Cat allergen-induced blood basophil reactivity in vitro predicts acute human nasal allergen challenge responses in vivo

M. Paterniti, D. C. Kelly, J. A. Eckman, P. M. Sterba, R. G. Hamilton, B. S. Bochner, D. W. Macglashan, S. S. Saini*

*Corresponding author for this work

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Background Basophil histamine release (BHR) to allergen has been used as a confirmatory test to support the clinical diagnosis of allergic disease. Objective Among subjects reporting respiratory cat allergy, we hypothesized that cat-induced BHR in vitro would predict nasal allergen challenge (NAC) response in that same individual. We therefore compared the magnitude of cat allergen-induced BHR to NAC outcome and serological measures of cat-specific IgE and the ratio of cat-specific IgE to total IgE. Methods Forty-two subjects with a history of cat allergy, positive cat puncture skin test (PST) and detectable cat-specific IgE (>0.1kAU/L, ImmunoCap) participated with consent. Subjects were grouped as positive or negative cat allergen-induced BHR, with a positive result defined as the release of 20% of the total cellular histamine content. The majority of subjects also underwent a NAC with a positive result defined as 5 total sneezes. Results Subjects with a positive compared with a negative cat allergen BHR had higher cat-specific IgE levels at 5.40±1.24kAU/L (n=25) vs. 1.55±0.73kAU/L (n=17, P=0.01) as well as a higher cat-specific IgE/total IgE ratio [6.1±1.4% (n=25) vs. 1.6±0.9% (n=17, P=0.01)]. Of the 31 subjects who underwent a NAC, a positive NAC was observed in 78% (18/23) with a positive cat allergen BHR compared with 37% (3/8) with a negative cat allergen BHR, giving a positive predictive value of 78% and a negative predictive value of 63%. The diagnostic sensitivity and specificity of a positive BHR to predict a positive NAC was 86% and 50%, respectively. Conclusions and Clinical Relevance A positive cat allergen-induced BHR is associated with higher cat-specific IgE levels, a higher cat-specific to total IgE ratio and is predictive of a positive cat-induced NAC [ClinicalTrials.gov NCT00604786].

Original languageEnglish (US)
Pages (from-to)963-969
Number of pages7
JournalClinical and Experimental Allergy
Volume41
Issue number7
DOIs
StatePublished - Jul 1 2011

Keywords

  • Basophils
  • Cat allergen
  • Nasal allergen challenge
  • Specific ige
  • Specific ige/total ige ratio

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy

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