Evaluation of the basophil response in patients with NSAID-exacerbated respiratory disease (NERD) after nasal provocation test with lysine-aspirin (NPT-LASA)
Sunday, March 4, 2018
South Hall A2 (Convention Center)
Jesus Verge, MD, Miguel Gonzalez, MSc, Carmen M. Rondon Segovia, MD, Inmaculada Dona, Tahia D. Fernandez, PhD, Ruben Fernandez, Jose A. Cornejo-Garcia, Cristobalina Mayorga, PhD, Maria J Torres, MD, PhD, Paloma Campo, MD PhD FAAAAI

Although nasal provocation test with lysine-aspirin (NPT-LASA) is useful for diagnosing NSAID-exacerbated respiratory disease (NERD), in vitro test such as basophil activation test (BAT) has also been applied but considered of limited use. Recent studies have shown that basophils circulate to inflammation sites in allergic individuals, and able to show differences in concentration or response to antigen stimulation. The aim was to evaluate the potential usefulness of BAT to evaluate NERD patients at baseline and different timepoints after NPT-LASA


Patients with clear history of immediate respiratory reactions to NSAIDs and 18 healthy controls underwent NPT-LASA. Response was evaluated by acoustic rhinometry and visual analogical scale at 15, 60 and 120 min. Blood was obtained at baseline, 60 and 180 minutes after challenge. Basophils activation test was carried out selecting basophils as CCR3+CD203c+ cells. Activation was measured as %CD63. Local ethical committee approved the study.


Seventeen patients (12F/5M) were recruited (82% polyposis, 53% atopic). NPT-LASA was positive in 9/17 (53%). At baseline, BAT was positive in 4/17 of cases (23,5% total, 22% NPT+, 25% of NPT-) and in 2/18 of controls (11%). BAT positive results in NPT- patients increased over time (baseline 2/8 (25%), 60 min 3/8 (37.5%), 120 min 4/8 (50%), showing all NPT- patients at least one positive result at any given point. Combining NPT and BAT results, positive results were also increasing over time (baseline 64.7%, 60 min 70.5%, 180 min 76.4%)


Performance of BAT in different timepoints after NPT-LASA may increase the sensitivity of the test