Allergy to PEG (polyethylene glycol) – sensitivity of basophil activation test with COVID-19 mRNA-vaccine BNT162B2

ABSTRACT

Basophil activation test (BAT) with COVID-19 mRNA vaccine seems particularly suitable for detecting sensitization to polyethylene glycol (PEG) in patients with PEG allergy. It was the aim of this study to determine the cutoffs for BAT using BNT162B2 (Comirnaty®) in a larger group of PEG allergic patients and controls. 10 PEG allergic patients and 10 controls were studied. BAT was performed using anti-CCR3 for basophil identification and anti-CD63 to assess basophil activation. Incubations with BNT162B2 at four different concentrations were performed. Basophil activation was significantly higher in PEG allergic patients compared to controls at the higher concentrations used. ROC curves showed best results with a sensitivity of 60% and specificity of 100% with a cutoff of 5% CD63⁺ basophils at a concentration of 4.5 µg/ml. Controls showed no positive results. In our group of PEG allergic patients, a concentration of 4.5 µg/ml BNT162B2 with a cutoff of 5% CD63⁺ basophils was the most suitable condition for identifying patients with a sensitization to PEG. Allergological work-up of PEG allergic patients including BAT with PEGylated lipid nanoparticles might play a role in the future when these substances will be used for other vaccines and cancer immunotherapies.

KEYWORDS:

• Basophil activation test
• polyethylene glycol allergy
• BNT162B2
• PEGylated lipid nanoparticles
• CD63

Acknowledgments

We thank Franziska Martin for her excellent technical support.

Disclosure statement

BE reports non-financial support from Bühlmann Laboratories outside the submitted work. KB received lecture fees from ALK, Bencard and ThermoFisher and reports non-financial support from Bühlmann Laboratories outside the submitted work. The rest of the authors declare that they have no relevant conflicts of interest.

Author contribution

BE conceived, designed and supervised the experiments. BE had full access to all of the data in the study, is the guarantors of this study and wrote the paper. SM, UD, TB and KB have made contributions to the allergology work-up of the patients, data interpretation and revision of the manuscript. All authors agree to be accountable for all aspects of the work.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website at https://doi.org/10.1080/21645515.2024.2312600.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.