Abstract

MOSCOSO, Teresa; MELO, Alcinda Campos; NETO, Marta  and  SANTOS, Maria Conceição Pereira. Basophil activation tests using CD63 and CD203c expression in patients with diclofenac hypersensitivity. Rev Port Imunoalergologia [online]. 2014, vol.22, n.3, pp.195-205. ISSN 0871-9721.

Background: Non‑steroidal anti‑inflammatory drugs (NSAIDs) represent a difficult group in what concerns hypersensitivity diagnosis, since most of the tests are not validated. The evaluation of the basophils surface molecules expression following activation by drugs has been described as a possible and useful tool for diagnosis of this kind of reactions. Objective: To evaluate the clinical usefulness of basophil activation test (BAT) in immediate diclofenac hypersensitivity reactions diagnosis. Patients and methods: 17 patients (M: 4, F: 7; mean age: 44.3 ± 18.7 years) with diclofenac hypersensitivity were studied. 11 healthy volunteers (M: 4, F: 7; mean age: 44.3 ± 18.7 years) without history of NSAIDs hypersensitivity were used as control group. BAT was carried out using different approaches for basophils identification: Flow2 CAST® method using CCR3, Basotest® - IgE, and the Basotest® modified - HLA‑DR‑/CD123 +. Basophil activation markers CD63 and CD203c were used, quantifying the expression of “new” CD63 and the “up regulation” of CD203c. Results: Comparing different markers for basophils identification, namely CCR3, IgE and CD123 expression in the absence of HLA‑DR, we obtained a sensitivity of 40%, 13% and 77% for this order, and a specificity of 91% for all. In the evaluation of drug‑induced activation, the flow cytometry analysis was based on the percentage and/or intensity of expression, yielding 40% and 77% of sensitivity and 91% of specificity, for CD63 and CD203c molecules, respectively. Conclusions: The test using CD63 showed lower sensitivity compared with the test using CD203c. These results suggest that BAT can be considered a complementary diagnosis tool for patients with diclofenac hypersensitivity

Keywords : Basophils activation test; CD203c; CD63; flow cytometry; NSAIDs hypersensitivity.

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