Airway Nitric Oxide in Children with HDM-Induced Allergic Rhinitis

2021 ◽  
pp. 194589242110644
Author(s):  
Woralak Sutiratanachai ◽  
Watcharoot Kanchongkittiphon ◽  
Natchanun Klangkalya ◽  
Wanlapa Jotikasthira ◽  
Potjanee Kiewngam ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Allergic Rhinitis ◽  
Provocation Test ◽  
Specific Ige ◽  
Nasal Symptom ◽  
Roc Curve Analysis ◽  
Prick Test ◽  
Vas Score ◽  
Total Nasal Symptom Score ◽  
Wheal Diameter

Background Rhinitis is a common problem in children. Airway nitric oxide (NO) was proposed to represent eosinophilic inflammation. Objectives To evaluate airway NO level in children with house dust mite (HDM)-induced allergic rhinitis Methods Children aged 5 to 18 years old with moderate–severe persistent rhinitis and positive result for the HDM nasal provocation test (NPT) was enrolled. The nasal symptoms evaluated by total nasal symptom score (TNSS) and visual analog scale (VAS) were recorded. Skin prick test (SPT) to common aeroallergens, fractional exhaled nitric oxide (FeNO), nasal nitric oxide (nNO), and blood test for specific IgE (sIgE) to HDM was measured. Rhinitis severity was categorized as severe if the VAS score > 7. Results Forty-eight children with HDM-induced allergic rhinitis with the mean age of 9.3 ± 2.4 years were enrolled. nNO levels and VAS score were significantly correlated (R = 0.398, P = .005). Children with severe rhinitis had significantly higher nNO levels than moderate rhinitis (1652.05 vs 941.30 parts per billion [ppb], P = .002), while there was no difference in FeNO level. ROC curve analysis demonstrated the cut-off value of nNO at 1350 ppb (AUC 0.764, 95% CI: 0.616-0.911, P = .002) for detecting severe HDM-induced allergic rhinitis with the sensitivity of 78% and the specificity of 71%. The level of FeNO in children who had HDM mean wheal diameter (MWD) > 8 mm was significantly higher than those with HDM MWD of 3 to 8 mm and those with a negative test (39.7 vs 14.3 vs 14.4 ppb; P = .006, respectively). Children who had sIgE to HDM < 0.35 KUA/L had significantly lower FeNO than those with sIgE to HDM 0.35 to 50 KUA/L and >50 KUA/L (9.5 vs 19.7 vs 40.4 ppb; P = .029, respectively). Conclusions Cut-off value for the diagnosis of severe HDM-induced chronic rhinitis was proposed. Rhinitis children who had a higher degree of HDM sensitization had a higher level of FeNO.

Skin Prick Test Versus Phadiatop as a Tool for Diagnosis of Allergic Rhinitis in Children

2020 ◽  
Vol 35 (1) ◽  
pp. 98-106
Author(s):  
Sasiwimon Traiyan ◽  
Wiparat Manuyakorn ◽  
Watcharoot Kanchongkittiphon ◽  
Cherapat Sasisakulporn ◽  
Wanlapa Jotikasthira ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Skin Prick Test ◽  
Provocation Test ◽  
Specific Ige ◽  
Prick Test ◽  
The Past ◽  
Negative Results ◽  
Dust Mite ◽  
The Mean ◽  
Positive Results

Background Skin prick test (SPT) or Phadiatop, a multi-allergen IgE screening test, was used as a tool for detecting aeroallergen sensitization. Objective To compare SPT and Phadiatop as a tool for diagnosis allergic rhinitis (AR) using the nasal provocation test (NPT) as a comparative standard. Methods Children aged 5-18 years with rhinitis symptoms more than 6 times in the past year were enrolled. SPT to 13 common aeroallergens, serum for Phadiatop, and NPT to Dermatophagoides pteronyssinus (Der p) were performed. NPT to mixed cockroach (CR) were performed in children who had CR sensitization and negative NPT to Der p. Children who had a disagreement between the result of SPT and Phadiatop or having negative results were evaluated for specific IgE (sIgE) to common aeroallergens. Results One hundred-forty children were enrolled with the mean age of 9.8 ± 3 years, 56% were male. Of 92 children (65.7%) with positive SPT to any aeroallergens, 88 children (95.6%) were sensitized to house dust mite (HDM). NPT showed positive results in 97 children (69.3%). Of 48 children who showed negative SPT, 4 children (8.3%) had sIgE to aeroallergens but NPT was positive in 1 child. Eighty-eight children (62.9%) had positive tests for Phadiatop and 4 (4.5%) of them had negative results for NPT to Der p. Among 52 children who had negative results for Phadiatop, 4 children (7.6%) had sIgE to aeroallergens but NPT was positive in 2 children (3.8%). SPT and Phadiatop showed 94.2% agreement: with Kappa 0.876, p < 0.001. Using NPT as a comparative standard for diagnosis for AR, SPT showed a sensitivity of 89.6% and specificity of 88.3% and Phadiatop provided the sensitivity of 88.6% and specificity of 95.3%. Conclusions SPT to aeroallergen and Phadiatop have good and comparable sensitivity and specificity for the diagnosis of AR in children.

scholarly journals COMPARATIVE STUDY ON THE EFFICACY OF MOMETASONE AND FLUTICASONE NASAL SPRAYS FOR TREATMENT OF ALLERGIC RHINITIS

2017 ◽  
Vol 9 (3) ◽  
pp. 211
Author(s):  
Mahshid Sadat Mirmoezzi ◽  
Mohammad Shurideh Yazdi ◽  
Omid Gholami
Keyword(s):  
Allergic Rhinitis ◽  
Nasal Spray ◽  
Allergic Diseases ◽  
Nasal Symptom ◽  
P Value ◽  
Inclusion Criteria ◽  
Prick Test ◽  
Nasal Sprays ◽  
Total Nasal Symptom Score ◽  
The Difference

Objective: Allergic rhinitis is the most prevalent of allergic diseases in the world. Nasal corticosteroids are the most applicable drugs for the treatment of allergic rhinitis. In this study, we compared the efficacy of fluticasone propionate (FP) and mometasone furoate (MF) nasal sprays in the treatment of allergic rhinitis based on total nasal symptom score (TNSS) questionnaire.Methods: For this study, 75 allergic rhinitis patients based on skin prick test and inclusion criteria were randomly assigned to two groups: FP and MF groups. FP group received 200 µg dose of FP nasal spray (1 spray/nostril) daily and the MF group received 100 mg dose of MF nasal spray (1 spray/nostril) daily for 8 w. The effects of the two agents were compared based on TNSS questionnaire in 0, 4 and 8 w after the beginning of the treatment.Results: Results showed that patients in both groups exhibited significant improvement in their TNSS (P Value<0.001). A detailed TNSS analysis showed MF to be more effective for relieving all symptoms than FP. The most difference is in decreasing postnasal discharge (PND) symptom. However, the difference for relieving all symptoms is not significant (P value>0.05).Conclusion: In conclusion, FP and MF are significantly effective in relieving of allergic rhinitis symptoms. Even though, the difference between the two is not significant for 8 w therapy. 

Correlation of Nasal Fluid Biomarkers and Symptoms in Patients with Persistent Allergic Rhinitis

2020 ◽  
Vol 129 (6) ◽  
pp. 542-547
Author(s):  
Su Il Kim ◽  
Oh Eun Kwon ◽  
Jung Min Park ◽  
Jeon Gang Doo ◽  
Seok Hyun Kim ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Inverse Correlation ◽  
Lavage Fluid ◽  
Nasal Symptom ◽  
Clara Cell ◽  
Cell Protein ◽  
Enzyme Linked Immunosorbent Assay ◽  
Prick Test ◽  
Persistent Allergic Rhinitis ◽  
Nasal Fluid

Objectives: This study investigated whether the biomarkers present in nasal fluid reflect the severity of symptoms in patients with persistent allergic rhinitis (PAR). Methods: We enrolled 29 PAR patients complaining of nasal symptoms and testing positive to skin prick test. Patients’ total nasal symptom score (TNSS) was measured and their nasal lavage fluid (NALF) was collected. The levels of biomarkers including Clara cell protein 16 (CC16), tryptase, and interleukin 5 (IL-5) in NALF were determined via enzyme-linked immunosorbent assay (ELISA). Results: PAR patients were classified into persistent mild and persistent moderate-to-severe groups according to the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines. The CC16 alone was significantly negatively correlated with TNSS ( P < .05). Further, the CC16 level was significantly lower in persistent moderate-to-severe group than persistent mild group of patients ( P < .05). Conclusions: The levels of CC16 alone among several NALF biomarkers showed an inverse correlation with symptoms of PAR patients.

scholarly journals Study of causal aeroallergens in allergic rhinitis

2019 ◽  
Vol 5 (4) ◽  
pp. 916
Author(s):  
Divya Aggarwal ◽  
Abhilash S. ◽  
Sunil Kapur ◽  
Divya Gupta
Keyword(s):  
Allergic Rhinitis ◽  
Skin Prick Test ◽  
Symptom Score ◽  
Eosinophil Count ◽  
Severe Disease ◽  
Nasal Symptom ◽  
Total Serum ◽  
Serum Ige ◽  
Prick Test ◽  
Absolute Eosinophil Count

<p class="abstract"><strong>Background:</strong> The diagnosis of allergic rhinitis requires a detailed history, thorough clinical examination and identification of aeroallergens by skin prick test. The diagnosis cannot be confirmed on the basis of symptoms alone because both allergic and non-allergic rhinitis can present with similar symptoms. The present study was undertaken to identify the common aeroallergens causing allergic rhinitis and to find any relationship of the severity of patient’s symptoms with raised levels of absolute eosinophil count, percentage of eosinophils in the peripheral blood and total serum IgE.</p><p class="abstract"><strong>Methods:</strong> It is cross sectional study was conducted among 100 patients including both the genders attending out-patient department of ENT. The patients were divided into mild, moderate and severe disease categories based on nasal symptom score (NSS) which was calculated taking into account the severity of four symptoms namely sneezing, watery rhinorrhoea, itching sensation in nose and nasal obstruction.  </p><p class="abstract"><strong>Results:</strong> 76% of patients had moderate nasal symptom score and 42% had symptoms of allergic rhinitis for less than 3 years. The prevalence of skin prick test was strongly positive for pollens (46.19%), followed by dust (16.4%), dust mites (15.7%), fungus (9.7%), insects (9.24%) and epithelia (2.77%). But, among 68 aeroallergens, most common offending allergen was D-farinae (30%). There was no significant relationship found to exist between Eosinophilia, Absolute eosinophil count and serum IgE level with that of nasal symptom score.</p><p class="abstract"><strong>Conclusions:</strong> Skin prick test is the gold standard investigation of choice for definitive diagnosis of allergic rhinitis.</p><p class="abstract"> </p>

scholarly journals Efektivitas salin hipertonik terhadap waktu transpor mukosiliar dan skor gejala hidung penderita rinitis alergi

2018 ◽  
Vol 47 (2) ◽  
pp. 123
Author(s):  
Woro Safitri ◽  
Dwi Reno Pawarti ◽  
Titiek Hidayati Ahadiah
Keyword(s):  
Clinical Trial ◽  
Allergic Rhinitis ◽  
Symptom Score ◽  
Saline Group ◽  
Nasal Symptom ◽  
Control Group ◽  
Mucociliary Transport ◽  
Transport Time ◽  
Total Nasal Symptom Score ◽  
The Mean

Latar belakang: Rinitis alergi (RA) adalah suatu penyakit inflamasi mukosa hidung yang diperantara oleh imunoglobulin E (IgE), setelah mukosa hidung terpapar alergen. Tujuan: Mengidentifikasi efektivitas cuci hidung salin hipertonik terhadap waktu transpor mukosiliar dan skor gejala hidung total (SGHT) pada penderita RA. Metode: Penelitian dilaksanakan pada bulan Juli hingga Desember 2016 di Poli Telinga Hidung Tenggorok – Bedah Kepala Leher Rumah Sakit Dr. Soetomo Surabaya. Uji klinis acak terkontrol pada 2 kelompok dengan desain control group in clinical trial. Pengambilan sampel dilakukan secara consecutive sampling. Uji korelasi yang digunakan adalah uji t berpasangan dan uji Wilcoxon. Hasil: Didapatkan sampel 42 penderita, yaitu 21 penderita pada kelompok loratadin, serta 21 penderita pada kelompok loratadin dan cuci hidung salin hipertonik. Didapatkan rerata penurunan transpor mukosiliar kelompok loratadin dan cuci hidung salin hipertonik lebih bermakna daripada kelompok loratadin (p=0,001). Penurunan transpor mukosiliar kelompok loratadin didapatkan rerata -2,30 (SD=2,77), kelompok loratadin dan cuci hidung salin hipertonik didapatkan rerata -6,27 (SD=3,91). Penurunan SGHT kelompok loratadin didapatkan rerata -2,48 (SD=1,72), sedangkan kelompok loratadin dan cuci hidung salin hipertonik didapatkan rerata -4,3 (SD=1,20). Kesimpulan: Penambahan cuci hidung salin hipertonik pada terapi loratadin lebih efektif dibandingkan terapi tunggal loratadin dalam menurunkan transpor mukosiliar dan SGHT pada penderita RA. Kata kunci: Loratadin, cuci hidung salin hipertonik, transpor mukosiliar, skor gejala hidung total, rinitis alergi ABSTRACT Background: Allergic rhinitis (AR) is a nasal mucous membrane inflamatory which mediated by Imunoglobulin E (IgE) after allergen exposure in nasal mucosa. Purpose: To identify the effectiveness of nasal hypertonic saline irrigation on reduction of mucociliary transport time (MCTT) and total nasal symptom score (TNSS) in AR patients. Methods: The was conducted from July until December 2016 in Oto Rhino Laryngology - Head and Neck Surgery of Dr. Soetomo Hospital Surabaya. The study was randomized controlled clinical trials on two groups, with the control group in clinical trial design. Paired t and Wilcoxon test was used as the correlation test. Results: There was 42 patients, 21 patients in loratadine group, and 21 patients in loratadine with hypertonic nasal saline group. The average of mucociliary transport time decrease of loratadine with hypertonic nasal saline group was more significant than loratadine group (p=0.001). The mean of decreasing mucociliary transport time in loratadine group was -2.30 (SD=2.77) and loratadine with hypertonic nasal saline group was -6.27 (SD=3.91). The mean of decreasing TNSS in loratadin group was -2.48 (SD=1.72), and loratadin with hypertonic nasal saline group was -4.3 (SD=1.20). Conclusions: The addition of hypertonic nasal saline in loratadine was more effective, compared to monotherapy of loratadine in decreasing mucociliary transport time and TNSS in patient with AR. Keywords: Loratadine, hypertonic nasal saline, mucociliary transport, total nasal symptom score, allergic rhinitis

scholarly journals Local allergic rhinitis

2014 ◽  
Vol 67 (suppl. 1) ◽  
pp. 49-56
Author(s):  
Maja Buljcik-Cupic ◽  
Dragana Lemez ◽  
Slobodan Savovic ◽  
Ljiljana Jovancevic ◽  
Danijela Dragicevic
Keyword(s):  
Allergic Rhinitis ◽  
Nasal Mucosa ◽  
Immunoglobulin E ◽  
Provocation Test ◽  
Allergic Response ◽  
Prick Test ◽  
Local Allergic Rhinitis ◽  
Provocation Tests ◽  
Number Of Patients ◽  
The Impact

Local allergic rhinitis is a localized allergic response of the nasal mucosa to aeroallergens in the absence of atopy with characteristic production of specific local immunoglobulin E antibodies in the nasal mucosa, T helper type 2 cellular infiltration response during the exposure to aeroallergens and positive results via the nasal allergic provocation test with the release of inflammatory mediators (triptase and eosinophil cationic proteins). Even though the prevalence of local allergic rhinitis has been and is still being investigated, a large number of patients with diagnosed non-allergic rhinitis or idiopathic rhinitis are currently classified as having local allergic rhinitis. The causes of local allergic rhinitis are most commonly house dust, dust mites, pollens and many others. Diagnosis of local allergic rhinitis is made using nasal allergen provocation tests when the prick test for standard inhalation allergens and the serum specific immunoglobulin analysis for aeroallergens are negative. The increasing amount of data on localized allergic response in non-atopic patients asks for many answers regarding local allergic rhinitis. These answers can be obtained by a study on the prevalence and incidence in children and adults, the impact of positive family atopy in the development of disease, the impact of associated diseases of the lower respiratory tract and conjunctiva, the effectiveness of drug treatment and the issue of administration of specific immunotherapy.

Potential Differences between Local and Systemic Allergic Rhinitis Induced by Birch Pollen

2020 ◽  
Vol 181 (11) ◽  
pp. 831-838
Author(s):  
Andrzej Bozek ◽  
Jolanta Zalejska Fiolka ◽  
Anna Krajewska Wojtys ◽  
Beata Galuszka ◽  
Anna Cudak
Keyword(s):  
Allergic Rhinitis ◽  
Birch Pollen ◽  
Provocation Test ◽  
Basophil Activation Test ◽  
Specific Ige ◽  
Immunological Parameters ◽  
Local Allergic Rhinitis ◽  
Before And After ◽  
Intermittent Allergic Rhinitis ◽  
Bet V1

<b><i>Introduction:</i></b> Different endotypes of rhinitis are known, but its pathomechanism has not been conclusively established. For example, the precise difference between systemic allergic rhinitis (SAR) and local allergic rhinitis (LAR) is still being checked. Comparison of patients with LAR and with allergies to birch of those with intermittent allergic rhinitis, same allergy, or with non-allergic rhinitis (NAR) was the purpose of this study. <b><i>Methods:</i></b> Twenty-six patients with LAR, 18 with SAR and allergy to birch, and 21 with NAR were included. Patients who met the inclusion criteria were selected to undergo the following procedures at baseline: medical examinations, nasal provocation test (NPT), detection of nasal-specific IgE to birch as well as basophil activation test (BAT). All immunological parameters were detected before and after NPT. <b><i>Results:</i></b> Concentration of nasal IgE to Bet v1 increased comparably in the LAR and SAR groups after NPT to birch as follows: in 21 (81%) patients with LAR, 14 (78%) with SAR, and in everyone in the NAR group. Serum concentration of allergen-specific IgE to Bet v1 increased significantly from a median of 20.7 (25–75% interval: 11.2–35.6) IU/mL to 29.9 (13.6–44.1) (<i>p</i> = 0.028) after NPT in patients with SAR. Allergen-specific IgE to Bet v1 was absent in all patients with LAR and NAR before and after NPT. BAT with Bet v1 was positive in 22 (85%) patients with LAR, in 14 (78%) with SAR, and 2 (9.5%) with NAR. <b><i>Conclusion:</i></b> These obtained data suggest there are no potential mechanisms that could explain LAR compared to SAR.

scholarly journals Role of Predatory Mites in Persistent Nonoccupational Allergic Rhinitis

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Paloma Poza Guedes ◽  
Inmaculada Sánchez Machín ◽  
Víctor Matheu ◽  
Víctor Iraola ◽  
Ruperto González Pérez
Keyword(s):  
Allergic Rhinitis ◽  
Provocation Test ◽  
Atopic Disease ◽  
Control Group ◽  
Clinical Role ◽  
Prick Test ◽  
Ige Response ◽  
Cheyletus Eruditus ◽  
Predator Mite

Mites can sensitize and induce atopic disease in predisposed individuals and are an important deteriorating factor in patients with allergic rhinitis, asthma, and atopic dermatitis. Although Pyroglyphidae mites have been extensively studied, very scarce reports are available on Cheyletidae spp. especially regarding human respiratory pathology. The main objective of the present study is to investigate the clinical role of this predator mite (Cheyletus eruditus) as a respiratory antigen in a selected sensitized human population. Fifty-two adult patients were recruited from the outpatient allergy clinic to assess their eligibility for the study. The thirty-seven subjects with persistent allergic rhinitis (PAR) who fulfilled the ARIA criteria had a positive IgE response confirmed by skin prick test (SPT) toC. eruditus. Only those individuals (37/47) with a positive SPT toC. eruditusshowed a positive nasal provocation test (NPT), while 10 patients with nonallergic mild-to-moderate persistent rhinitis,control group, had a negative NPT withC. eruditus. The present paper describes a new role for the predator miteCheyletus eruditusas a respiratory allergen in a selected subset of patients in a subtropical environment afflicted with persistent nonoccupational allergic rhinitis.

Skin Prick Test and Serum Specific IgE May Not Be Sufficient for the Diagnosis of Perennial Allergic Rhinitis in Atopic Patients

2013 ◽  
Vol 131 (2) ◽  
pp. AB41
Author(s):  
Miguel Blanca ◽  
Carmen Rondon ◽  
Paloma Campo ◽  
Francisca Gomez ◽  
Rosa García Mendoza ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Skin Prick Test ◽  
Specific Ige ◽  
Perennial Allergic Rhinitis ◽  
Prick Test

scholarly journals KAITAN IgE SPESIFIK METODE IMUNOBLOT TERHADAP ELISA PADA RINITIS ALERGI (Association Between Specific IgE Immunoblot Method with ELISA on Allergic Rhinitis)

2018 ◽  
Vol 21 (3) ◽  
pp. 298
Author(s):  
Aryati Aryati ◽  
Dwi Retno Pawarti ◽  
Izzuki Muhashonah ◽  
Janti Tri Habsari
Keyword(s):  
Allergic Rhinitis ◽  
Correlation Coefficient ◽  
Sensitivity And Specificity ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Specific Ige ◽  
Total Serum ◽  
Inhalant Allergen ◽  
Elisa Method ◽  
Prick Test

Allergic rhinitis is an allergic disease that is most often found beside bronchial asthma and eczema with the prevalence of is about33.3%, 9.8% and 11.2% respectively. The main examinations of allergic rhinitis are Skin Prick Test (SPT) and specific IgE, becausethe sensitivity and specificity of specific IgE examination depend on the examination method. To know the diagnostic value of specificIgE immunoblot examination by determination and were compared with ELISA in patients with allergic rhinitis. The cross-sectionaldesign of the study is con-ducted on patients at the Outpatient Clinic Department of ENT-Head and Neck from May until October 2014.Patients were grouped as diagnosis of allergic rhinitis and non-allergic non-infectious rhinitis based on clinical signs and symptoms,physical examina-tion, positive in SPT examination with or without an increase in total serum IgE and/or blood eosinophils. SpecificIgE immunoblot was conducted by using Foresight®, Acon Laboratories and the ELISA method using Allercoat™. The sensitivity andspecificity of inhalant allergen -specific IgE immunoblot Foresight® method was 73.9% and 42.9%, respectively. The sensitivity andspecificity of inhalant allergen -specific IgE ELISA method was 67.4% and 57.1%, respectively. The results of these two methods havea correlation coefficient 0.531 with p=0.000. The sensitivity and specificity of ingestan allergen specific IgE immunoblot Foresight®method was 41.3% and 85.7%, respectively. The sensitivity and specificity of ingestan allergen specific IgE ELISA method was 17.4 and78.6%, res-pectively. Results of these two methods have a correlation coefficient 0.375 with p=0.003. Based on this study of specificIgE immunoblot and ELISA methods, both have diagnostic sensitivity and specificity, which are almost the same. The sensitivity ofimmunoblot method inhalant allergens are superior to ELISA. The Immunoblot method ingestan allergen specificity is superior toELISA.

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