Jose J Laguna1, Gador Bogas2, Maria Salas3, Cristobalina Mayorga4, Javier Dionicio5, Rosario Gonzalez-Mendiola5, Adriana Ariza4, Ruben Fernández-Santamaría4, Isabel Olazabal6, Inmaculada Doña2, Tahia D Fernandez4, Maria J Torres2. 1. Allergy Unit, Hospital de la Cruz Roja, Madrid, Spain; Immunology Department, Alfonso X el Sabio University, Madrid, Spain. 2. Allergy Unit, IBIMA-Regional University Hospital of Malaga, UMA, Malaga, Spain. 3. Allergy Unit, IBIMA-Regional University Hospital of Malaga, UMA, Malaga, Spain. Electronic address: mariasalascassinello@hotmail.com. 4. Research Laboratory, IBIMA-Regional University Hospital of Malaga, UMA, Malaga, Spain. 5. Allergy Unit, Hospital de la Cruz Roja, Madrid, Spain. 6. Immunology Department, Alfonso X el Sabio University, Madrid, Spain.
Abstract
BACKGROUND: Proton pump inhibitors (PPIs) are commonly used to treat gastrointestinal diseases. Incidence of hypersensitivity reactions to PPIs has risen, likely because of increased consumption. Their diagnosis is difficult, with skin tests (STs) presenting low sensitivity, making it necessary to perform drug provocation tests (DPTs). The value of in vitro tests for the diagnosis of immediate reaction to PPI is unclear. OBJECTIVE: To analyze the diagnostic value of the basophil activation test (BAT) in a group of patients diagnosed with immediate allergy to omeprazole. METHODS: The study included 42 patients with confirmed immediate allergic reactions to omeprazole confirmed by positive ST results or DPT results and 22 age- and sex-matched subjects tolerant to PPIs. BAT was performed with omeprazole, pantoprazole, and lansoprazole using CD63 and CD203c as activation markers. RESULTS: ST sensitivity was 66.7% with a specificity of 100%. BAT using CD63 with a stimulation index of more than 2 as positive revealed a sensitivity of 73.8%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 66.7%. BAT was positive in 57.1% of patients with negative ST result, and thus by combining ST and BAT we can correctly diagnose 85.7% of patients with immediate allergy to omeprazole. CONCLUSION: BAT represents a complementary tool for inclusion in the allergological workup for patients allergic to omeprazole. When combined with ST, it can be of value to guide the clinician as to whether to perform a DPT.
BACKGROUND: Proton pump inhibitors (PPIs) are commonly used to treat gastrointestinal diseases. Incidence of hypersensitivity reactions to PPIs has risen, likely because of increased consumption. Their diagnosis is difficult, with skin tests (STs) presenting low sensitivity, making it necessary to perform drug provocation tests (DPTs). The value of in vitro tests for the diagnosis of immediate reaction to PPI is unclear. OBJECTIVE: To analyze the diagnostic value of the basophil activation test (BAT) in a group of patients diagnosed with immediate allergy to omeprazole. METHODS: The study included 42 patients with confirmed immediate allergic reactions to omeprazole confirmed by positive ST results or DPT results and 22 age- and sex-matched subjects tolerant to PPIs. BAT was performed with omeprazole, pantoprazole, and lansoprazole using CD63 and CD203c as activation markers. RESULTS: ST sensitivity was 66.7% with a specificity of 100%. BAT using CD63 with a stimulation index of more than 2 as positive revealed a sensitivity of 73.8%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 66.7%. BAT was positive in 57.1% of patients with negative ST result, and thus by combining ST and BAT we can correctly diagnose 85.7% of patients with immediate allergy to omeprazole. CONCLUSION: BAT represents a complementary tool for inclusion in the allergological workup for patientsallergic to omeprazole. When combined with ST, it can be of value to guide the clinician as to whether to perform a DPT.
Authors: Jitesh Chauhan; Alex J McCraw; Mano Nakamura; Gabriel Osborn; Heng Sheng Sow; Vivienne F Cox; Chara Stavraka; Debra H Josephs; James F Spicer; Sophia N Karagiannis; Heather J Bax Journal: Antibodies (Basel) Date: 2020-10-16
Authors: Jitesh Chauhan; Chara Stavraka; Melanie Grandits; Lais C G F Palhares; Debra H Josephs; Katie E Lacy; James Spicer; Heather J Bax; Sophia N Karagiannis Journal: Cells Date: 2022-01-27 Impact factor: 7.666
Authors: Heather J Bax; Jitesh Chauhan; Chara Stavraka; Atousa Khiabany; Mano Nakamura; Giulia Pellizzari; Kristina M Ilieva; Sara Lombardi; Hannah J Gould; Christopher J Corrigan; Stephen J Till; Sidath Katugampola; Paul S Jones; Claire Barton; Anna Winship; Sharmistha Ghosh; Ana Montes; Debra H Josephs; James F Spicer; Sophia N Karagiannis Journal: Cells Date: 2020-07-07 Impact factor: 6.600