Basophil Activation Testing in Clinical Immunology and Allergy

Levels of reported immediate allergic disease and anaphylaxis have increased in developed countries over the last ten years. Yet, the tools we have to diagnose allergic disease have not changed significantly for decades. To-date, clinical history combined with skin testing and serum analysis for allergen specific IgE have remained the basic pillars of allergy diagnostics. The Basophil Activation Test (BAT) uses flow-cytometric detection and analysis to measure functional and phenotypic changes of in-vitro activated basophils. The BAT assay is emerging as an important diagnostic indicator for food-, insect venom-, and drug allergy and chronic urticaria. It may be also used to monitor patients on allergen immunotherapy, anti-IgE treatment or in the natural resolution of allergy. Importantly, as an in-vitro test, it is not only safe for the patient and avoids severe allergic reactions, but also allows for testing of multiple allergens at the same time. Here, we will provide an overview of the practical and technical details of the BAT as well as the clinical utility of BAT in diagnosis and management of allergic diseases.

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