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ABOUT ALLERGIES
" Have you got asthma?"

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allergy_diagnosis_thematic_monthIn modern allergy diagnosis, the responsiveness to allergen suggested by the clinical history of an allergic patient should be confirmed by an ex vivo or in vitro test. These laboratory tests are the realm of the Interest Group for Allergy Diagnosis (IGAD). The commonly used in vitro test is determination of specific IgE, whereas the ex vivo test may be histamine release or up regulation of surface molecules CD63 or CD203c on basophil granulocytes, known as the basophil activation test, BAT.

In the last decade, specific IgE testing has expanded from using only standardised extracts of allergen sources to more precisely defined purified natural or recombinant allergens. This gives the allergist access to knowledge of the identity of allergenic molecules recognised by specific IgE; are they members of one large Pan allergen group like PR-10 allergens with Bet v1 as an important member, that gives rise to oral allergy syndrome, or is the allergen specific for one particular species (like Fel d1, the major cat allergen) and unlikely to ever cross-react? Allergen-based diagnosis will have an impact on diagnosis of food allergy, and allergies with discordance between clinical history and specific IgE data. We can hope that the regulatory authorities devise methods to develop reagents for immunotherapy that can match the diagnostic potential of this technology.

The 3rd International Symposium on Molecular Allergy, ISMA, was held in April 2008 in Salzburg, Austria, and Markus Ollert, Stephan Vieths and Adriano Mari will arrange the fourth ISMA as an EAACI Mini-Congress on 29-31 October 2010 in Munich, Germany. The symposium will cover aspects of allergenic molecules with an emphasis on the transition from complex extracts to molecular entities. International top experts will address topics covering structural, allergenic and diagnostic aspects of molecular Allergology. Furthermore, contributions on application of other technologies like microtechnologies and Information Technologies will be discussed during the meeting.

Whilst measuring specific IgE is a step in the right direction, we still only measure one interaction between IgE and an allergen, whilst an allergic response requires two simultaneous interactions of allergen with IgE on the same effector cell. This is simulated in the ex vivo tests based on basophil granulocytes.

Edward Knol and IngeTerstappen arranged the fourth EuroBAT meeting on 19-21 September in Rotterdam, NL, with 67 participants from 17 countries together with the ENDA meeting. Preliminary reports of a European collaboration, and application of the BAT in food & drug allergy (no, this is not the new FDA), and insect sting allergy were the major topics of the meeting. Two invited lectures on basic basophil biology broadened the horizon of the participants beyond p-values in clinical trials. The basophil activation group is really divided into the camp that wants to develop the best ex vivo test, and the group that is willing to use a little more time, and explore the responsiveness of the basophil more thoroughly. No doubt, the truth is that both approaches are valid, but are useful in different scenarios.

Bernadette Eberlein and an international group of BAT enthusiasts will arrange the fifth EuroBAT will be held 31.10 – 1.11. 2010 in Munich, Germany, just after the ISMA 2010. See the programme on www.basophil.org

We look forward to meeting you at the EAACI Meeting in London – attend our business meeting on Tuesday, 8 June 2010 at 13:30 – 15:00 to meet people you share an interest with, and get involved!

Hans Jurgen Hoffmann, Denmark
Adriano Mari, Italy
Markus Ollert, Germany