Histamine Release Test – Procedure & Significance
The histamine release test is a laboratory procedure used to diagnose allergies and intolerances by measuring the release of histamine from blood cells upon allergen exposure.
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The histamine release test is a laboratory procedure used to diagnose allergies and intolerances by measuring the release of histamine from blood cells upon allergen exposure.
What is the Histamine Release Test?
The histamine release test is a diagnostic laboratory method used to identify allergic reactions and hypersensitivity responses. It examines how strongly certain immune cells in the blood – particularly basophil granulocytes and mast cells – react when exposed to a specific allergen or suspected substance by releasing histamine. Histamine is a naturally occurring signaling molecule that plays a central role in allergic reactions and causes typical symptoms such as itching, skin redness, and respiratory irritation.
How Does the Test Work?
For the histamine release test, a blood sample is taken from the patient. In the laboratory, the blood cells – primarily basophil granulocytes – are deliberately exposed to various allergens or substances. If the cells react to a particular allergen, they release histamine. The amount of histamine released is then measured and evaluated using appropriate analytical methods such as fluorometry or ELISA.
Step-by-Step Overview
- Blood sample collection from the patient
- Isolation of basophil granulocytes from the blood
- Incubation of the cells with the test substance or allergen
- Measurement of the released histamine quantity
- Evaluation and interpretation of results by a physician
When is the Histamine Release Test Used?
The histamine release test is particularly useful when other allergy tests – such as the skin prick test or conventional IgE blood tests – do not yield clear results or cannot be performed. Typical areas of application include:
- Suspected food allergies (e.g., to peanuts, milk, eggs, or wheat)
- Diagnosis of drug allergies (e.g., to antibiotics or pain relievers)
- Evaluation of insect venom allergies (e.g., bee or wasp venom)
- Investigation of latex allergy
- Suspected histamine intolerance
Advantages and Limitations of the Test
A key advantage of the histamine release test over the skin prick test is that it is performed in vitro (outside the body), meaning there is no direct allergic risk to the patient. Additionally, the test can be used in patients who are taking antihistamines or who have certain skin conditions that would interfere with skin testing.
However, the test also has limitations: the quality of results can depend on the freshness of the blood sample and the stability of the basophils. Furthermore, the test is technically demanding and not available in all laboratories. A definitive diagnosis should therefore always be made by a specialist in combination with other clinical findings.
Clinical Significance and Interpretation
The results of the histamine release test are typically expressed as the percentage of histamine released relative to the total histamine content of the cells. A high value indicates a strong immune cell response to the tested allergen and may suggest a clinically relevant allergy. However, the interpretation of results must always be considered in the context of the patient's clinical symptoms and medical history.
References
- Kleine-Tebbe J, Jakob T (eds.) – Molecular Allergy Diagnostics. Springer Verlag, 2nd edition, 2015.
- Lichtenstein LM, Osler AG – Studies on the mechanisms of hypersensitivity phenomena. Journal of Experimental Medicine, 1964. PubMed PMID: 14237839.
- World Allergy Organization (WAO) – White Book on Allergy, 2013. Available at: https://www.worldallergy.org
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