Innovative diagnostic tool in allergy: the mast cell activation test

Published online: March 5, 2018

Food allergy is the most common cause of life-threatening allergic reactions. Current tests for food allergy measure levels of food-specific IgE, but these can overestimate the rate of true clinical allergy, thus causing unnecessary dietary/social restrictions and anxiety which can impair nutrition and quality of life.

In an article recently published in The Journal of Allergy & Clinical Immunology (JACI), Bulfone-Paus, Turner and colleagues describe the development of a novel diagnostic tool, the mast cell activation test (MAT). The MAT uses patient blood (serum) to sensitize blood progenitor-derived human mast cells, which can then be stimulated in vitro with allergen and the response measured by flow cytometry.

Sera from peanut, grass pollen and wasp venom allergic patients caused an allergen-specific and dose-dependent degranulation of mast cells. Importantly, the researchers showed that in a cohort of peanut-sensitized patients who underwent a double-blind, placebo-controlled challenge to peanut, the novel MAT assay appeared to confer superior diagnostic accuracy compared to existing diagnostics in distinguishing between patients with true peanut allergy from those who were sensitized, but tolerant to peanut at challenge.

These exciting and novel results indicate that MAT is a robust test which may provide better diagnostic accuracy than current tests and may provide further data relating to how patients react to allergen exposure. The MAT test is based on patient sera, and therefore less prone to interference during transport and storage.

The Journal of Allergy and Clinical Immunology (JACI) is the official scientific journal of the AAAAI and is the most-cited journal in the field of allergy and clinical immunology.