RT Journal Article
T1 Successful Application of the Mast Cell Activation Test in Immediate Hypersensitivity to Amoxicillin
A1 Céspedes, Jose A.
A1 Lebrón-Martín, Clara
A1 Vallecillos-Azor, Lucía
A1 Torres, Pablo
A1 Tesfaye Ayane, Amene
A1 Bogas, Gádor
A1 Salas, María
A1 Ariza, Adriana
A1 Montañez-Vega, María Isabel
A1 Torres, María José
A1 Mayorga, Cristobalina
K1 Alergia a los medicamentos
AB ABSTRACTBackgroundImmediate drug allergic reactions (IDAR) to betalactams are frequent, yet mislabelling remains common and negatively impacts clinical decisions. Conventional diagnostics such as STs and drug provocation are effective but limited by time, risk, and contraindications in severe cases. In vitro alternatives—sIgEquantification and basophil activation tests (BAT)—offer safer options, although performance may be affected by biological variability and suboptimal sensitivity with an important drawback for the latter in patients with non-releaser basophils. This study aimed to evaluate a mast cell activation test (MAT) based on human CD34+-derived mast cells (dMCs) for IDAR diagnosis to amoxicillin (AX) using both free AX and dendrimeric amoxicilloyl conjugates (G4/G5-AXO).MethodsCD34+ cells were cultured for 10–12 weeks to generate dMCs. After passive sensitization with sera from AX-allergic patients (N = 28) or tolerant controls (N = 11), dMCs were stimulated with free AX, G4-AXO, or G5-AXO. Activation was quantified by CD63 expression via flow cytometry. Diagnostic performance was compared with BAT and sIgE determination by ImmunoCAP.ResultsMAT with free AX achieved 53.57% sensitivity, G4/G5-AXO reached 46.43%, and all methods maintained 100% specificity. Combining results with AX or dendrimeric stimuli increased sensitivity to 75% while preserving specificity. Importantly, MAT identified positive cases among BAT non-releasers and patients with undetectable sIgE.ConclusionsUnder optimized conditions, MAT using dMCs and different AX determinants reached 75% sensitivity and 100% specificity. The complementary use of free AX and dendrimeric conjugates expands detection across heterogeneous IgE reactivity profiles from AX-allergic patients, reinforcing the diagnostic value of advanced cellular models and engineered allergens.
PB Wiley
YR 2026
FD 2026-02
LK https://hdl.handle.net/10630/46138
UL https://hdl.handle.net/10630/46138
LA eng
NO J. A. Céspedes, C. Lebrón-Martín, L. Vallecillos-Azor, et al., “ Successful Application of the Mast Cell Activation Test in Immediate Hypersensitivity to Amoxicillin,” Allergy (2026): 1–13, https://doi.org/10.1111/all.70267.
NO Funding for open access charge: Universidad de Málaga / CBUA
DS RIUMA. Repositorio Institucional de la Universidad de Málaga
RD 11 abr 2026