{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T15:40:23Z","timestamp":1768318823078,"version":"3.49.0"},"reference-count":72,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:00:00Z","timestamp":1614643200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Autoimmune chronic spontaneous urticaria (CSU) is due to mast cell (MC)\u2010activating autoantibodies, which are screened for by the autologous serum skin test (ASST) and basophil tests (BTs). Many CSU patients are positive in only one of these tests. How often this occurs and why is currently unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To characterize the prevalence of mismatched ASST and BTs in CSU patients, and to investigate possible reasons for these mismatches.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We determined the rates of ASST+\/BT\u2212 and ASST\u2212\/BT+ mismatches in published CSU studies. We assessed sera from 48 CSU patients by ASST, two BTs (basophil histamine release assay, BHRA; basophil activation test, BAT), a MC histamine release assay (MCHRA) and by <jats:italic>ex vivo<\/jats:italic> skin microdialysis (SMD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The ASST\/BT mismatch rate in published CSU studies was 31% (ASST+\/BT\u2212: 22%, ASST\u2212\/BT+: 9%). In our patients, the ASST\/BHRA and ASST\/BAT mismatch rate was 35.4% (ASST+\/BHRA\u2212: 18.8% and ASST\u2212\/BHRA+: 16.7%) and 31.3% (ASST+\/BAT\u2212: 6.3% and ASST\u2212\/BAT+: 25.0%), respectively, and the two BTs were significantly correlated (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.0002). The use of heterologous MCs, <jats:italic>in vitro<\/jats:italic> and <jats:italic>in situ,<\/jats:italic> instead of basophils produced similar results (MCHRA mismatch: 47.9%, ASST+\/MCHRA\u2212: 18.8%, ASST\u2212\/MCHRA+: 29.2%; SMD mismatch: 40.0%, ASST+\/SMD\u2212: 10.0% and ASST\u2212\/SMD+: 30.0%), and the MCHRA was highly correlated with SMD results (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.0002).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The ASST and BTs show divergent results in a third of CSU patients. Mismatches cannot be explained by the choice of basophil assay, the type of heterologous cells exposed to CSU serum <jats:italic>in vitro<\/jats:italic> (basophils vs. mast cells), nor the experimental setting of heterologous skin mast cells (<jats:italic>in vitro<\/jats:italic> vs. <jats:italic>in situ<\/jats:italic>). Thus, serum\u2010induced whealing, in CSU patients, seems to involve autologous skin signals modulating MC degranulation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.17131","type":"journal-article","created":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T19:01:41Z","timestamp":1611255701000},"page":"1338-1345","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Autologous serum skin test reactions in chronic spontaneous urticaria differ from heterologous cell reactions"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0656-3897","authenticated-orcid":false,"given":"K.","family":"Baumann","sequence":"first","affiliation":[{"name":"Department of Dermatology and Allergy Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin Berlin Germany"},{"name":"RefLab ApS Copenhagen Denmark"},{"name":"LEO Foundation Skin Immunology Research Center, Department of Immunology and Microbiology 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