THE Hoxb8 mast cell activation test (Hoxb8 MAT) shows high diagnostic accuracy in identifying peanut allergies, with results comparable to existing tests and particular promise for patients who do not respond to traditional basophil activation tests (BAT). Peanut allergy, a severe and common condition, significantly affects quality of life and necessitates reliable diagnostic methods to support effective management. Recent research assessed the performance of the Hoxb8 MAT, a cell-based assay developed to improve peanut allergy diagnostics, by analysing blinded sera samples from a validated cohort of peanut-allergic and tolerant children and adolescents.
In this study, Hoxb8 mast cells (Hoxb8 MCs) were sensitized with sera from 112 peanut-allergic and peanut-tolerant participants. Upon exposure to varying doses of peanut extract, degranulation of Hoxb8 MCs was measured using flow cytometry, with CD107a serving as an activation marker. The results were then compared with established diagnostic tools, including the skin prick test (SPT), specific IgE (sIgE) levels, and BAT. Serum samples from BAT nonresponses were also evaluated using the Hoxb8 MAT to determine its diagnostic capability for this subgroup.
Results indicated that the Hoxb8 MAT exhibited strong, dose-dependent responses to peanut extract, achieving optimal diagnostic accuracy at concentrations of 100 ng/mL or higher, with an area under the receiver operating characteristic curve (AUROC) of 0.97. Sensitivity and specificity rates were 93% and 96%, respectively, surpassing those of SPT and sIgE testing. The diagnostic effectiveness of the Hoxb8 MAT was on par with BAT, and it accurately classified BAT nonresponses into allergic and non-allergic categories.
These findings suggest that the Hoxb8 MAT could serve as a highly accurate diagnostic tool for peanut allergy, particularly valuable for patients who show no response in traditional BAT. The test’s precision and ability to address nonresponsive cases make it a potential asset for clinical allergy diagnosis. Future studies should further explore its feasibility and reliability in routine clinical practice, which may ultimately enhance diagnostic options and management strategies for peanut allergy.
Reference
Bachmeier-Zbären N et al. Clinical utility analysis of the Hoxb8 mast cell activation test for the diagnosis of peanut allergy. Allergy. 2024. DOI:10.1111/all.16341.
