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PubMed1999

[Biological diagnosis of immediate drug allergy. Comparative study of histamine liberation tests and CD63 expression by flow cytometry (preliminary results)].

The diagnosis of drug allergy is mainly based upon a detailed clinical history, positive skin tests (ST) and detection of specific IgE. In case of discrepant results, in vitro investigations to identify the responsible drug are needed. The histamine release test (HR) is usually performed. Nevertheless, its clinical benefit remains controversial. Flow cytometric methods (FCM) for the study of allergen induced basophil activation have been recently described. We assessed their usefulness in the diagnosis of drug allergy in comparison to HR results. Eighteen patients were included and 24 drugs (mainly antibiotics and muscle relaxant drugs) were tested. On the basis of clinical signs, 15 patients were classified as allergic (18 drugs). Sensitivity of biological investigations were found as follows: 71% (ST), 71% (FCM) and 24% (HR). This suggests performing FCM rather than HR. In addition, HR is more costly in terms of both reagents and laboratory technician time. Thus, CD63 detection by FCM seems to be a more reliable method in the clinical immunology laboratory. Additional data are needed to validate these preliminary results (sensitivity and specificity, especially in atopic patients) and to assess the interest of the method to investigate drug allergy due to other types of molecules.

Antigens, CD↗
PubMedDate not supplied

[The histamine liberation test as a diagnostic parameter and its possible modification following specific immunotherapy].

It is generally accepted that the allergic reaction depends on the levels of specific IgE, on the concentration of blocking antibodies and on the capacity of the basophils to release mediators. The fact that in the histamine release test (HRT) all of the elements intervening in an allergic reaction (antigens, IgE, basophils and mononuclear cells of a lymphoid origin) have been found, has led some authors to consider it as the most suitable method of "in vitro" diagnosis. This is a reflection of what biologically occurs "in vivo". Furthermore, the HRT can be used as a control parameter following immunotherapy, permitting us not only to quantify the level of blocking antibodies but also to study the possible presence of a control mechanism of histamine release. Accordingly, in a group of 50 patients with extrinsic asthma we carried out a HRT, skin tests (prick test) and Rast with house dust, Dermatophagoides pteronyssinus and Dermatophagoides farinae. In another group comprising 74 subjects with extrinsic allergic asthma (45 with perennial allergic rhinitis) we performed a HRT with aeroallergens. This group was subjected to immunotherapy (dust with mites) for a year. Following this treatment another HRT was carried out with house dust, Dermatophagoides pteronyssinus and Dermatophagoides farinae. With regard to our results in the first group we obtained 80% agreement in the HRT/prick test/Rast for house dust and Dermatophagoides pteronyssinus and 78% agreement for Dermatophagoides farinae.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

[Leukocyte histamine liberation tests for the diagnosis of anaphylactic reaction to curare-like agents].

Anaphylaxis to myorelaxants is the main etiology of adverse reactions to anesthetics and adjuvants. The diagnosis relies on skin tests--prick or intradermal tests--radio-immunoassays for series specific IgE, human basophil degranulation tests and leucocyte histamine++ release. 28 patients with an anaphylaxis to myorelaxants have been studied, using the two tests. Skin tests are the more specific and accurate ones. ARIA using a quaternary ammonium hydrated gel, is highly specific and its sensitivity reaches 80%. The leucocyte histamine release may be interest in evaluating anaphylaxis especially when another drug might be involved. The sensitivity of HBDT is low, indicating that HBDT is to be discarded as far as other tests have been developed, for myorelaxants. However, its usefulness for other drugs has to be compared to leucocyte histamine release.

Anaphylaxis↗
PubMed1988

[The basophilic histamine liberation test as a diagnostic method in Hymenoptera venom allergy].

In 181 patients with systemic reactions to hymenoptera stings as a result of immediate-type allergy to bee or wasp venom confirmed by history, skin testing and demonstration of hymenoptera venom-specific IgE antibodies on radioallergosorbent testing (RAST), in vitro histamine release from peripheral basophilic granulocytes following stimulation with bee or wasp venom was evaluated. Suspensions of washed peripheral leukocytes at a density of 2 x 10(6)/ml were incubated with four different concentrations of hymenoptera venoms. Histamine was measured by spectrofluorometry, and histamine release was calculated as a percentage of the total histamine content. Tests performed with peripheral leukocytes obtained from 18 non-allergic individuals served as controls. In both bee venom allergy and wasp venom allergy the corresponding allergen induced concentration-dependent histamine release. Upper normal limits of histamine release were defined for the venom concentrations used. When these were used as reference values the basophil histamine release test exhibited a specificity of 94% and a sensitivity of 82% in the diagnosis of bee venom allergy, and a specificity of 83% and a sensitivity of 68% in the diagnosis of wasp venom allergy. Since there was no relevant significant correlation between the results of the basophil histamine release test on one hand and the severity of sting reactions and the prick test and RAST results on the other, it seems that the histamine release test determined additional parameters of sensitization. Thus, the method is a valuable adjunct to the in vitro methods available for the diagnosis of hymenoptera venom allergy.

Adolescent↗
PubMed1985

[Risk factors in histamine liberation: a prospective study in an anesthetized population].

23,444 anaesthetic files were collected over a 12-month period from all the anaesthetic departments of the Regional Hospital in Nancy and three private clinics in town. The data were set out on a computer data-sheet aimed at defining the risk factors for histamine release. As a result, two groups are defined: a group of patients who released histamine (HL+; n = 212) and a group of patients who did not release histamine (HL-; n = 23,232). In increasing order of severity, the incidence of reactions were 1 in 143 for chest erythema, 1 in 630 for generalized erythema and Quincke's oedema, 1 in 230 for generalized erythema and hypotension, and 1 in 23,444 for fatal shock. The two groups were compared one with the other for each factor, using the chi-squared test or Fisher's test of exact probabilities. The statistically significant risk factors were: female patients, patients aged between 15 and 25 years, patients with an allergic history, a history of multiple anaesthesias, close one after the other, and exaggerated preanaesthetic anxiety. The drugs most often incriminated were: Althesin, propanidid, suxamethonium, alcuronium, gallamine and Haemaccel. A multifactorial analysis is being carried out to determine the part played by each factor in the release of histamine.

Adolescent↗
PubMed1991

[Inhibition of histamine liberation in mast cells from the lung and the intestine of the dog by isoproterenol].

Enzymatically isolated dog lung and gut mast cells were stimulated with compound 48/80, ionophore A23187, concanavalin A and FNa-Ca. Cell response elicited by A23187, concanavalin A or 48/80 is almost completely inhibited by isoproterenol. Concanavalin A induced histamine release on gut mast cells is high, indicating an elevated degree of sensitization of these cells. Results point to the existence of beta adrenergic inhibitory activity on dog lung and gut mast cells.

Animals↗