@article{4d257ed35f904ca4b5e2b5494166c4ff,
title = "Basophil activation test has high reproducibility and is feasible in the clinical setting",
abstract = "Background: The basophil activation test (BAT) has high accuracy to diagnose peanut allergy and can reduce the need for oral food challenges (OFC); however, so far it has not been incorporated in clinical practice. Methods: We assessed the reproducibility of BAT within the same laboratory and between two different laboratories and the feasibility of using BAT in the clinical setting. Results: One hundred and two children being assessed for peanut allergy were tested on BAT (72 allergic, 30 sensitized tolerant). There was little internal variation (coefficient of variation <15%) in the BAT and a very strong correlation (Rs >.95) between BAT performed across laboratories. The 2 BAT methods were strongly correlated but not interchangeable. In the cases of discrepancy, our in house BAT method was 100% accurate. BAT was feasible and well-accepted by clinicians: no patient with positive BAT was referred for OFC, leading to reduction in the number of OFC required. Twenty one percent of patients who underwent OFC reacted to peanut. A negative BAT also encouraged the performance of OFC in sensitized children who would otherwise be considered allergic, 50% of whom did not react and incorporated peanut in the diet. Conclusions: The BAT is a robust test that can reliably be transferred between laboratories; however, different BAT methods are not interchangeable. BAT was well integrated in the clinical decision-making process in a specialized center.",
keywords = "anaphylaxis, basophil activation test, CD203c, CD63, diagnosis, food allergy, oral food challenge, peanut allergy",
author = "Hannah Jaumdally and Matthew Kwok and Zainab Jama and Rochelle Hesse-Lamptey and Richard McKendry and Oliver Galvez and Yvonne Daniel and Santos, {Alexandra F.}",
note = "Funding Information: The authors wish to thank the BAT study team, especially Faye Harrison and Helen Willis, and also the members of the Seal Unit for helping with the recruitment of study participants, and the clinicians in the Pediatric Allergy Team at the Evelina London Children's Hospital for referring participants to the study, namely to Professor George Du Toit, Professor Gideon Lack, Dr Erika Harnik, Dr Helen Brough, Ileana Fernandes, Dr Kate Swan, Dr Kathleen Sims, Kiran Tiwana, Dr Lauri-Ann Van Der Poel, Dr Maeve Kelleher, Dr Marta Krawiec, Dr Morium Aktar, Rachel De Boer, Rebecca Batt, Rebecca Brocklehurst, Dr Ru-Xin Foong, Dr Sophie Flammarion and Dr Tom Marrs. The authors would also like to thank Dr Jean-Marc Busnel and Penelope Bourgoin from Beckman Coulter for the useful discussions and for reviewing a final draft of the manuscript. The authors acknowledge support by the UK National Institute for Health Research comprehensive Biomedical Research Centre award to Guy's and St Thomas' National Health Service (NHS) Foundation Trust, in partnership with the King's College London and King's College Hospital NHS Foundation Trust. Funding Information: The authors wish to thank the BAT study team, especially Faye Harrison and Helen Willis, and also the members of the Seal Unit for helping with the recruitment of study participants, and the clinicians in the Pediatric Allergy Team at the Evelina London Children's Hospital for referring participants to the study, namely to Professor George Du Toit, Professor Gideon Lack, Dr Erika Harnik, Dr Helen Brough, Ileana Fernandes, Dr Kate Swan, Dr Kathleen Sims, Kiran Tiwana, Dr Lauri‐Ann Van Der Poel, Dr Maeve Kelleher, Dr Marta Krawiec, Dr Morium Aktar, Rachel De Boer, Rebecca Batt, Rebecca Brocklehurst, Dr Ru‐Xin Foong, Dr Sophie Flammarion and Dr Tom Marrs. The authors would also like to thank Dr Jean‐Marc Busnel and Penelope Bourgoin from Beckman Coulter for the useful discussions and for reviewing a final draft of the manuscript. The authors acknowledge support by the UK National Institute for Health Research comprehensive Biomedical Research Centre award to Guy's and St Thomas' National Health Service (NHS) Foundation Trust, in partnership with the King's College London and King's College Hospital NHS Foundation Trust. Funding Information: This study was funded by the MRC Confidence in Concept Scheme to address the barriers to the transition of BAT to the clinic. Equally important to asking probing questions at the bedside and addressing them with rigorous scientific methods is to facilitate the transition of the novel findings for the benefit of patients. A survey done by the EAACI Task Force for the Quality Assurance of BAT served as a proof‐of‐concept that it is possible to undertake round robins using blood samples sent from a central laboratory that various laboratories could test overtime for the purpose of quality assurance. As part of this exercise, however, it was evident that different BAT methodologies provided different results, despite the general overall agreement in terms of positive/negative result. This observation raised the question as to whether it is possible to standardize the methodology, both for the in vitro test and for the flow cytometry, and transfer the assay reliably between laboratories. The present study systematically compared BAT results across different methods, cytometers, and independent laboratories. 13 Funding Information: This work was supported by the Medical Research Council (MRC Confidence in Concept Scheme MC/PC/18052, MRC Clinician Scientist Fellowship MR/M008517/1 and MRC Transition Support MR/T032081/1 awarded to A.F. Santos), Asthma UK (AUK‐BC‐2015‐01) and by the UK National Institute for Health Research comprehensive Biomedical Research Centre award to Guy's and St Thomas' National Health Service (NHS) Foundation Trust, in partnership with the King's College London and King's College Hospital NHS Foundation Trust. Publisher Copyright: {\textcopyright} 2022 The Authors. Pediatric Allergy and Immunology published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.",
year = "2022",
month = nov,
doi = "10.1111/pai.13870",
language = "English",
volume = "33",
journal = "Pediatric Allergy and Immunology",
issn = "0905-6157",
publisher = "Blackwell Munksgaard",
number = "11",
}