Basophil Activation Test to Diagnose Food Allergy

Conditions

Egg Allergy, Food Allergen Sensitisation, Food Allergy, Food Allergy in Children, Food Allergy in Infants, Milk Allergy, Nut Allergy

Keywords

Food allergy, Milk allergy, Egg allergy, Nut allergy, Basophil activation test, Diagnosis, Specific IgE, Skin prick test

Brief summary

The BAT II Study is a cross-sectional diagnostic study in which children with suspected IgE-mediated allergy to foods (namely cow's milk, egg, sesame and cashew), as defined by a history of an immediate-type allergic reaction to a food or no history of food consumption or the presence of food-specific IgE as documented by skin prick test or serum specific IgE, will undergo a diagnostic work-up to confirm or refute the diagnosis of IgE-mediated food allergy. Participants will be prospectively recruited from specialised Paediatric Allergy clinics in London and will undergo skin prick testing (SPT), specific IgE testing to allergen extracts and allergen components, basophil activation test (BAT) and oral food challenge. The diagnostic accuracy of the BAT and of other allergy tests will be assessed against the clinical gold-standard.

Boyd H, Bartha I, Foong RX, Krawiec M, Marques-Mejias A, Marshall HF, Radulovic S, Harrison F, Antoneria G, Jama Z, Kwok M, Pietraszewicz E, Eghleilib M, Ricci C, Marrs T, Lack G, Du Toit G, Santos AF.

2025-12-18

10.1111/all.70175

The Basophil Activation Test Is the Most Accurate Test in Predicting Allergic Reactions to Baked and Fresh Cow's Milk During Oral Food Challenges

Irene Bartha, Holly Boyd, Ru‐Xin Foong, Marta Krawiec, Andreina Marques‐Mejias et al. (18 authors)

Allergy2025-08-133 citations

10.1111/all.16675

Partial Egg Consumption Modifies the Diagnostic Performance of Allergy Tests to Predict Outcome of Double-Blind Placebo-Controlled Food Challenges to Egg.

Marques-Mejias A, Radulovic S, Foong RX, Bartha I, Krawiec M, Kwok M, Jama Z, Harrison F, Ricci C, Lack G, Du Toit G, Santos AF.

2023-12-276 citations

10.1016/j.jaip.2023.12.036

Diagnostic utility of allergy tests to predict baked egg and lightly cooked egg allergies compared to double‐blind placebo‐controlled food challenges

Marta Krawiec, Suzana Radulović, Ru‐Xin Foong, Andreina Marques‐Mejias, Irene Bartha et al. (12 authors)

Allergy2023-07-0734 citations

10.1111/all.15797

Interventions

DIAGNOSTIC_TESTOral food challenge

Patients with suspected food allergy will undergo clinical and dietary assessments and oral food challenge. Different allergy tests will be performed, including skin prick test, specific IgE test and basophil activation test, and its diagnostic utility will be determined against the clinical gold-standard.

Study design

Observational model

COHORT

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

6 Months to 16 Years

Healthy volunteers

No

Inclusion criteria

1. Children ≥6 months and \<16 years old; 2. Suspected IgE-mediated food allergy defined by: * History of an immediate-type allergic reaction to a specific food or * No history of consumption of the specific food or * IgE sensitisation documented by skin prick test (≥1 mm) or serum specific IgE (≥0.10 KU/L); 3. Avoidance of the specific food for at least 2 days prior to blood collection for BAT and specific IgE and prior to the challenge; 4. Informed consent obtained from parent or guardian and assent obtained from the child.

Exclusion criteria

1. Clinically significant chronic illness other than atopic diseases; 2. Previous history of severe life-threatening reaction to the suspected food with documented decrease in oxygen saturation (\<90%), hypotension (≥20% reduction in systolic blood pressure) and/or admission to intensive care; 3. Unwillingness to comply with study procedures, namely to undergo a diagnostic food challenge; 4. Contra-indication for diagnostic food challenge, namely: * Uncontrolled atopic diseases (e.g. eczema, asthma, rhinitis); * Chronic medical conditions that pose significant risk in the event of anaphylaxis or treatment of anaphylaxis (e.g. cardiac disease, severe lung disease, pregnancy, mastocytosis); * Inability to discontinue medications that might interfere with assessment or safety (e.g. antihistamines, β-agonists, β-blockers, NSAIDs, ACE inhibitor, antacids); * Recent (within 7-14 days) treatment with systemic steroids or prolonged high-dose systemic steroids or immunosuppressants; 5. Undergoing treatment with omalizumab, food allergen immunotherapy or other systemic immunomodulatory treatment; 6. Inability to stop anti-histamines prior to SPT.

Design outcomes

Primary

Measure	Time frame	Description
Diagnostic accuracy of the basophil activation test (for each individual food allergy)	3 years	Accuracy of %CD63+ basophils

Secondary

Measure	Time frame	Description
Diagnostic accuracy of SPT, specific IgE to extracts and to single allergens	3 years	Accuracy of weal diameter or level of IgE
Association between BAT and severity of symptoms during challenges	3 years	Correlation between %CD63+ basophils and severity grade
Association between BAT and threshold of reactivity during challenges	3 years	Correlation between CD-sens and cumulative threshold dose

Countries

United Kingdom

Contacts

Primary ContactAlexandra Santos, MD PhD

alexandra.santos@kcl.ac.uk+442071886424

Backup ContactGeorgia Hill

georgia.hill@gstt.nhs.uk+442071887188

Outcome results

None listed