As research in the field of food allergy is gaining momentum with new and emerging therapies there is need for both researchers and clinicians to have a better understanding on how to put all this new information into context in clinical care. We are continuously learning from other fields, such as oncology, that a one-shoe-fits all type approaches are becoming the practice of the past and there is need to incorporate markers of disease activity as well as drug selection into clinical care. In the United States, this can happen in two ways; laboratory developed testing and companion diagnostics, generally former leading the path to the later. The findings in this letter is a collaboration between four CLIA/CAP accredited in-office flow cytometry laboratories in Utah, New York and Virginia that are part of very busy food allergy clinics directed by board certified Allergist/Immunologists. The identification of changes in basophils and B cells during oral food immunotherapy are proving to be potentially useful markers in monitoring these patients. We show a high ratio of CD63 to CD203c and CD73 expression on B-cells, compared to healthy non-allergic controls and patients who have outgrown their food allergies. This ratio of basophil surface markers as well as B cell CD73 expression drops as patients are undergoing food-OIT. Quite interestingly, we see a similar low pattern in patients who have non-releaser basophils. Altogether these biomarkers are providing useful and important information monitoring patients and we have validated these assays for clinical use as laboratory developed tests. The Basophil Activation Test is used much more routinely outside the United States, and the powerful correlation it provides to oral food challenge outcomes is making it a very attractive tool. We have just submitted two manuscripts on the validation of the BAT as well as sample stability which is under review elsewhere. We expect more utility of the BAT in the United States in the future. Incorporating biomarkers to clinical care of patients with food allergies will provide to be important in assessing efficacy as well as complications of various therapies as well as monitoring the natural resolution of the food allergies.

中文翻译：

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嗜碱性粒细胞和B细胞生物标志物在食品过敏和食品口服免疫疗法中监测疾病活动的临床用途

随着食品过敏领域的研究通过新兴疗法获得发展势头，研究人员和临床医生都需要对如何将所有这些新信息用于临床护理有更好的了解。我们正在不断地从其他领域（例如肿瘤学）中学习，一种适用于所有类型的单鞋疗法已成为过去的实践，并且需要将疾病活动性标记以及药物选择纳入临床护理。在美国，这可以通过两种方式发生：实验室开发了测试和伴随诊断程序，通常前者引领后者。这封信的发现是犹他州四个CLIA / CAP认可的办公室流式细胞仪实验室之间的合作，纽约和弗吉尼亚州是由董事会认证的过敏症/免疫学家领导的非常繁忙的食品过敏诊所的一部分。口服食品免疫治疗过程中嗜碱性粒细胞和B细胞变化的鉴定被证明是监测这些患者的潜在有用标记。与健康的非过敏性对照和食物过敏症患者相比，我们在B细胞上显示出很高的CD63与CD203c和CD73表达比率。当患者进行食品OIT时，嗜碱性粒细胞表面标志物以及B细胞CD73表达的比率下降。非常有趣的是，我们发现患有非释放性嗜碱性粒细胞的患者出现了类似的低模式。这些生物标记物共同为监测患者提供了有用且重要的信息，我们已经将这些测定法作为实验室开发的测试方法进行了临床验证。嗜碱性粒细胞激活测试在美国以外的地区更加频繁地使用，并且它与口服食物挑战性结果之间的强大关联使其成为非常有吸引力的工具。我们刚刚提交了关于BAT验证以及样品稳定性的两份手稿，目前正在其他地方进行审查。我们期望BAT在美国的效用更高。将生物标志物纳入食物过敏患者的临床护理将对评估各种疗法的功效和并发症以及监测食物过敏的自然解决方案具有重要意义。我们刚刚提交了关于BAT验证以及样品稳定性的两份手稿，目前正在其他地方进行审查。我们期望BAT在美国的效用更高。将生物标志物纳入食物过敏患者的临床护理将对评估各种疗法的功效和并发症以及监测食物过敏的自然消退具有重要意义。我们刚刚提交了关于BAT验证以及样品稳定性的两份手稿，目前正在其他地方进行审查。我们期望BAT在美国的效用更高。将生物标志物纳入食物过敏患者的临床护理将对评估各种疗法的功效和并发症以及监测食物过敏的自然消退具有重要意义。