Basophil activation test in allergic rhinitis.

903 a different perception on rhinitis, be it caused by an IgEor a non -IgE -mediated challenge, because CD63 is easily activated by nonallergic stimulation.4 Furthermore, the ability to perform an accurate BAT depends also on the gating strategy used by the test to catch basophils in the flow cytometry electronic capture.5 The Flow2CASTTM (BÜHLMANN, Schönenbuch, Switzerland) used by Leśniak et al1 should improve the use of the previous commercial Flow -CAST, but gating basophils with CCR3 may create analytical bias. The best way to address this problem is to initially use 2 different BATs in order to gain a more reliable insight into the ability of the test to prevent a diagnostic misinterpretation whereby NAR is diagnosed instead of LAR. Leśniak et al1 replicated an experience similar to the latest one recently published by using a CD63-CD203c markers-endowed BAT6, and in this sense, their paper does not seem to add truly novel findings to the field. BATs should provide further insight into the ability of a diagnostic test to achieve a better analytical performance respect to further assays, such as NPT. However, the complex immunology of rhinitis may raise further concerns about patients’ eligibility for immunotherapy, particularly in the case of asthma and AR when immunotherapy is accomplished with a sublingual approach, the efficacy of which depends on the feature of the allergic pathology. This might be foreseeing also for serum immunotherapy. This would mean that, as it occurred in the study by Leśniak et al,1 if one applies clinical instead of objective NPT evaluation, the number of truly LAR -positive subjects assessed with the BAT may decrease significantly.2 The study published by Leśniak et al1 suggests that the BAT may be successfully used in the diagnosis of allergy once the clinical scenario of the allergy onset has been thoroughly elucidated.