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　　原标题：肥大细胞活化试验在过敏性疾病和过敏反应诊断中的应用
　　①食物过敏是一个日益严重的公共卫生问题，也是危及生命的过敏反应的最常见原因。常规过敏试验评估过敏原特异性IgE的存在，明显高估了真实的临床过敏率，导致过度诊断和对健康相关生活质量的不良影响。②为了对一种新的诊断工具进行初步验证和评估，我们使用了肥大细胞活化测试(MAT)。③人原发性血源性肥大细胞(MCs)由外周血前体细胞产生，经患者血清敏化后与过敏原孵育。采用流式细胞术和介质释放法检测MC脱颗粒情况。我们将MATs的诊断性能与现有的诊断工具进行了比较，以评估在接受双盲安慰剂对照挑战的花生致敏受试者队列中的诊断性能。④花生、草花粉,和膜翅目昆虫(黄蜂毒)过敏病人血清致敏的人类血液肥大细胞证实有过敏原特异性和剂量依赖性脱颗粒的存在,确定是基于表面活化标记物(CD63和CD107a)的表达和功能性试验(前列腺素D2和β-氨基己糖苷酶的释放)。在这组花生致敏受试者中，MAT被发现与其他测试方法(包括组份诊断和嗜碱性细胞激活试验)相比具有更好的鉴别性能。通过功能性主成分分析，我们在结果的剂量-反应曲线中确定了5个反应簇或反应模式，这些在初步分析中与挑战时看到的反应表型相对应。⑤MAT是一个有力的工具，可以提供优于现有过敏诊断的诊断性能，并可能有助于探索在过敏反应期间嗜碱性细胞和肥大细胞之间效应细胞功能的差异。


延伸阅读
Mast cell activation test in the diagnosis of allergic disease and anaphylaxis
DOI: https://doi.org/10.1016/j.jaci.2018.01.043
Background
Food allergy is an increasing public health issue and the most common cause of life-threatening anaphylactic reactions. Conventional allergy tests assess for the presence of allergen-specific IgE, significantly overestimating the rate of true clinical allergy and resulting in overdiagnosis and adverse effect on health-related quality of life.
Objective
To undertake initial validation and assessment of a novel diagnostic tool, we used the mast cell activation test (MAT).
Methods
Primary human blood-derived mast cells (MCs) were generated from peripheral blood precursors, sensitized with patients' sera, and then incubated with allergen. MC degranulation was assessed by means of flow cytometry and mediator release. We compared the diagnostic performance of MATs with that of existing diagnostic tools to assess in a cohort of peanut-sensitized subjects undergoing double-blind, placebo-controlled challenge.
Results
Human blood-derived MCs sensitized with sera from patients with peanut, grass pollen, and Hymenoptera (wasp venom) allergy demonstrated allergen-specific and dose-dependent degranulation, as determined based on both expression of surface activation markers (CD63 and CD107a) and functional assays (prostaglandin D2 and β-hexosaminidase release). In this cohort of peanut-sensitized subjects, the MAT was found to have superior discrimination performance compared with other testing modalities, including component-resolved diagnostics and basophil activation tests. Using functional principle component analysis, we identified 5 clusters or patterns of reactivity in the resulting dose-response curves, which at preliminary analysis corresponded to the reaction phenotypes seen at challenge.
Conclusion
The MAT is a robust tool that can confer superior diagnostic performance compared with existing allergy diagnostics and might be useful to explore differences in effector cell function between basophils and MCs during allergic reactions.
All Authors:
Rajia Bahri Adnan Custovic Peter Korose Marina Tsoumani Martin Barron Jiakai Wu Rebekah Sayers Alf Weimann , Monica Ruiz-Garcia Nandinee Patel Abigail Robb Mohamed H. Shamji
Sara Fontanella Sara Fontanella Mira Silar E.N.Clare Mills Angela Simpson Paul J. Turner Paul J. Turner
　　创建过敏性疾病的科研、科普知识交流平台，为过敏患者提供专业诊断、治疗、预防的共享平台。