Allergies to food, drugs and insect venom have not only the potential to be life-threatening, but have significant impact on quality of life. The rate of allergic disease in both children and adults have increased dramatically over the last few decades. While the prevalence of asthma has stabilized, and the prevalence of hayfever and eczema appears to be slowing, the prevalence of food allergy and anaphylaxis continues to rise.
The diagnosis of allergy currently relies on a good clinical and demonstration of presence of sIgE to the culprit allergen by doing either in-vitro sIgE testing or in-vivo skin prick testing. This testing is currently fraught with problems including un-availability of testing reagents for many allergens including drugs, lack of standardisation, and inability to distinguish between sensitisation and clinical allergy. The most robust test available to diagnose allergies is to challenge the subject with putative allergen. This has to be done in hospital setting with expertise to manage the severe allergic reactions. This poses a small but significant risk of having a major allergic reaction in the subject and associated anxiety surrounding the procedure.
The basophil activation test (BAT) is a flow cytometry blood test, currently only available in research settings, which may be useful in diagnosing and risk-stratifying allergy in patients where traditional blood or skin testing is non-diagnostic or unhelpful, and where challenge testing would otherwise be required. BAT has the potential to fulfill the unmet need of a reliable and reproducible laboratory test to correctly diagnose clinical allergy without the need for risky and expensive challenge testing.
Our laboratory has two grants to develop and standardise BAT as a diagnostic and prognostic test for subjects suffering from Drug, Food or Insect Venom anaphylaxis.