Application of basophil activation test in peanut allergy: a Hong Kong experience

Background: Peanut allergy is one of the most common food allergies. The onset is often in early childhood, with the majority persisting to adulthood. The main management approach remains strict allergen avoidance and emergency action plan. However, with peanut being a major ingredient in the East Asian diet, there is a significant risk of accidental exposure, which can result in severe reactions, including life-threatening anaphylaxis in susceptible individuals. Despite skin prick test (SPT) and sIgE to peanut and its components being commonly used by clinicians in the diagnosis of immediate hypersensitivity reactions, their sensitivity are not perfect and studies using basophil activation test (BAT), another in vitro assay, to predict immediate hypersensitivity have shown promising performance characteristics to help select suitable candidates to proceed to food challenges for food allergy delabelling. Here we share our local data.