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Review
. 2025 May 30:6:1568670.
doi: 10.3389/falgy.2025.1568670. eCollection 2025.

Enhancing allergy diagnosis: mass spectrometry as a complementary technique to the basophil activation test

Nicole Wheeler  1 , Miloslav Sanda  2 , Lanya Rasool  1 , Noha Elemary  1 , Arda Alpan  1 , Hamed Safi  1 , Denise Loizou  3 , Matthew Plassmeyer  4 , Mikell Paige  1   5 , Soren Ulrik Sonder  4 , Oral Alpan  4 , Michael Girgis  5   6
Affiliations
Review

Enhancing allergy diagnosis: mass spectrometry as a complementary technique to the basophil activation test

Nicole Wheeler et al. Front Allergy. .

Abstract

Accurate diagnostic tools for allergic conditions are essential for effective treatment. Traditional methods, such as skin prick tests (SPT) and specific IgE measurements are widely used, but they have limitations in sensitivity and specificity for certain allergens. While the Basophil Activation Test (BAT) offers improved specificity, particularly for allergens such as peanuts and sesame, its practicality and accessibility remain challenges. Mass spectrometry (MS) has recently gained recognition as a promising complementary tool in allergy diagnostics, offering high analytical precision and the capability to detect a wide range of allergen-specific biomarkers. This review explores the integration of MS into allergy diagnostics, emphasizing its potential to enhance BAT applications, particularly for non-responders. We discuss the underlying mechanisms, recent research highlighting its efficacy, and the technical challenges that must be addressed for clinical adoption. Additionally, we examine the standardization requirements and ethical considerations necessary for MS to become a routine diagnostic tool. Finally, we consider the future of allergy diagnostics, highlighting how MS technology could contribute to more precise, personalized, and patient-centered care in allergy management.

Keywords: BAT; diagnostics; food allergy; mass spectrometry; sensitivity; specificity.

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Conflict of interest statement

Author(s) AA, DL, MP, SU and OA were employed by Amerimmune LLC. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The handling editor, RW, declared a past co-authorship with the author OA.

Figures

Figure 1
Figure 1
The mechanism of IgE-mediated allergic reaction.
Figure 2
Figure 2
The workflow for BAT test.
Figure 3
Figure 3
Phosphorylation of signaling proteins in basophils after IgE stimulation. (A,B) Expression of phosphorylated PLCγ1 (pPLCγ1, Tyr783) in basophils treated with PBS (black) vs. IgE (red). (C,D) Expression of phosphorylated ZAP70/SYK (pZAP, Tyr319/Tyr354) in basophils treated with PBS (black) vs. IgE (red). (E) Basophil CD63 upregulation in patients with mild peanut allergy with perioral hives (dashed line) vs. full anaphylactic reaction (solid line) requiring epinephrine.
Figure 4
Figure 4
Effect of Ibrutinib on basophil activation and CD63 surface expression across different stimuli.
Figure 5
Figure 5
A workflow incorporating extraction of allergens with magnetic beads for UPLC –MS/MS analysis.
See this image and copyright information in PMC

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References

    1. Alvarez-Arango S, Kumar M, Chow TG, Sabato V. Non-IgE-mediated immediate drug-induced hypersensitivity reactions. Allergy Clin Immunol Pract. (2024) 12(5):1109–19. 10.1016/j.jaip.2024.02.019 - DOI - PMC - PubMed
    1. Vitte J, Vibhushan S, Bratti M, Montero-Hernandez JE, Blank U. Allergy, anaphylaxis, and nonallergic hypersensitivity: IgE, mast cells, and beyond. Med Princ Pract. (2022) 31(6):501–15. 10.1159/000527481 - DOI - PMC - PubMed
    1. Tedner SG, Asarnoj A, Thulin H, Westman M, Konradsen JR, Nilsson C. Food allergy and hypersensitivity reactions in children and adults-a review. J Intern Med. (2022) 291(3):283–302. 10.1111/joim.13422 - DOI - PubMed
    1. Fong M, Crane JS. Histology, mast cells. In: Herbert DBR, editor. StatPearls. Treasure Island (FL): StatPearls Publishing; (2025). - PubMed
    1. Dobrzanski MJ. Expanding roles for CD4T cells and their subpopulations in tumor immunity and therapy. Front Oncol. (2013) 3:63. 10.3389/fonc.2013.00063 - DOI - PMC - PubMed

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