Basophil CD203c Levels Are Increased at Baseline and Can Be Used to Monitor Omalizumab Treatment in Subjects with Nut Allergy

Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA.
International Archives of Allergy and Immunology (Impact Factor: 2.67). 10/2010; 154(4):318-27. DOI: 10.1159/000321824
Source: PubMed


Basophils contribute to anaphylaxis and allergies. We examined the utility of assessing basophil-associated surface antigens (CD11b/CD63/CD123/CD203c/CD294) in characterizing and monitoring subjects with nut allergy.
We used flow cytometry to analyze basophils at baseline (without any activation) and after ex vivo stimulation of whole blood by addition of nut or other allergens for 2, 10, and 30 min. We also evaluated whether basophil expression of CD11b/CD63/CD123/CD203c/CD294 was altered in subjects treated with anti-IgE monoclonal antibody (omalizumab) to reduce plasma levels of IgE.
We demonstrate that basophil CD203c levels are increased at baseline in subjects with nut allergy compared to healthy controls (13 subjects in each group, p < 0.0001). Furthermore, we confirm that significantly increased expression of CD203c occurs on subject basophils when stimulated with the allergen to which the subject is sensitive and can be detected rapidly (10 min of stimulation, n = 11, p < 0.0008). In 5 subjects with severe peanut allergy, basophil CD203c expression following stimulation with peanut allergen was significantly decreased (p < 0.05) after 4 and 8 weeks of omalizumab treatment but returned toward pretreatment levels after treatment cessation.
Subjects with nut allergy show an increase of basophil CD203c levels at baseline and following rapid ex vivo stimulation with nut allergen. Both can be reduced by omalizumab therapy. These results highlight the potential of using basophil CD203c levels for baseline diagnosis and therapeutic monitoring in subjects with nut allergy.

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    • "Compared with other activation markers, the regulation of CD203c is not limited to the FcεRI-mediated reaction, but is also induced by IL-3. CD203c is thought to be the most useful marker of basophil activation and differentiation (18, 26, 27). The measurement of basophil CD203c expression has been demonstrated to be useful for detecting causative allergenic components in patients with wheat allergy and wheat dependent exercise-induced anaphylaxis, insect sting and amoxicillin allergy (17, 19). "
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    • "Nevertheless, BAT is a widely validated and reliable tool, particularly for the diagnosis of hymenoptera venom131, nut132, grass pollen133 and rare allergies (such as drugs and exotic foods)113, and anaphylaxis134 and anaphylactoid reactions120. BAT exhibited the highest sensitivity and specificity, with a significantly better ability than sIgE testing for the identification of Anisakis species in the patients with acute urticaria, potentially supplementing current standardized procedures in both diagnosis and follow-up135. "
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