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Assessment of related white blood cells and other factors includes the measurement of eosinophils, basophils, and basophil degranulation tests, along with various other diagnostic techniques.
(A) Eosinophil Count: Eosinophils play a key role in type I allergic reactions, making an elevated eosinophil count a useful auxiliary indicator for diagnosing such allergies. It can also serve as one of the parameters to evaluate treatment effectiveness.
Eosinophil counts are typically performed using either a white blood cell differential method or a direct counting technique, with the latter being more commonly used today. These cells contain cytoplasmic granules rich in basic proteins and amino acids, giving them an isoelectric point around pH 11. This makes them highly responsive to anionic stains. A common staining solution includes eosin, carbolic acid, and formalin, which helps dissolve red blood cells and other white blood cells, thereby improving background clarity and facilitating the identification of eosinophils.
(B) Basophil Count: Basophils are also involved in allergic responses. The primary method for counting them is the direct counting technique. The heparin sulfate found in their granules reacts with cationic dyes, allowing them to be easily stained. Common acidic staining solutions include 0.1% EDTA, alixin blue, cetylpyridinium chloride, and cesium chloride. These solutions help eliminate red blood cells and other white blood cells, making it easier to distinguish basophils.
A basophil count greater than 33/mm³ is considered increased, while over 50/mm³ indicates a significant increase. This test serves as a screening tool for type I allergic reactions, with a positive rate ranging from 60% to 70%. It can also be used as an auxiliary marker for monitoring treatment outcomes.
(C) Basophil Granule Degranulation Test: Normal basophils have numerous basophilic granules that stain purple-red or blue when exposed to cationic dyes like toluidine blue or alixin blue. When an allergen or anti-IgE antibody is introduced, it binds to IgE on the cell surface, triggering degranulation and reducing the number of stained cells. This change can be observed under a microscope. The test can be conducted using either a slide method or a test tube method. While the slide method is more complex and has higher variability, the test tube method is simpler, time-efficient, and reproducible, making it more suitable for widespread use.
RAST and skin tests are widely accepted methods for identifying allergens, studying desensitization mechanisms, and evaluating the effectiveness of immunotherapy.
(IV) Other Detection Methods: 1. Sensitized T Cell Detection: Evaluating the overall activity of T cells and their sensitization to specific antigens is crucial for diagnosing type IV allergic reactions. For detailed procedures, refer to specialized resources.
2. Lymphokine Detection: Lymphokines are essential in the development of type IV hypersensitivity reactions, so detecting these molecules holds clinical and research significance.
3. Anti-Blood Cell Antibody Detection: These antibodies are major mediators in type II allergic reactions. Detecting them is vital for diagnosing this type of allergy. For detailed methods and clinical interpretation, consult Hematology Test Materials.
Additional allergy-related tests include cold antibody testing, anti-basement membrane antibody testing, and platelet-related assays. These methods provide further insights into various types of allergic responses.
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