O Uso Do Teste De Ativação De Basófilos No Diagnóstico De Pacientes Alérgicos À Proteína Do Leite De Vaca: Uma Revisão Da Literatura

Abstract

Introduction: The Basophil Activation Test (BAT) is an in vitro diagnostic tool that evaluates basophil activation upon exposure to specific allergens. It employs flow cytometry to quantify markers such as CD63 and CD203c, which indicate basophil activation in response to allergens bound to specific IgE antibodies. BAT has been widely used in diagnosing Cow's Milk Protein Allergy (CMPA), a condition characterized by immune-mediated adverse reactions. CMPA can affect multiple organ systems, including the skin, respiratory, and cardiovascular systems, significantly impairing patients' quality of life and, in some cases, leading to anaphylaxis—a severe, potentially fatal reaction to allergen exposure.The diagnosis of CMPA often involves methods such as the Oral Food Challenge (OFC), specific IgE (sIgE) measurement, and skin tests. While these tests are useful, OFC can provoke acute allergic reactions, and skin tests may lead to adverse responses. sIgE measurement, for instance, detects IgE antibodies that bind to allergenic extracts or specific molecular components. Objective: To evaluate the efficacy of the Basophil Activation Test as a diagnostic method for cow's milk protein allergy. Methodology: An integrative literature review was conducted. The bibliographic search utilized the keywords basophil activation test, allergy, and cow's milk in the PubMed and ScienceDirect databases, focusing on studies published between 2014 and 2024, available in full text in English or Portuguese. Eleven articles were included. Excluded materials comprised non-available full texts, studies not directly

addressing the topic, conference abstracts, editorials, reviews, opinion pieces, articles from non- academic sources, theses, dissertations, and duplicates.Results: BAT demonstrated the ability to assess

individual sensitivity to specific allergens without the need for oral provocation, effectively simulating clinical allergic reactions. The test showed high sensitivity and specificity in diagnosing CMPA, with a higher negative predictive value compared to other diagnostic tools. When compared to sIgE measurement, BAT exhibited greater diagnostic accuracy and enabled differentiation between allergic patients and those merely sensitized. Furthermore, BAT proved effective in assessing the severity and threshold of allergic reactions, potentially reducing the need for OFC.Conclusion: BAT is a promising diagnostic tool for cow's milk protein allergy, as well as for other food allergies such as peanut and egg

allergies. Its advantages include non-interference by antihistamines and the ability to evaluate both IgE- mediated and non-IgE-mediated reactions. However, further studies are necessary to standardize and

validate the method. BAT could complement traditional diagnostic approaches, reducing reliance on invasive and potentially hazardous tests like OFC.