Responsiveness of Nasal Provocation Testing—But Not Skin Test and Specific Immunoglobulin E Blood Level—Correlates With Severity of Allergic Rhinitis in Dermatophagoides Species-Sensitized Patients

2018 ◽  
Vol 32 (4) ◽  
pp. 236-243 ◽  
Author(s):  
Wang Wanjun ◽  
Hu Qiurong ◽  
Xie Yanqing ◽  
Xian Mo ◽  
Wei Nili ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Immunoglobulin E ◽  
Life Questionnaire ◽  
Nasal Provocation ◽  
Nasal Symptoms ◽  
Sige Level ◽  
Specific Immunoglobulin E ◽  
Specific Immunoglobulin ◽  
Provocation Testing ◽  
Nasal Provocation Testing

Background The results of skin and blood allergen testing are not consistently relevant to clinical manifestations in allergic patients. Objective The aim of the study was to investigate the relationship between severity of allergic rhinitis and different allergen diagnostic tests in Dermatophagoides species-sensitized patients. Methods Study subjects included 65 rhinitis patients—50 with Dermatophagoides pteronyssinus (DP) sensitization (DP+) and 15 without DP sensitization (DP−), and 15 DP+ and 37 DP− healthy controls (HCs) confirmed by allergen skin prick (SPT) and blood specific immunoglobulin E (sIgE) tests. The Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) was tested. All subjects underwent DP nasal provocation test (DP-NPT). Visual analogue scoring (VAS) of nasal symptoms and nasal airway resistance (NAR) were measured before and after NPT. Correlations between the 3 allergen tests and score of RQLQ were performed. Results All rhinitis subjects had significantly higher VAS and NAR after DP-NPT than HCs ( P < .01). All DP+ rhinitis, 40% of DP− rhinitis subjects, 13.3% of DP+ HCs and 0% of DP− HCs had positive DP-NPT. Dose of positive DP-NPT positively correlated with SPT diameter and sIgE level in all tested subjects ( P < .001). Score of RQLQ positively correlated with dose of DP-NPT ( P < .001), but not with SPT diameter and sIgE level in rhinitis patients. Conclusion Although DP nasal provocation, skin prick wheal size and blood sIgE level correlate with each other, only nasal provocation testing is associated with severity of nasal symptoms. It is suggested that NPT should be performed to verify a clinically relevant allergy.

The Importance of Nasal Provocation Testing in the Diagnosis of Dermatophagoides pteronyssinus-Induced Allergic Rhinitis

2021 ◽  
pp. 194589242110379
Author(s):  
Hao Xiao ◽  
Qiaoru Jia ◽  
Hongting Zhang ◽  
Li Zhang ◽  
Guo Liu ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Immunoglobulin E ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Dermatophagoides Pteronyssinus ◽  
Allergen Specific Immunotherapy ◽  
Prick Test ◽  
Nasal Provocation ◽  
Provocation Testing ◽  
Nasal Provocation Testing

Background Allergen identification is the first step for allergen-specific immunotherapy (AIT) of allergic rhinitis (AR). Currently, the diagnosis of AR is based mainly on the positive results of the skin prick test (SPT) and/or serum specific immunoglobulin E (sIgE) measurement. However, the results of these two tests may not always directly correlate with AR. Objective To investigate the importance of nasal provocation testing (NPT) in the diagnosis of Dermatophagoides pteronyssinus (Der p)-induced AR. Methods Rhinitis patients willing to undergo AIT (n = 171) were enrolled. The correlations of Der p SPT, sIgE, NPT, and clinical symptom severity were assessed. Results NPT-positive responses were more common in patients with higher SPT and sIgE levels. The optimal cut-off value for a NPT-positive response for SPT was 5.5 mm and for sIgE was 2.77 kUA/L, based on the respective receiver operating characteristic (ROC) curves. The area under the curve (AUC) of the ROCs was 0.814 (SPT only) and 0.794 (sIgE only) and increased to 0.828 with the combination of SPT and sIgE. The Der p-NPT concentration was inversely correlated with SPT and sIgE levels ( r = −0.477, P < .001, and r = −0.461, P < .001, respectively), but none was correlated with the total nasal symptom score. Conclusion For patients who are willing to receive Der p AIT, NPT is a useful and safe test to confirm diagnosis prior to treatment initiation, especially in patients with lower levels of Der p SPT (< 5.5 mm) or sIgE (< 2.77 kUA/L).

scholarly journals High Dust Mite specific Immunoglobulin E (sIgE): a Promising Indicator of Allergic Rhinitis to Asthma

2020 ◽  
Author(s):  
Rui Tang ◽  
Xiaohong Lyu ◽  
Yuelun Zhang ◽  
Shi Chen ◽  
Hong Li
Keyword(s):  
Allergic Rhinitis ◽  
House Dust ◽  
House Dust Mite ◽  
Immunoglobulin E ◽  
House Dust Mites ◽  
Kaplan Meier ◽  
Sige Level ◽  
Specific Immunoglobulin E ◽  
Dust Mite ◽  
Specific Immunoglobulin

Abstract Background: House dust mites are the most prevalent allergens in patients with asthma and/or rhinitis in China. Cross-sectional data in 2009 have shown that allergic rhinitis often preceded or occurred at the same time as asthma in patients which was used to investigate the association of serum specific immunoglobulin E (sIgE) levels to house dust mite with the onset of asthma in patients with allergic rhinitis. Methods: 321 patients with allergic rhinitis were face-to-face interviewed and underwent sIgE tests to house dust mite. The temporal sequence of allergic rhinitis and asthma was documented. Univariate analysis, multinomial logistic regression, and Kaplan-Meier survival analysis were performed. Results: Of the 321 participants, 213 (66.4%) had asthma, which occurred after or simultaneously with rhinitis, and 108 (33.6%) suffered from allergic rhinitis only. After controlling basic parameters, factors correlated to sIgE, and essential factors considered by clinical allergists, the risk of developing asthma always increased with the levels of sIgE to house dust mite in all four models (p < 0.01). In Kaplan–Meier analysis, in the first ten years with allergy rhinitis, a high sIgE level represented a high probability of the coexistence of allergic rhinitis and asthma (p < 0.01). For house dust mite sIgE level 5-6, 5 years Rhinitis-Asthma Conversion Rate (RACR) had reached almost 70%. Conclusion: High-level house dust mite sIgE can exist as an indicator of rhinitis to asthma. It provides a theoretical basis for early intervention in patients with high sIgE levels in order to prevent asthma. This assessment and intervention should be performed at the early stage of rhinitis.

Local Atopy in Childhood Adenotonsillar Hypertrophy

2018 ◽  
Vol 32 (3) ◽  
pp. 160-166 ◽  
Author(s):  
Kyu-Sup Cho ◽  
Seong Heon Kim ◽  
Sung-Lyong Hong ◽  
Jaeyoung Lee ◽  
Sue Jean Mun ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Risk Factor ◽  
Immunoglobulin E ◽  
Clinical Symptoms ◽  
Allergic Inflammation ◽  
Inhalant Allergen ◽  
Adenotonsillar Hypertrophy ◽  
Nasal Symptoms ◽  
Specific Immunoglobulin E ◽  
Specific Immunoglobulin

Background Although the cause of adenotonsillar hypertrophy remains unknown, some studies have shown that allergy may be a risk factor. Purpose This study determined the levels of allergen-specific immunoglobulin E (sIgE) in the adenotonsillar tissues of children with adenotonsillar hypertrophy and evaluated the clinical significance of local atopy in adenotonsillar tissues. Methods We measured 21 types of specific immunoglobulin E in the serum and adenotonsillar tissues of 102 children with adenotonsillar hypertrophy and compared the sensitization patterns of the serum and local tissues. The patients were divided into three groups—atopy, local atopy, and nonatopy—according to the sensitization of serum and adenotonsillar tissues, and the clinical symptoms among the groups were analyzed. Results Seventy-two (70.6%) children with adenotonsillar hypertrophy were sensitized to more than one allergen in the serum and/or adenotonsillar tissue. Thirty (29.4%) children had no IgE positivity to any allergen in both serum and adenotonsillar tissues. Fifty-five (53.9%) were sensitized to at least one allergen in the serum. Seventy (68.6%) were sensitized to at least one allergen in the adenotonsillar tissue. Seventeen (36.2%) of 47 children with specific immunoglobulin E-negative serum had specific immunoglobulin E-positive adenotonsillar tissues. The rate of specific immunoglobulin E was significantly higher in local tissues than in serum. The rate of inhalant allergen specific immunoglobulin E was significantly higher in the adenoids than in the tonsils. However, the rate of food allergen specific immunoglobulin E was significantly higher in the tonsils than adenoids. The lifetime prevalence of asthma and allergic rhinitis, recent symptoms or treatment of allergic rhinitis, and severity of nasal symptoms (rhinorrhea, sneezing, and nasal itching) were significantly higher in children with local atopy than with nonatopy. Conclusions These results confirm that allergic response may be a risk factor for adenotonsillar hypertrophy. Local allergic inflammation may play an important role in childhood adenotonsillar hypertrophy, and local atopy in adenotonsillar tissues can cause respiratory allergic symptoms in children.

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