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Allergen Response Assays

Using the BÜHLMANN CAST® range of Allergy assays can significantly decrease the amount of provocation tests that need to be performed.


The new Flow2 CAST® system represents a significant step forward in in vitro allergy testing, allowing the simple detection of Basophil Activation on whole blood samples. The Flow2 CAST system, which replaces the Flow CAST assay, uses a dual labelling system to identify basophils in whole blood samples, negating the requirement for lengthy and labour intensive leukocyte isolation steps. Using a flow cytometer, basophils are identified in the sample by using a specific marker (CCR3) and then the level of CD63 is analysed on this sub-population to give a read out of the response to a purified allergen which is added to the sample.

In the CAST-2000® ELISA, leukocytes isolated from patient blood are simultaneously primed with Interleukin 3 (IL-3) and stimulated with allergens. The ELISA measures de novo synthesis of the allergic sulfidoleukotriene mediators (LTC4, LTD4 and LTE4) as a quantitative read-out of the patient’s response to the allergen.

The Flow2 CAST system, together with the CAST 2000 ELISA, is particularly suited for the following types of allergies:

  • Drug hyper-sensitivites (e.g. anaesthetics, antibiotics, NSAIDs)
  • Food allergies
  • Bee and wasp stings

The BÜHLMANN CAST® assays detect immediate type allergic reactions and hypersensitivities to suspected allergens. 

In some cases, specific IgE fails to demonstrate absolute diagnostic reliability. This happens mainly in more complex reactions such as drug, venom or food allergies. The CAST® (Cellular Allergen Stimulation Test) allergy assays will identify both IgE and non-IgE allergies.

  • Allergen Product List

    • PDF size: 1.67MB
    • Updated on: 04/07/2018

    Reference list of available BÜHLMANN Allergens

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  • Basophil Activation Testing - A Safer Alternative for your Patients

    • PDF size: 11.35KB
    • Updated on: 03/09/2018

    Leading Edge Article

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    • PDF size: 13.22KB
    • Updated on: 04/07/2018

    Procedure and Characteristics

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  • Drug Allergen Booklet

    • PDF size: 1.78MB
    • Updated on: 04/07/2018

    Details and References relating to the CAST Drug Allergens

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  • Flow CAST® Procedure and Characteristics

    • PDF size: 13.30KB
    • Updated on: 04/07/2018

    Product Flyer

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  • Inhalant, Venom, Food and Environmental Allergens Booklet

    • PDF size: 1.34MB
    • Updated on: 04/07/2018

    Details and References relating to the CAST Inhalant, Venom, Food and Environmental Allergens

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  • Diagnosing Drug Allergy: A Rational Approach

    • PDF size: 10.26KB
    • Updated on: 05/07/2018

    Discussion by Dr Cathy van Rooyen, Allergy, Immunology & Virology Pathologist at AMPATH Pathology

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  • CAST Southampton NHST user report

    • PDF size: 11.09KB
    • Updated on: 09/07/2018

    The Department of Immunology describes their experience using the Basophil Activation Test in a clinical setting.

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Road map for the clinical application of the basophil activation test in food allergy
Santos, A.F. and Shreffler, W.G. Clin. & Exp. Allergy Volume 47, Issue 9, September 2017, Pages 1115–1124

Basophil activation test discriminates between allergy and tolerance in peanut-sensitized children
Santos at al. Journal of Allergy and Clinical Immunology;Volume 134, Issue 3, September 2014, Pages 645–652

Diagnosis of Immediate-Type ß-Lactam Allergy In Vitro by Flow-Cytometric Basophil Activation Test and Sulfi doleukotriene Production: A Multicenter Study
De Weck at al. J Investig Allergol Clin Immunol;Volume 19, Issue 2, 2009, Pages 91-109

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