Med Centre of Excellence University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Margo M. Hagendorens
- Faculty of Medicine and Health Sciences Department of Immunology, Allergology, Rheumatology and Infla‐Med Centre of Excellence University of Antwerp and Antwerp University Hospital Antwerp Belgium
- Faculty of Medicine and Health Sciences Department of Paediatrics and the Infla‐Med Centre of Excellence University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Margaretha A. Faber
- Faculty of Medicine and Health Sciences Department of Immunology, Allergology, Rheumatology and Infla‐Med Centre of Excellence University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Jessy Elst
- Faculty of Medicine and Health Sciences Department of Immunology, Allergology, Rheumatology and Infla‐Med Centre of Excellence University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Christel M. Mertens
- Faculty of Medicine and Health Sciences Department of Immunology, Allergology, Rheumatology and Infla‐Med Centre of Excellence University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Leander De Puysseleyr
- Faculty of Medicine and Health Sciences Department of Immunology, Allergology, Rheumatology and Infla‐Med Centre of Excellence University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Samuel Coenen
- Faculty of Medicine and Health Sciences Vaccine & Infectious Disease Institute (VAXINFECTIO) University of Antwerp Antwerp Belgium
| | - Vito Sabato
- Faculty of Medicine and Health Sciences Department of Immunology, Allergology, Rheumatology and Infla‐Med Centre of Excellence University of Antwerp and Antwerp University Hospital Antwerp Belgium
| |
Collapse
|
29
|
Decuyper II, Rihs HP, Mertens CH, Van Gasse AL, Elst J, De Puysseleyr L, Faber MA, Sabato V, Hagendorens MM, Lapeere H, Bridts CH, De Clerck LS, Ebo DG. A new cannabis allergen in Northwestern Europe: The oxygen-evolving enhancer protein 2 (OEEP2). The Journal of Allergy and Clinical Immunology: In Practice 2020; 8:2421-2424.e2. [DOI: 10.1016/j.jaip.2020.03.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/04/2020] [Accepted: 03/14/2020] [Indexed: 11/25/2022]
|
30
|
van der Poorten MLM, Van Gasse AL, Hagendorens MM, Faber MA, De Puysseleyr L, Elst J, Mertens CM, Sabato V, Ebo DG. Serum specific IgE antibodies in immediate drug hypersensitivity. Clin Chim Acta 2020; 504:119-124. [DOI: 10.1016/j.cca.2020.02.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 02/05/2020] [Accepted: 02/05/2020] [Indexed: 12/20/2022]
|
31
|
Ebo DG, Baldo BA, Van Gasse AL, Mertens C, Elst J, Sermeus L, Bridts CH, Hagendorens MM, De Clerck LS, Sabato V. Anaphylaxis to sugammadex-rocuronium inclusion complex: An IgE-mediated reaction due to allergenic changes at the sugammadex primary rim. The Journal of Allergy and Clinical Immunology: In Practice 2020; 8:1410-1415.e3. [DOI: 10.1016/j.jaip.2019.11.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/26/2019] [Accepted: 11/05/2019] [Indexed: 11/15/2022]
|
32
|
Van Gasse AL, Ebo DG, Mertens CM, Bridts CH, Elst J, De Puysseleyr L, Faber MA, Hagendorens MM, De Clerck LS, Sabato V. CD154 (CD40L): A novel aid to document nonimmediate hypersensitivity to amoxicillin or amoxicillin clavulanic acid. Clin Exp Allergy 2020; 50:640-642. [PMID: 32056306 DOI: 10.1111/cea.13581] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 02/08/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Athina L Van Gasse
- Department of Immunology, Faculty of Medicine and Health Sciences, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium.,Department of Paediatrics and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, and Antwerp University Hospital, Antwerpen, Belgium
| | - Didier G Ebo
- Department of Immunology, Faculty of Medicine and Health Sciences, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium.,Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| | - Christel M Mertens
- Department of Immunology, Faculty of Medicine and Health Sciences, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
| | - Chris H Bridts
- Department of Immunology, Faculty of Medicine and Health Sciences, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
| | - Jessy Elst
- Department of Immunology, Faculty of Medicine and Health Sciences, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
| | - Leander De Puysseleyr
- Department of Immunology, Faculty of Medicine and Health Sciences, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
| | - Margaretha A Faber
- Department of Immunology, Faculty of Medicine and Health Sciences, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
| | - Margo M Hagendorens
- Department of Immunology, Faculty of Medicine and Health Sciences, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium.,Department of Paediatrics and the Infla-Med Centre of Excellence, Faculty of Medicine and Health Sciences, University of Antwerp, and Antwerp University Hospital, Antwerpen, Belgium
| | - Luc S De Clerck
- Department of Immunology, Faculty of Medicine and Health Sciences, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium
| | - Vito Sabato
- Department of Immunology, Faculty of Medicine and Health Sciences, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerpen, Belgium.,Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| |
Collapse
|
33
|
Decuyper II, Pascal M, Van Gasse AL, Mertens C, Díaz‐Perales A, Araujo G, Torradeflot M, Rius J, Balsells S, Muñoz‐Cano RM, Bartra J, Li L, Sabato V, Hagendorens MM, Bridts CH, De Clerck LS, Ebo DG, Faber MA. Performance of basophil activation test and specific IgG4 as diagnostic tools in nonspecific lipid transfer protein allergy: Antwerp-Barcelona comparison. Allergy 2020; 75:616-624. [PMID: 31512256 DOI: 10.1111/all.14040] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 07/23/2019] [Accepted: 08/07/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND Recent studies show that nsLTP sensitization is not limited to the Mediterranean basin and can present diverse clinical phenotypes. It remains challenging to predict clinical outcome when specific IgE antibodies (sIgE) to nsLTPs are present. This study compares both clinical and in vitro allergy characteristics but also diagnostic performance of a basophil activation test (BAT) and sIgG4 in nsLTP-sensitized patients from Antwerp (ANT, Belgium) and Barcelona (BCN, Spain). METHODS Adult subjects with positive sIgE rPru p 3 and/or rMal d 3 ≥ 0.10 kUA /L (n = 182) and healthy controls (n = 37) were included. NsLTP-sensitized individuals were stratified according to clinical symptoms with peach/apple, respectively. BAT rPru p 3 and rMal d 3 were performed and sIgG4 antibodies to both components quantified. RESULTS In BCN, only ratios of sIgG4/sIgE rMal d 3 and BAT rMal d 3 (0.001 µg/mL) can identify clinically relevant Mal d 3 sensitization (sensitivity of 60%-63% and a specificity of 75%-67%, respectively). In ANT, only the sIgE/total IgE rPru p 3 ratio shows added value (sensitivity 60% and specificity 83%). Finally, it appears that symptomatic patients in BCN are more sensitive to lower allergen concentrations compared to ANT. In addition, it was shown that ANT patients were more often sensitized to pollen and that specific pollen sources differed between regions. CONCLUSIONS NsLTP-related allergy profiles and diagnostic performance differ significantly between regions and are component-specific, which makes extrapolation of data difficult to do. In addition, it seems that basophil sensitivity might show geographical differences. Additional research is needed to confirm these findings.
Collapse
Affiliation(s)
- Ine I. Decuyper
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
- Pediatric Department University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Mariona Pascal
- Immunology Department Centre de Diagnòstic Biomèdic (CDB)Hospital Clínic de Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona Barcelona Spain
- Spanish Network for Allergy – RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL) Madrid Spain
| | - Athina L. Van Gasse
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
- Pediatric Department University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Christel Mertens
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Araceli Díaz‐Perales
- Spanish Network for Allergy – RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL) Madrid Spain
- Plant Biotechnology Institute (UPM‐INIA) Madrid Spain
| | - Giovanna Araujo
- Allergy Section Pneumology Department Institut Clínic Respiratori (ICR)Hospital Clínic de Barcelona Barcelona Spain
| | - Maria Torradeflot
- Immunology Department Centre de Diagnòstic Biomèdic (CDB)Hospital Clínic de Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona Barcelona Spain
| | - Josefina Rius
- Immunology Department Centre de Diagnòstic Biomèdic (CDB)Hospital Clínic de Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona Barcelona Spain
| | - Sara Balsells
- Immunology Department Centre de Diagnòstic Biomèdic (CDB)Hospital Clínic de Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Universitat de Barcelona Barcelona Spain
| | - Rosa M. Muñoz‐Cano
- Spanish Network for Allergy – RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL) Madrid Spain
- Allergy Section Pneumology Department Institut Clínic Respiratori (ICR)Hospital Clínic de Barcelona Barcelona Spain
| | - Joan Bartra
- Spanish Network for Allergy – RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL) Madrid Spain
- Allergy Section Pneumology Department Institut Clínic Respiratori (ICR)Hospital Clínic de Barcelona Barcelona Spain
| | - Lynne Li
- Department of Medicine University of British Columbia Vancouver BC Canada
| | - Vito Sabato
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Margo M. Hagendorens
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
- Pediatric Department University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Chris H. Bridts
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Luc S. De Clerck
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Didier G. Ebo
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Margaretha A. Faber
- Department of Immunology‐Allergology‐Rheumatology University of Antwerp and Antwerp University Hospital Antwerp Belgium
| |
Collapse
|
34
|
Ebo DG, Elst J, Houdt M, Pintelon I, Timmermans J, Horiuchi T, Faber MA, Hagendorens MM, Mertens CM, Sabato V. Flow cytometric basophil activation tests: Staining of exteriorized basophil granule matrix by fluorescent avidin versus appearance of CD63. Cytometry 2020; 98:483-490. [DOI: 10.1002/cyto.b.21868] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/06/2020] [Accepted: 01/10/2020] [Indexed: 11/06/2022]
Affiliation(s)
- Didier G. Ebo
- Department of Immunology, Allergology, Rheumatology and the Infla‐Med Research Consortium of Excellence University of Antwerp and Antwerp University Hospital Antwerp Belgium
- Department of Immunology and Allergology AZ Jan Palfijn Gent, Ghent Belgium
| | - Jessy Elst
- Department of Immunology, Allergology, Rheumatology and the Infla‐Med Research Consortium of Excellence University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Michel Houdt
- Department of Immunology, Allergology, Rheumatology and the Infla‐Med Research Consortium of Excellence University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Isabel Pintelon
- Laboratory of Cell Biology and Histology Department of Veterinary Sciences, University of Antwerp Antwerp Belgium
| | - Jean‐Pierre Timmermans
- Laboratory of Cell Biology and Histology Department of Veterinary Sciences, University of Antwerp Antwerp Belgium
| | - Tatsuo Horiuchi
- Department of Anesthesiology Gunma University Graduate School of Medicine Maebashi Gunma Japan
| | - Margaretha A. Faber
- Department of Immunology, Allergology, Rheumatology and the Infla‐Med Research Consortium of Excellence University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Margo M. Hagendorens
- Department of Immunology, Allergology, Rheumatology and the Infla‐Med Research Consortium of Excellence University of Antwerp and Antwerp University Hospital Antwerp Belgium
- Department of Pediatrics University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Christel M. Mertens
- Department of Immunology, Allergology, Rheumatology and the Infla‐Med Research Consortium of Excellence University of Antwerp and Antwerp University Hospital Antwerp Belgium
| | - Vito Sabato
- Department of Immunology, Allergology, Rheumatology and the Infla‐Med Research Consortium of Excellence University of Antwerp and Antwerp University Hospital Antwerp Belgium
- Department of Immunology and Allergology AZ Jan Palfijn Gent, Ghent Belgium
| |
Collapse
|
35
|
Elst J, Sabato V, Hagendorens MM, van Houdt M, Faber MA, Bridts CH, Ebo DG, Mertens C. Basophil Activation Techniques: Staining of Exteriorized Granule Matrix. Methods Mol Biol 2020; 2163:213-218. [PMID: 32766978 DOI: 10.1007/978-1-0716-0696-4_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
The basis of traditional flow cytometry allergy diagnosis is measurement of the expression of basophilic surface activation and/or degranulation markers. Basophils, upon encounter with a specific allergen that cross-links surface FcRI-bound IgE antibodies, not only secrete and release quantifiable bioactive mediators but also upregulate the expression of different markers (e.g., CD63, CD203c) which can be detected by multicolor flow cytometry using specific monoclonal antibodies. Here, we describe a novel technique that relies upon the staining of exteriorized anionic proteoglycans from a basophil granule matrix by cationic fluorescent avidin probes.
Collapse
Affiliation(s)
- Jessy Elst
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium.
| | - Vito Sabato
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
- Department of Immunology and Allergology, AZ Jan Palfijn Gent, Gent, Belgium
| | - Margo M Hagendorens
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
- Faculty of Medicine and Health Science, Department of Pediatrics, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Michel van Houdt
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Margaretha A Faber
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Chris H Bridts
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Didier G Ebo
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
- Department of Immunology and Allergology, AZ Jan Palfijn Gent, Gent, Belgium
| | - Christel Mertens
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| |
Collapse
|
36
|
Elst J, Sabato V, Hagendorens MM, van Houdt M, Faber MA, Bridts CH, Ebo DG, Mertens C. Measurement and Functional Analysis of the Mas-Related G Protein-Coupled Receptor MRGPRX2 on Human Mast Cells and Basophils. Methods Mol Biol 2020; 2163:219-226. [PMID: 32766979 DOI: 10.1007/978-1-0716-0696-4_18] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Basophils and mast cells (MCs) are important effector cells in the immune system. For a long time, it has been known that these cells can be activated though the cross-linking of IgE antibodies bound to their high-affinity receptor (FcεRI). However, evidence has accumulated suggesting that these cells can also be activated by various IgE-independent mechanisms. Occupation of MAS Related GPR Family Member X2 (MRGPRX2), a G protein-coupled receptor, is described as an alternative IgE-independent activation mechanism. Here we describe a flow cytometric technique to analyze MRGPRX2 expression and its functionality on cultured human MCs and conditioned basophils, that is, basophils with upregulated surface expression of MRGPRX2.
Collapse
Affiliation(s)
- Jessy Elst
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium.
| | - Vito Sabato
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
- Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| | - Margo M Hagendorens
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
- Faculty of Medicine and Health Science, Department of Pediatrics, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Michel van Houdt
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Margaretha A Faber
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Chris H Bridts
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Didier G Ebo
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
- Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| | - Christel Mertens
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| |
Collapse
|
37
|
Abstract
The basis of flow cytometric allergy diagnosis is the quantification of changes in the expression of basophilic surface membrane markers (Ebo et al., Clin Exp Allergy 34: 332-339, 2004). Upon encountering specific allergens recognized by surface receptor FcεRI-bound IgE, basophils not only secrete and generate quantifiable bioactive mediators but also upregulate the expression of different markers (e.g., CD63, CD203c) which can be detected by multicolor flow cytometry using specific monoclonal antibodies (Ebo et al., Cytometry B Clin Cytom 74: 201-210, 2008). Here, we describe two flow cytometry-based protocols which allow the detection of surface marker activation (Method 1) and changes in intragranular histamine (Method 2), both reflecting different facets of basophil activation.
Collapse
Affiliation(s)
- Chris H Bridts
- Department of Immunology, Allergology, Rheumatology, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Vito Sabato
- Department of Immunology, Allergology, Rheumatology, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Christel Mertens
- Department of Immunology, Allergology, Rheumatology, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Margo M Hagendorens
- Department of Immunology, Allergology, Rheumatology, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Luc S De Clerck
- Department of Immunology, Allergology, Rheumatology, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Didier G Ebo
- Department of Immunology, Allergology, Rheumatology, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium.
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium.
| |
Collapse
|
38
|
Ebo DG, Elst J, Van Gasse A, De Puysseleyr L, Faber MA, Hagendorens MM, Mayorga L, Mertens C, Bridts CH, De Clerck LS, Sabato V. Basophil Activation Experiments in Immediate Drug Hypersensitivity: More Than a Diagnostic Aid. Methods Mol Biol 2020; 2163:197-211. [PMID: 32766977 DOI: 10.1007/978-1-0716-0696-4_16] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
BACKGROUND Correct diagnosis of immediate drug hypersensitivity reactions (IDHRs) can pose a significant challenge, mainly because of the absence of reliable in vitro tests, uncertainties associated with skin testing, and incomplete understanding of the underlying mechanisms. AIM To summarize and hypothesize on the potential of basophil activation test (BAT) as a safe aid to explore the mechanistic endotypes of IDHR, to identify antibody recognition sites, and to monitor drug desensitization. METHODS A literature search was conducted using the keywords "allergy, basophil activation, CD63, CD203c, diagnosis, drugs, hypersensitivity, flow cytometry"; this was complemented by the authors' own expertise. RESULTS At present BAT has mainly been employed as a diagnostic aid. However, evidence is emerging that the technique might also deepen our insights in immune (allergic) and nonimmune (nonallergic) mechanistic processes of IDHR. It is anticipated that BAT might also benefit the identification of antibody recognition sites and benefit our understandings of desensitization strategies. CONCLUSION Although the nondiagnostic application of BAT in IDHR is still in its infancy, with increasing employment, we can expect the technique to become a valuable asset to study many domains of IDHR that remain poorly understood.
Collapse
Affiliation(s)
- Didier G Ebo
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium.
- Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium.
| | - Jessy Elst
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Athina Van Gasse
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
- Faculty of Medicine and Health Science, Department of Pediatrics, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Leander De Puysseleyr
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Margaretha A Faber
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Margo M Hagendorens
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
- Faculty of Medicine and Health Science, Department of Pediatrics, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Lina Mayorga
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA and Allergy Unit, Hospital Regional Universitario de Málaga, ARADyAL, Malaga, Spain
| | - Christel Mertens
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Chris H Bridts
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Luc S De Clerck
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Vito Sabato
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
- Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| |
Collapse
|
39
|
Ebo DG, Van Gasse AL, Decuyper II, Uyttebroek A, Sermeus LA, Elst J, Bridts CH, Mertens CM, Faber MA, Hagendorens MM, De Clerck LS, Sabato V. Acute Management, Diagnosis, and Follow-Up of Suspected Perioperative Hypersensitivity Reactions in Flanders 2001-2018. The Journal of Allergy and Clinical Immunology: In Practice 2019; 7:2194-2204.e7. [DOI: 10.1016/j.jaip.2019.02.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/25/2019] [Accepted: 02/15/2019] [Indexed: 12/20/2022]
|
40
|
Faber MA, Lommaert E, Meukens L, Rosier S, Sabato V, Hubens G, Hagendorens MM, Ebo DG. Gastric bypass surgery: Risk for food allergy? J Allergy Clin Immunol Pract 2019; 8:346-348. [PMID: 31306797 DOI: 10.1016/j.jaip.2019.06.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 06/16/2019] [Accepted: 06/20/2019] [Indexed: 01/01/2023]
Affiliation(s)
- Margaretha A Faber
- Department of Immunology-Allergology-Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Ellen Lommaert
- Department of Immunology-Allergology-Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Laura Meukens
- Department of Immunology-Allergology-Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Sarah Rosier
- Department of Immunology-Allergology-Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Vito Sabato
- Department of Immunology-Allergology-Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; Department of Immunology-Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
| | - Guy Hubens
- Department of Abdominal Surgery, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Margo M Hagendorens
- Department of Immunology-Allergology-Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Didier G Ebo
- Department of Immunology-Allergology-Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; Department of Immunology-Allergology, AZ Jan Palfijn Gent, Ghent, Belgium.
| |
Collapse
|
41
|
Van Gasse AL, Ebo DG, Chiriac AM, Hagendorens MM, Faber MA, Coenen S, Bridts CH, Mertens CM, De Clerck LS, Sabato V. The Limited Value of Prolonged Drug Challenges in Nonimmediate Amoxicillin (Clavulanic Acid) Hypersensitivity. J Allergy Clin Immunol Pract 2019; 7:2225-2229.e1. [PMID: 31034997 DOI: 10.1016/j.jaip.2019.04.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/12/2019] [Accepted: 04/04/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND Misdiagnosis of amoxicillin (clavulanic acid) (AX(/CL)) hypersensitivity has serious consequences. A drug challenge (DC) is the final diagnostic to affirm or infirm AX(/CL) hypersensitivity. However, uncertainties remain whether a prolonged drug challenge (pDC) should benefit the diagnosis of a nonimmediate AX(/CL) hypersensitivity. OBJECTIVE To assess the added value of a standardized 7-day pDC in the diagnosis of nonimmediate or unclear penicillin hypersensitivity. METHODS A total of 132 patients with a history of a nonimmediate hypersensitivity reaction or an unclear reaction to AX(/CL) or an undefined penicillin with a negative diagnostic workup including a single-day DC (DC) with AX(/CL) were selected. In all these patients, an additional pDC with AX(/CL) was planned. Thirteen patients started the pDC immediately after the DC. To ensure that hypersensitivity symptoms manifesting during the pDC course do not result from the DC, in the remaining 119 patients, the pDC was scheduled after a washout of 1 week. RESULTS A total of 128 patients (12 without washout, 116 with washout) completed the pDC. Three patients reacted with a mild maculopapular exanthema. However, the value of a pDC was evidenced in only 1 patient who reacted during her pDC after an uneventful washout. In 2 patients pDC was cancelled because they reacted during the washout. CONCLUSIONS A pDC is of limited added value to the diagnostic algorithms of nonimmediate hypersensitivity reaction or unclear hypersensitivity reactions to AX(/CL). In our hands, the traditionally recommended diagnostic algorithm that offers a 1-day DC as a final diagnostic in patients with negative workup for AX(/CL) is appropriate.
Collapse
Affiliation(s)
- Athina L Van Gasse
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; Faculty of Medicine and Health Sciences, Department of Paediatrics and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Didier G Ebo
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; AZ Jan Palfijn Gent, Department of Immunology and Allergology, Ghent, Belgium.
| | - Anca M Chiriac
- Department of Pulmonology, Division of Allergy, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France; UMR-S 1136 INSERM-Sorbonne Université, Equipe EPAR - IPLESP, Paris, France
| | - Margo M Hagendorens
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; Faculty of Medicine and Health Sciences, Department of Paediatrics and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Margaretha A Faber
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Samuel Coenen
- Faculty of Medicine and Health Sciences, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Chris H Bridts
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Christel M Mertens
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Luc S De Clerck
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; AZ Jan Palfijn Gent, Department of Immunology and Allergology, Ghent, Belgium
| | - Vito Sabato
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; AZ Jan Palfijn Gent, Department of Immunology and Allergology, Ghent, Belgium
| |
Collapse
|
42
|
Van Gasse AL, Elst J, Bridts CH, Mertens C, Faber M, Hagendorens MM, De Clerck LS, Sabato V, Ebo DG. Rocuronium Hypersensitivity: Does Off-Target Occupation of the MRGPRX2 Receptor Play a Role? The Journal of Allergy and Clinical Immunology: In Practice 2019; 7:998-1003. [DOI: 10.1016/j.jaip.2018.09.034] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 09/22/2018] [Accepted: 09/25/2018] [Indexed: 12/13/2022]
|
43
|
Decuyper II, Rihs HP, Mertens C, Van Gasse AL, Faber MA, Hagendorens MM, Sabato V, Bridts CH, Ebo DG. Piecing Together the IgE-Reactivity Profile of Cannabis sativa in a North-Western European Region. J Allergy Clin Immunol 2019. [DOI: 10.1016/j.jaci.2018.12.965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
44
|
Faber MA, Van Gasse AL, Decuyper II, Sabato V, Hagendorens MM, Mertens C, Bridts CH, De Clerck LS, Ebo DG. Cross-Reactive Aeroallergens: Which Need to Cross Our Mind in Food Allergy Diagnosis? J Allergy Clin Immunol Pract 2018; 6:1813-1823. [PMID: 30172018 DOI: 10.1016/j.jaip.2018.08.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 08/02/2018] [Accepted: 08/20/2018] [Indexed: 01/08/2023]
Abstract
Secondary food allergies due to cross-reactivity between inhalant and food allergens are a significant and increasing global health issue. Cross-reactive food allergies predominantly involve plant-derived foods resulting from a prior sensitization to cross-reactive components present in pollen (grass, tree, weeds) and natural rubber latex. Also, primary sensitization to allergens present in fungi, insects, and both nonmammalian and mammalian meat might induce cross-reactive food allergic syndromes. Correct diagnosis of these associated food allergies is not always straightforward and can pose a difficult challenge. As a matter of fact, cross-reactive allergens might hamper food allergy diagnosis, as they can cause clinically irrelevant positive tests to cross-reacting foods that are safely consumed. This review summarizes the most relevant cross-reactivity syndromes between inhalant and food allergens. Particular focus is paid to the potential and limitations of confirmatory testing such as skin testing, specific IgE assays, molecular diagnosis, and basophil activation test.
Collapse
Affiliation(s)
- Margaretha A Faber
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Athina L Van Gasse
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; Faculty of Medicine and Health Science, Department of Pediatrics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Ine I Decuyper
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; Faculty of Medicine and Health Science, Department of Pediatrics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Vito Sabato
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Margo M Hagendorens
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium; Faculty of Medicine and Health Science, Department of Pediatrics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Christel Mertens
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Chris H Bridts
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Luc S De Clerck
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Didier G Ebo
- Faculty of Medicine and Health Science, Department of Immunology, Allergology, Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium.
| |
Collapse
|
45
|
Faber MA, Decuyper II, Van Gasse AL, Sabato V, Hagendorens MM, Ebo DG. Letter to the Authors Concerning the Published Manuscript by Rial and Sastre: Food Allergies Caused by Allergenic Lipid Transfer Proteins: What Is Behind the Geographic Restriction? Curr Allergy Asthma Rep 2018; 18:70. [PMID: 30361881 DOI: 10.1007/s11882-018-0828-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Margaretha A Faber
- Department of Immunology-Allergology-Rheumatology, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium.
| | - Ine I Decuyper
- Department of Immunology-Allergology-Rheumatology, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Athina L Van Gasse
- Department of Immunology-Allergology-Rheumatology, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Vito Sabato
- Department of Immunology-Allergology-Rheumatology, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Margo M Hagendorens
- Department of Immunology-Allergology-Rheumatology, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium.,Department of Paediatrics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Didier G Ebo
- Department of Immunology-Allergology-Rheumatology, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| |
Collapse
|
46
|
Van Gasse AL, Sabato V, Faber MA, Hagendorens MM, Ebo DG. An alternative explanation for immediate hypersensitivity reactions to opioids. The Journal of Allergy and Clinical Immunology: In Practice 2017; 5:1806. [DOI: 10.1016/j.jaip.2017.08.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 08/02/2017] [Indexed: 11/17/2022]
|
47
|
Affiliation(s)
- Athina L Van Gasse
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology, University of Antwerp, Antwerp University Hospital, Campus Drie Eiken T5.95, Universiteitsplein 1, 2610, Antwerpen, Belgium.,Faculty of Medicine and Health Science, Department of Pediatrics, University of Antwerp, Antwerp University Hospital, 2610, Antwerpen, Belgium
| | - Vito Sabato
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology, University of Antwerp, Antwerp University Hospital, Campus Drie Eiken T5.95, Universiteitsplein 1, 2610, Antwerpen, Belgium
| | - Margaretha Faber
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology, University of Antwerp, Antwerp University Hospital, Campus Drie Eiken T5.95, Universiteitsplein 1, 2610, Antwerpen, Belgium
| | - Margo M Hagendorens
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology, University of Antwerp, Antwerp University Hospital, Campus Drie Eiken T5.95, Universiteitsplein 1, 2610, Antwerpen, Belgium.,Faculty of Medicine and Health Science, Department of Pediatrics, University of Antwerp, Antwerp University Hospital, 2610, Antwerpen, Belgium
| | - Didier G Ebo
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology, University of Antwerp, Antwerp University Hospital, Campus Drie Eiken T5.95, Universiteitsplein 1, 2610, Antwerpen, Belgium.
| |
Collapse
|
48
|
Cop N, Ebo DG, Bridts CH, Elst J, Hagendorens MM, Mertens C, Faber MA, De Clerck LS, Sabato V. Influence of IL-6, IL-33, and TNF-α on human mast cell activation: Lessons from single cell analysis by flow cytometry. Cytometry B Clin Cytom 2017; 94:405-411. [PMID: 28802100 DOI: 10.1002/cyto.b.21547] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 07/14/2017] [Accepted: 08/03/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND Mechanisms that govern priming and degranulation of human mast cells (MCs) remain elusive. Besides, most of our knowledge is based on experiments from which data only reflect an average of all stimulated cells. This study aims at investigating the effects of proinflammatory cytokines IL-6, IL-33, and TNF-α on IgE-dependent and IgE-independent activation of individual MCs. METHODS MCs were derived from CD34+ progenitors isolated from 50 mL whole blood from 4 healthy controls and 5 birch pollen allergic patients. Passively sensitized MCs were preincubated with IL-6, IL-33, or TNF-α and stimulated with anti-IgE/birch pollen allergen or substance P, the latter being a ligand for the G-protein-coupled MRGPRX2-receptor. Activation-i.e., upregulation of CD203c-and anaphylactic degranulation-i.e., appearance of CD63-were measured using flow cytometry. RESULTS Preincubation with IL-33 demonstrated upregulated CD203c density without degranulation. Subsequent IgE-dependent stimulation (anti-IgE/birch pollen allergen) resulted in higher appearance of CD63 as compared to cells without preincubation, indicating IL-33 to exert a priming effect (P = 0.04). IL-6 only increased allergen-specific responses but to a lesser extent than IL-33. Combination of IL-33/IL-6 had a synergistic effect, demonstrating more degranulation in response to allergen. TNF-α had no effect on IgE-mediated activation, nor synergistic effects with IL-33. Stimulation with substance P resulted in degranulation that could not be enhanced by preincubation. CONCLUSIONS In conclusion, IL-33, and in a lesser extent IL-6, prime individual MCs for subsequent IgE-mediated activation. Moreover, this priming effect is synergistic. In contrast, none of the cytokines had a priming effect on MRGPRX2-mediated activation of MCs. © 2017 International Clinical Cytometry Society.
Collapse
Affiliation(s)
- Nathalie Cop
- Department of Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Science, University of Antwerp, Antwerp University Hospital, Antwerp 2610, Belgium
| | - Didier G Ebo
- Department of Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Science, University of Antwerp, Antwerp University Hospital, Antwerp 2610, Belgium
| | - Chris H Bridts
- Department of Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Science, University of Antwerp, Antwerp University Hospital, Antwerp 2610, Belgium
| | - Jessy Elst
- Department of Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Science, University of Antwerp, Antwerp University Hospital, Antwerp 2610, Belgium
| | - Margo M Hagendorens
- Department of Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Science, University of Antwerp, Antwerp University Hospital, Antwerp 2610, Belgium.,Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Science, University of Antwerp, Antwerp 2610, Belgium
| | - Christel Mertens
- Department of Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Science, University of Antwerp, Antwerp University Hospital, Antwerp 2610, Belgium
| | - Margaretha A Faber
- Department of Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Science, University of Antwerp, Antwerp University Hospital, Antwerp 2610, Belgium
| | - Luc S De Clerck
- Department of Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Science, University of Antwerp, Antwerp University Hospital, Antwerp 2610, Belgium
| | - Vito Sabato
- Department of Immunology - Allergology - Rheumatology, Faculty of Medicine and Health Science, University of Antwerp, Antwerp University Hospital, Antwerp 2610, Belgium
| |
Collapse
|
49
|
Pouessel G, Claverie C, Labreuche J, Renaudin JM, Dorkenoo A, Eb M, Moneret-Vautrin A, Deschildre A, Leteurtre S, Grabenhenrich L, Worm M, Dölle S, Scherer K, Hutteger I, Christensen M, Bindslev-Jensen C, Mortz C, Eller E, Kjaer HF, Carneiro-Leão L, Badas J, Coimbra A, Levy DP, Ben-Shoshan M, Rimon A, Benor S, Arends NJT, Edelbroek N, de Groot H, Emons JAM, Brand HKA, Verhoeven D, van Veen LN, de Jong NW, Noh G, Jang EH, Pascal M, Dominguez O, Piquer M, Alvaro M, Jimenez-Feijoo R, Lozano J, Machinena A, del Mar Folqué M, Giner MT, Plaza AM, Turner P, Patel N, Vazquez-Ortiz M, Lindsley S, Walker L, Rosenberg S, Mari A, Alessandri C, Giangrieco I, Tuppo L, Rafaiani C, Mitterer G, Ciancamerla M, Ferrara R, Bernardi ML, Zennaro D, Tamburrini M, Ciardiello MA, Harwanegg C, Fernandez A, Selb R, Egenmann P, Epstein M, Hoffmann-Sommergruber K, Koning F, Lovik M, Clare Mills EN, Moreno J, van Loveren H, Wal JM, Diesner S, Bergmayr C, Pfitzner B, Assmann VE, Starkl P, Endesfelder D, Eiwegger T, Szepfalusi Z, Fehrenbach H, Jensen-Jarolim E, Hartmann A, Pali-Schöll I, Untersmayr E, Wille S, Meyer P, Klingebiel C, Lidholm J, Ehrenberg A, Östling J, Cleach I, Mège JL, Vitte J, Aina R, Dubiela P, Pfeifer S, Bublin M, Radauer C, Humeniuk P, Kabasser S, Asero R, Bogas G, Gomez F, Campo P, Salas M, Doña I, Barrionuevo E, Guerrero MA, Mayorga C, Prieto A, Barber D, Torres MJ, Jamin A, Wangorsch A, Ballmer B, Vieths S, Scheurer S, Apostolovic D, Mihailovic J, Krstic M, Starkhammar M, Velickovic TC, Hamsten C, van Hage M, van Erp FC, Knol EF, Kansen HM, Pontoppidan B, Meijer Y, van der Ent CK, Knulst AC, Sayers R, Brown H, Custovic A, Simpson A, Mills C, Schulz J, Akkerdaas J, Totis M, Capt A, Herouet-Guicheney C, van Ree R, Banerjee T, Banerjee A, Claude M, Bouchaud G, Lupi R, Castan L, Tranquet O, Denery-Papini S, Bodinier M, Brossard C, De Poi R, Gritti E, De Dominicis E, Popping B, de Laureto PP, Palosuo K, Kukkonen AK, Pelkonen A, Mäkelä M, Lee NA, Rost J, Muralidharan S, Campbell D, Mehr S, Nock C, Baumert J, Taylor S, Mastrorilli C, Tripodi S, Caffarelli C, Perna S, Di Rienzo Businco A, Sfika I, Dondi A, Bianchi A, Dascola CP, Ricci G, Cipriani F, Maiello N, del Giudice MM, Frediani T, Frediani S, Macrì F, Pistoletti C, Iacono ID, Patria MF, Varin E, Peroni D, Comberiati P, Chini L, Moschese V, Lucarelli S, Bernardini R, Pingitore G, Pelosi U, Olcese R, Moretti M, Cirisano A, Faggian D, Travaglini A, Plebani M, Verga MC, Calvani M, Giordani P, Matricardi PM, Ontiveros N, Cabrera-Chavez F, Galand J, Beaudouin E, Pineau F, Sakai S, Matsunaga K, Teshima R, Larré C, Denery S, Tschirner S, Trendelenburg V, Schulz G, Niggemann B, Beyer K, Bouferkas Y, Belabbas Y, Saidi D, Kheroua O, Mecherfi KEE, Guendouz M, Haddi A, Kaddouri H, Amaral L, Pereira A, Rodrigues S, Datema M, Jongejan L, Clausen M, Knulst A, Papadopoulos N, Kowalski M, de Blay F, Zwinderman A, Hoffman-Sommergruber K, Ballmer-Weber B, Fernandez-Rivas M, Deng S, Yin J, Eisenmann C, Nassiri M, Reinert R, van der Valk JPM, van Wijk RG, Vergouwe Y, Steyerberg EW, Reitsma M, Wichers HJ, Savelkoul HFJ, Vlieg-Boerstra B, Dubois AEJ, de Jong NW, Carolino F, Rodolfo A, Cernadas J, Roa-Medellín D, Rodriguez-Fernandez A, Navarro J, Albendiz V, Baeza ML, Intente-Herrero S, Mikkelsen A, Mehlig K, Lissner L, Verrill L, Luccioli S, van Bilsen J, Kuper F, Wolterbeek A, Rankouhi TR, Verschuren L, Cnossen H, Jeurink P, Garssen J, Knippels L, Garthoff J, Houben G, Leeman W, Eleonore Pettersson M, Schins AMM, Koppelman GH, Kollen BJ, Zubchenko S, Kuntz S, Mérida P, Álvaro M, Piquer M, Riggioni C, Castellanos JH, Jimenez R, Cap M, Drumez E, Lejeune S, Thumerelle C, Mordacq C, Nève V, Ricò S, Varini M, Nocerino R, Cosenza L, Amoroso A, Di Costanzo M, Di Scala C, Bedogni G, Canani RB, Turner PJ, Poza-Guedes P, González-Pérez R, Sánchez-Machín I, Matheu-Delgado V, Wambre E, Ballegaard AS, Madsen C, Gregersen J, Bøgh KL, Aubert P, Neunlist M, Magnan A, Lozano-Ojalvo D, Pablos-Tanarro A, Pérez-Rodríguez L, Molina E, López-Fandiño R, Rekima A, Macchiaverni P, Turfkruyer M, Holvoet S, Dupuis L, Baiz N, Annesi-Maesano I, Mercenier A, Nutten S, Verhasselt V, Mrakovcic-Sutic I, Banac S, Sutic I, Baricev-Novakovic Z, Sutic I, Pavisic V, Muñoz-Cano R, Jiménez-Rodríguez T, Corbacho D, Roca-Ferrer J, Bartra J, Bulog A, Micovic V, Markiewicz L, Szymkiewicz A, Szyc A, Wróblewska B, Harvey BM, Harthoorn LF, Wesley Burks A, Rentzos G, Björk ALB, Bengtsson U, Barber C, Kalicinsky C, Breynaert C, Coorevits L, Jansen C, Van Hoeyveld E, Verbeke K, Kochuyt AM, Schrijvers R, Deleanu D, Muntean A, Konstantakopoulou M, Pasioti M, Papadopoulou A, Iliopoulou A, Mikos N, Kompoti E, de Castro ED, Bartalomé B, Ue KL, Griffiths E, Till S, Grimshaw K, Roberts G, Selby A, Butiene I, Larco JI, Dubakiene R, Fiandor A, Fiocchi A, Papadopoulos N, Sigurdardottir S, Sprikkelman A, Schoemaker AF, Xepapadaki P, Keil T, Cojocariu Z, Barbado BS, Iancu V, Arroabarren E, Esarte MG, Arteaga M, Andrade MC, Borges D, Kalil J, Bianchi PG, Agondi RC, Gupta RK, Sharma A, Gupta K, Das M, Dwivedi P, Karseladze R, Jorjoliani L, Saginadze L, Tskhakaia M, Basello K, Piuri G, Speciani AF, Speciani MC, Camerotto C, Zinno F, Pakholchuk O, Nedelska S, Pattini S, Costantino MT, Peveri S, Villalta D, Savi E, Costanzi A, Revyakina VA, Kiseleva MA, Kuvshinova ED, Larkova IA, Shekhetov AA, Silva D, Moreira A, Plácido J, van der Kleij H, van Twuijver E, Sutorius R, de Kam PJ, van Odijk J, Lindqvist H, Lustig E, Jácome AAA, Aguilar KLB, Domínguez MG, Hernández DAM, Caruso C, Casale C, Rapaccini GL, Romano A, De Vitis I, Cocco RR, Aranda C, Mallozi MC, Motta JF, Moraes L, Pastorino A, Rosario N, Goudouris E, Porto A, Wandalsen NF, Sarinho E, Sano F, Solé D, Pitsios C, Petrodimopoulou M, Papadopoulou E, Passioti M, Kontogianni M, Adamia N, Khaleva E, del Prado AP, Du Toit G, Krzych E, Samolinska-Zawisza U, Furmanczyk K, Tomaszewska A, Raciborski F, Lipiec A, Samel-Kowalik P, Walkiewicz A, Borowicz J, Samolinski B, Nano AL, Recto M, Somoza ML, López NB, Alzate DP, Ruano FJ, Garcimartín MI, Haroun E, de la Torre MV, Rojas A, Onieva ML, Canto G, Rodrigues A, Forno A, Cabral AJ, Gonçalves R, Vorozhko I, Sentsova T, Chernyak O, Denisova S, Ilènko L, Muhortnich V, Zimmermann C, Rohrbach A, Bakhsh FR, Boudewijn K, Oomkes-Pilon AM, Van Ginkle D, Šilar M, Jeverica A, Vesel T, Avčin T, Korošec P, van der Valk J, Berends I, Arends N, van Maaren M, Wichers H, Emons J, Dubois A, de Jong N, Matsyura O, Besh L, Huang CH, Jan TR, Stiefel G, Tratt J, Kirk K, Carolino F, Arasi S, Caminiti L, Crisafulli G, Fiamingo C, Fresta J, Pajno G, Remington B, Kruizinga A, Marty Blom W, Westerhout J, Bijlsma S, Baumert J, Blankestijn M, Otten H, Klemans R, Michelsen-Huisman AD, van Os-Medendorp H, Kruizinga AG, Versluis A, van Duijn G, de Zeeuw-Brouwer HML, Castenmiller JJM, Noteborn HPJM, Houben GF, Bravin K, Luyt D, Javed B, Couch P, Munro C, Padfield P, Sperrin M, Byrne A, Oosthuizen L, Kelleher C, Ward F, Brosnan N, King G, Corbet E, Guzmán JAH, García MB, Asensio O, Navarrete LV, Larramona H, Miró XD, Pyrz K, Austin M, Boloh Y, Couch P, Galloway D, Hernandez P, Hourihane JO, Kenna F, Majkowska-Wojciechowska B, Regent L, Themisb M, Schnadt S, Semic-Jusufagic A, Galvin AD, Kauppila T, Kuitunen M, Kitsioulis NA, Douladiris N, Kostoudi S, Manolaraki I, Mitsias D, Manousakis E, Papadopoulos NG, Knibb R, Hammond J, Cooke R, Yrjänä J, Hanni AM, Vähäsarja P, Mustonen O, Dunder T, Kulmala P, Lasa E, D’Amelio C, Martínez S, Joral A, Gastaminza G, Goikoetxea MJ, Candy DCA, Van Ampting MTJ, Oude Nijhuis MM, Butt AM, Peroni DG, Fox AT, Knol J, Michaelis LJ, Padua I, Padrao P, Moreira P, Barros R, Sharif H, Ahmed M, Gomaa N, Mens J, Smit K, Timmermans F, Poredoš T, Jeverica AK, Sedmak M, Benedik E, Accetto M, Zupančič M, Yonamine G, Soldateli G, Aquilante B, Pastorino AC, de Moraes Beck CL, Gushken AK, de Barros Dorna M, dos Santos CN, Castro APM, Al-Qahtani A, Arnaout R, Khaliq AR, Amin R, Sheikh F, Alvarez J, Anda M, Palacios M, De Prada M, Ponce C, Balbino B, Sibilano R, Marichal T, Gaudenzio N, Karasuyama H, Bruhns P, Tsai M, Reber LL, Galli SJ, Ferreira AR, Cernadas JR, del Campo García A, Fernández SP, Carrera NS, Sánchez-Cruz FB, Lorenzo JRF, Claus S, Pföhler C, Ruëff F, Treudler R, Jaume ME, Madroñero A, Perez MTG, Julia JC, Plovdiv CH, Gethings L, Langridge J, Adel-Patient K, Bernard H, Barcievic-Jones I, Sokolova R, Yankova R, Ivanovska M, Murdjeva M, Popova T, Dermendzhiev S, Karjalainen M, Lehnigk U, Brown D, Locklear JC, Locklear J, Maris I, Hourihane J, Ornelas C, Caiado J, Ferreira MB, Pereira-Barbosa M, Puente Y, Daza JC, Monteseirin FJ, Ukleja-Sokolowska N, Gawronska-Ukleja E, Zbikowska-Gotz M, Bartuzi Z, Sokolowski L, Adams A, Mahon B, English K, Gourdon-Dubois N, Sellam L, Pereira B, Michaud E, Messaoudi K, Evrard B, Fauquert JL, Palomares F, Gomez G, Rodriguez MJ, Galindo L, Molina A, Paparo L, Mennini M, Aitoro R, Wawrzeńczyk A, Przybyszewski M, Wawrzeńczyk A, Sarıcoban HE, Ugras M, Yalvac Z, Flokstra-de Blok BMJ, van der Velde JL, Vereda A, Ippolito C, Traversa A, Adriano D, Bianchi DM, Gallina S, Decastelli L, Makatsori M, Miles A, Devetak SP, Devetak I, Tabet SA, Trandbohus JF, Winther P, Malling HJ, Hansen KS, Garvey LH, Wang CC, Cheng YH, Tung CW, Dietrich M, Marenholz I, Kalb B, Grosche S, Blümchen K, Schlags R, Price M, Rietz S, Esparza-Gordillo J, Lau S, Lee YA, Almontasheri A, Bahkali MA, Elshorbagi S, Alfhaid A, Altamimi M, Madbouly E, Al-Dhekri H, Arnaout RK, Basagaña M, Miquel S, Bartolomé B, Brix B, Rohwer S, Brandhoff S, Berger A, Suer W, Weimann A, Bueno C, Martín-Pedraza L, Abián S, Segundo-Acosta PS, López-Rodríguez JC, Barderas R, Batanero E, Cuesta-Herranz J, Villalba MT, Correia M, Benito-Garcia F, Arêde C, Piedade S, Morais-Almeida M, Hindley J, Yarham R, Kuklinska-Pijanka A, Gillick D, Patient K, Chapman MD, Bøgh KL, Miranda A, Matos E, Sokolova A, Rao H, Baricevic-Jones I, Smith F, Xue W, Magnusdottir H, Vidarsdottir AG, Lund S, Jensen AB, Ludviksson BR, Simon R, Elfont R, Bennett S, Voyksner R, de Lurdes Torre M, Yürek S, Faber MA, Bastiaensen A, Mangodt E, van Gasse A, Decuyper I, Sabato V, Hagendorens MM, Bridts CH, De Clerck LS, Ebo D, Schwarz S, Ziegert M, Albroscheit S, Schwager C, Kull S, Behrends J, Röckendorf N, Schocker F, Frey A, Homann A, Becker WM, Jappe U, Zaabat N, Osscini S, Agabriel C, Sterling B, Carsin A, Liabeuf V, Maćków M, Zbróg A, Bronkowska M, Courtois J, Gadisseur R, Bertholet C, Lukas P, Cavalier E, Delahaut P, Quinting B, Gertmo MB, Hasseus ET, Barzylovych V, Oliveira J, Ensina LF, Aranda CS, Dopazo L, Lopez R, Perez R, Santos-Diez L, Bilbao A, Garcia JM, Núñez IG, Mármol MÁA, Villarejo MJB, Martos JAB, Vergara MS, García JMI, Michalska A, Sergiejko G, Zacniewski R, Ghiordanescu IM, Deaconu C, Popescu M, Bumbacea RS, Ibranji A, Nikolla E, Loloci G, Juel-Berg N, Larsen LF, Poulsen LK, Marcelino J, Prata R, Costa AC, Duarte F, Neto M, Santos J, Pestana LC, Sampaio D, Minale P, Dignetti P, Bignardi D, Nedelea I, Popescu FD, Vieru M, Secureanu FA, Ganea CS, Vieira M, Silva JPM, Watts T, Watts S, Lomikovska M, Peredelskaya M, Nenasheva N, Filipovic I, Zivkovic Z, Filipovic D, Higgs J, Warner A, Jones C. Abstracts from the Food Allergy and Anaphylaxis Meeting 2016. Clin Transl Allergy 2017. [PMCID: PMC5384531 DOI: 10.1186/s13601-017-0142-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
|
50
|
Uyttebroek AP, Decuyper II, Bridts CH, Romano A, Hagendorens MM, Ebo DG, Sabato V. Cefazolin Hypersensitivity: Toward Optimized Diagnosis. The Journal of Allergy and Clinical Immunology: In Practice 2016; 4:1232-1236. [DOI: 10.1016/j.jaip.2016.05.011] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 05/04/2016] [Accepted: 05/13/2016] [Indexed: 01/28/2023]
|