Original Articles Open access

[Use of the basophil activation test in the healthsurveillance of workers exposed to beta-lactams and production intermediates]

Authors

Published
3 April 2025
Section
Original Articles
Pages
79-82

Abstract

Background. Cutaneous tests and specific IgE are used in the diagnosis of allergy due to betalactams, although drug administration at therapeutic dosage is considered gold standard in drug allergy. Objectives. The diagnostic approach in symptomatic workers is more critical when they are exposed because of work, unlike reactions to drug in case of therapy. There is not a general consensus about markers in workers occupationally exposed to drugs. Indeed, basophil activation test (BAT) is a new and promising laboratory tool, particularly useful to test intermediate molecules involved in the production. In this article we show our experience on the health surveillance of workers exposed to beta lactams and intermediate molecule (7-ZACA) in a pharmaceutical industry. Methods. We studied 15 workers divided into 3 groups: 5 exposed and symptomatic (group A), 5 exposed and asymptomatic (group B), 5 non exposed and asymptomatic (group C). Results. BAT was positive for 7-ZACA in three subjects of group A, and in one subject of group B and one of group C. There was e concordance between clinical history, respiratory symptoms, and results of texts. It was possible to determine allergic nature of symptoms and sensitization in a preclinical phase, correctly discriminating symptoms related to irritants from theallergic ones. Conclusions. BAT, a simple and quick diagnostic procedure if compared to challenge, can be used as a useful and practical tool by occupational doctors forprevention measures, evaluation of ability to a specific job and reallocation of workers.

References

  1. 1) Anca M, Chiriac, Demoly P. Drug Allergy Diagnosis. Immunol Allergy Clin N Am 2014; 34: 461-471. DOI: https://doi.org/10.1016/j.iac.2014.03.002
  2. 2) Bousquet PJ, Pipet A, Bousquet-Rouanet L, et al. Oral challenges are needed in the diagnosis of B-lactam hypersensitivity. Clin Exp Allergy 2008; 38: 185-190. DOI: https://doi.org/10.1111/j.1365-2222.2007.02867.x
  3. 3) Díaz Angulo S, Szram J, Welch J, et al. Occupational Asthma in Antibiotic Manufacturing Workers: Case Reports and Systematic Review. Journal of Allergy, vol. 2011, Article ID 365683, 9 pages, 2011. doi: 10.1155/2011/365683. DOI: https://doi.org/10.1155/2011/365683
  4. 4) Edwards IR, Aronson JK. Adverse drug reactions: definitions, diagnosis, and management. Lancet 2000; 356: 1255-1259. DOI: https://doi.org/10.1016/S0140-6736(00)02799-9
  5. 5) Lorenz I, Schneider EM, Stolz P, et al. Sensitive flowcytometric method to test basophil activation influenced by homeopathic histamine dilutions. Forsch Komplementarmed Klass Naturheilkd 2003; 10: 316-324 6) Macy E. Penicillin and Beta-Lactam Allergy: Epidemiology and Diagnosis. Curr Allergy Asthma Rep 2014; 14: 476. DOI: https://doi.org/10.1159/000075885
  6. 7) Marraccini P, Salimbeni R, Lodola L, et al. Occupational rhinitis and bronchospastic reaction in a worker exposed to imipenem. J of Occup Health 2000; 42: 338-340. DOI: https://doi.org/10.1539/joh.42.338
  7. 8) Marraccini P, Digiesi G, Pignatti P, et al. Utilizzo del test di attivazione dei basofili (BAT) per la diagnosi di reazione allergica a piperacillina in ambito professionale: descrizione di un caso clinico. Med Lav 2013: 104 (6): 434-439.
  8. 9) Romano A, Warrington R. Antibiotic Allergy. Immunol Allergy Clin N Am 2014; 34: 489-506. DOI: https://doi.org/10.1016/j.iac.2014.03.003
  9. 10) Sanz ML, Gamboa PM, Antépara I, et al. Flow cytometric basophil activation test by detection of CD63 expression in patients with immediate-type reactions to betalactam antibiotics. Clin Exp Allergy 2002; 32(2): 277-286. DOI: https://doi.org/10.1046/j.1365-2222.2002.01305.x
  10. 11) Sanz ML, Gamboa PM, Mayorga C. Basophilactivationtests in the evaluation of immediate drug hypersensitivity. Curr Opin Allergy
  11. Clin Immunol 2009; 9(4): 298-304. DOI: https://doi.org/10.1111/j.1440-1819.2009.01936.x

Metrics

Citations and online attention from Dimensions, Altmetric and PlumX.