Intérêt d’un nouveau protocole de cytomètrie en flux appliqué au diagnostic et à la prévention des accidents peranesthésiques aux curares

Abstract

Aim of the study

We tested here a new cytometric method based on the use of two activation markers (CD63 and IgE) and result's expression in activation index (AI).

Material and methods

Twenty-six allergic patients and 23 controls having received a neuromuscular blocker (NMB) have been selected on the basis of clinical history, skin tests and specific IgEs. NMB were tested mixed (n = 26) or alone (injectable form, (n = 30) and allergens commercialized for flow cytometry (n = 9)). Concentrations used were the same than for IDR according to the recommandations of the French Society of Anaesthesia and Resuscitation (SFAR). The cytometric protocol used was the IgE/CD63 protocol, results being expressed in percentage CD63 and in AI calculated by a specific algorithm involving the mean fluorescence intensity (MFI) of the IgE+ and the CD63+ and − populations.

Results

In the technical described here NMB exhibited no toxicity even for concentretions 10 times higher than concentrations used for diagnosis. With the injectable form, the respective sensitivities observed for CD63 alone and the AI were 68 and 100% for the mixture of NMB and, 67 and 100% for the isolated NMB. With the NMB commercialized for flow cytometry, sensitivities were 47 and 100%. Specificities were 100% for CD63 alone and 98% for the AI. The link (Chi²) between skin tests and flow cytometry was significant for the two markers and the two allergen types. Correlation between AI and specific IgEs was not significant.

Conclusion

The new flow cytometric protocol described here has the necessary characteristics of a biological test which could be included in the pre-anaesthetic check up.