Basophil Activation Test in the diagnosis and monitoring of mastocytosis patients with wasp venom allergy Dear Editor, We read with interest the letter by Salvatore Chirumbolo (ref in press) and his precious comments on our paper published recently in your journal (1). There are a few points that we would like to discuss. We would like to start with a correction of some statements made in the manuscript of Chirumbolo. Firstly, the so called previous report as mentioned by Chirumbolo (ref in press) is the same publication as in reference 1 but in different phases of publication. Secondly, references 3 and 11 in the paper of Chirumbolo appear to be the same. Thirdly, in the remarks about different mast cell responses between men and women, the referral to reference 11 is incorrect. In this reference (2), no gender differences were discussed at all. Fourthly, the referral to reference 16 to underline the remark about reduction of tryptase levels which may be found (also) in controls throughout a VIT protocol, is also wrong. In this study (from our own group) no VIT protocol was used at all. Furthermore, changes in tryptase levels have not been analyzed in reference 16. Fifthly, the measurement of IgG4 antibodies to wasp venom was only measured to evaluate effects of immunotherapy. Therefore, IgG4 was not measured in patients without wasp venom allergy (and who did not receive immunotherapy). In our opinion, measurement of allergen specific IgG4 antibodies is not recommended for diagnosis of allergy. Other points which are addressed by Chirumbolo might be explained by two main differences in the setup of both studies: Chirumbolo investigated the behavior of isolated basophils (buffy coat) from normal volunteers whereas we explored whole blood basophils in patients with mastocytosis. The main purpose of our study was to compare the BAT in mastocytosis patients with and without wasp venom allergy. Further studies are needed to confirm our data and to elucidate possible pathophysiological mechanisms. Irrespective of the faulty references and inaccurate interpretation for literature data, the main criticism from Chirumbolo being BAT to screen IgE-mediated responses is not relevant because BAT was performed on whole blood in the context of all cells and cytokines with wasp venom containing all constituents. The outcome was measured irrespective of the mechanism. Further studies are needed to elucidate the probable pathways and mechanisms. K.Bidad, M. Nawijn, A.J.M. van Oosterhout, S. van der Heide, and JNG Oude Elberink References: 1. Bidad K, Nawijn MC, van Oosterhout AJ, van der Heide S, Oude Elberink JN. Basophil activation test in the diagnosis and monitoring of mastocytosis patients with wasp venom allergy on immunotherapy. Cytometry B Clin Cytom 2014. 2. Chirumbolo S, Zanoni G, Ortolani R, Vella A. In vitro Biphasic Effect of Honey Bee Venom on Basophils from Screened Healthy Blood Donors. Allergy Asthma Immunol Res 2011;3(1):58-61.
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process which may lead to differences between this version and the Version of Record. Please cite this article as an ‘Accepted Article’, doi: 10.1002/cytob.21181
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process which may lead to differences between this version and the Version of Record. Please cite this article as an ‘Accepted Article’, doi: 10.1002/cytob.21181
