Evaluation of drug allergic reactions using in vitro cell-based methods (RBL vs. BAT)

Physicians frequently encounter difficulties when it comes to evaluation of allergic reactions to drugs because of the poor sensitivity of in vivo tests, which makes controlled administration of the drug necessary to confirm the diagnosis. The risks of in vivo testing can be avoided using in vitro assays, which are less stressful for the patient. In the present review, we describe two different in vitro methods to evaluate drug hypersensitivity reactions: basophil activation test, in which the activation of basophils upon exposure to a certain drug is measured by flow cytometry, and β-hexosaminidase determination using RBL-2H3 cell line (rat basophilic leukemia cells). These methods need to be standardized in order to be used in clinical routine, but they have a great potential for providing an accurate diagnosis.