BACKGROUND A rate of subjects (15-30%) affected by chronic idiopathic urticaria (CIU) have an autoimmune aetiology thus as to be classified as Chronic Autoimmune Urticaria (CAU). The diagnosis of CAU is based on the demonstration of the presence of anti-FcεRIα and/or anti-IgE autoantibodies in the serum. The commonly screening procedures is represented by Autologous Serum Skin Test (ASST), but this test has low sensitivity and specificity (70%-80%). The aim of this study is to demonstrate that the new in vitro method such as Basophils Autoinduced Degranulation Test (BADT) is useful and reliable to be at least associated to ASST in the diagnosis of CAU. METHOD 24 CAU affected patients, previously diagnosed by BADT were submitted to ASST in order to confirm the diagnosis. Serum and peripheral whole blood were collected before the ASST procedure. The serum was divided into two parts, one of which was decomplemented (DS), and the other was used whole (WS). These sera were employed to stimulate autologous peripheral whole blood in vitro and to perform skin test on subjects. In order to perform the BADT we used a two-colours protocol in flow cytometry with anti-human CCR3 and CD63 antibodies marked respectively by R-PhycoErythrin (PE) and Fluorescein IsoThioCyanate (FITC). RESULTS All the subjects showed a significant increase of CD63 expression on basophils stimulated with WS and/or DS, but just 21 of 24 CIU patients showed a positivity to ASST. All the subjects were positive to the histamine control. Of the BADT 12 on 24 subjects showed degranulation only with WS, only 1 with DS and 11 with both stimuli. CONCLUSIONS BAD test is useful and more reliable of ASST for the determination of autoimmune etiopathogenesis of the CIU. Recent studies conducted with similar methods confirmed that the sensitivity and specificity of BAD test are approximately of 95% and 90%. In our study we confirmed 100% of the CAU diagnosis by BADT, and only 87,5% by ASST. Moreover our method is more faster and cheaper than previous that used leucocytes separation and a three-colours procedures.
Confirmation of the greatest sensibility of Basophils Autoinduced Degranulation Test in the Diagnosis Of Chronic Autoimmune Urticaria.
CARUSO, MASSIMO;POLOSA, Riccardo
2013-01-01
Abstract
BACKGROUND A rate of subjects (15-30%) affected by chronic idiopathic urticaria (CIU) have an autoimmune aetiology thus as to be classified as Chronic Autoimmune Urticaria (CAU). The diagnosis of CAU is based on the demonstration of the presence of anti-FcεRIα and/or anti-IgE autoantibodies in the serum. The commonly screening procedures is represented by Autologous Serum Skin Test (ASST), but this test has low sensitivity and specificity (70%-80%). The aim of this study is to demonstrate that the new in vitro method such as Basophils Autoinduced Degranulation Test (BADT) is useful and reliable to be at least associated to ASST in the diagnosis of CAU. METHOD 24 CAU affected patients, previously diagnosed by BADT were submitted to ASST in order to confirm the diagnosis. Serum and peripheral whole blood were collected before the ASST procedure. The serum was divided into two parts, one of which was decomplemented (DS), and the other was used whole (WS). These sera were employed to stimulate autologous peripheral whole blood in vitro and to perform skin test on subjects. In order to perform the BADT we used a two-colours protocol in flow cytometry with anti-human CCR3 and CD63 antibodies marked respectively by R-PhycoErythrin (PE) and Fluorescein IsoThioCyanate (FITC). RESULTS All the subjects showed a significant increase of CD63 expression on basophils stimulated with WS and/or DS, but just 21 of 24 CIU patients showed a positivity to ASST. All the subjects were positive to the histamine control. Of the BADT 12 on 24 subjects showed degranulation only with WS, only 1 with DS and 11 with both stimuli. CONCLUSIONS BAD test is useful and more reliable of ASST for the determination of autoimmune etiopathogenesis of the CIU. Recent studies conducted with similar methods confirmed that the sensitivity and specificity of BAD test are approximately of 95% and 90%. In our study we confirmed 100% of the CAU diagnosis by BADT, and only 87,5% by ASST. Moreover our method is more faster and cheaper than previous that used leucocytes separation and a three-colours procedures.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
