Basophil Activation Test in the diagnosis and monitoring of mastocytosis patients with wasp venom allergy.

Background: There is need for an accurate diagnostic test in mastocytosis patients with wasp venom allergy (WVA) and monitoring of these patients during immunotherapy (IT). In this study, we aimed to evaluate sensitivity and specificity of the Basophil Activation Test (BAT) as a diagnostic and monitoring test in patients with mastocytosis and WVA. Methods: Seventeen patients with mastocytosis and WVA and 6 mastocytosis patients without WVA were included. BAT was performed before the start of IT (1st visit) and at 6 weeks (2nd visit) and 1 year (3rd visit), after reaching the maintenance dose. Of 17 patients included, 11 complerted the 3rd visit.In mastocytosis patients with WVA, dose-dependent wasp-venom induced upregulation of CD63 and CD203c expression on basophils was observed compared to mastocytosis patients without WVA. Serum specific IgE, IgG4 and tryptase levels were measured in all patients. Results: BAT had a sensitivity of 87% and specificity of 100% in diagnosing WVA in mastocytosis patients. Basophil allergen threshold sensitivity with respect to CD63 and CD203c was significantly decreased in the second visit compared to the first visit and increased significantly in the third visit compared to the second visit. Specific IgE levels increased significantly in the 2nd visit compared to first and decreased significantly in the third visti compared to the second. Specific IgG4 levels rose significantly in the 2nd visit compared to the 1st and on the 3rd visit compared to the 2nd . Tryptase levels did not change significantly during the study. Conclusions: BAT can represent a diagnostic test in allergic patients with mastocytosis and these patients are better to be monitored for a longer period during IT. © 2013 Clinical Cytometry Society.

Naive CD4+ T cells and recent thymic emigrants in common variable immunodeficiency.

BACKGROUND: Common variable immunodeficiency (CVID) comprises a heterogeneous group of disorders classified as predominantly antibody deficiencies. The aim of this study was to analyze levels of naïve CD4+ T cells and recent thymic emigrant (RTE) cells in CVID patients and healthy controls. METHODS: Twenty patients with CVID and 20 age- and sex-matched healthy controls were studied. CD4+ T cells were negatively isolated from peripheral blood mononuclear cells by magnetic beads, and cell surface markers (CD45RA, CD62L and CD31) were assessed by flow cytometry. The normal range of naïve CD4+ T cells detected in the control group (33%-63%) was used to classify the CVID patients into 2 groups (< or = 33% and >33% naïve CD4+ T cells). RESULTS: Naïve CD4+ T cells (CD45RA+ CD62L+) and RTE cells (CD45RA+CD62L+CD31+) were significantly lower in male CVID patients compared to both female patients and healthy male controls. There were also more male patients in the group with naive CD4+ T-cell levels of 33% or less. Autoimmunity was only observed in this group. CONCLUSIONS: Lower numbers of naïve CD4+ T cells and RTE cells in male CVID patients might be due to lower thymic output in these patients. The classification of patients based on naïve CD4+ T cell levels seems to be consistent with clinical features.