Correlation of Skin Test Results and Specific Immunoglobulin E Blood Levels with Nasal Provocation Testing for House-Dust Mite Allergies

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.

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Specific Immunoglobulin E and Immunoglobulin G4 toward Major Allergens of House-Dust Mite during Allergen-Specific Immunotherapy

American Journal of Rhinology and Allergy ◽

10.2500/ajra.2017.31.4434 ◽

2017 ◽

Vol 31 (3) ◽

pp. 156-160 ◽

Cited By ~ 7

Author(s):

Jianjun Chen ◽

Yue Zhou ◽

Yanjun Wang ◽

Yiwu Zheng ◽

Xuxin Lai ◽

...

Keyword(s):

House Dust ◽

House Dust Mite ◽

Immunoglobulin E ◽

Allergen Specific Immunotherapy ◽

Specific Immunoglobulin E ◽

Dust Mite ◽

Specific Immunoglobulin ◽

Clinical Responses ◽

Major Allergens ◽

Group 2

Background Specific immunoglobulin E (sIgE) and sIgG4 to house-dust mite (HDM) major allergens during allergen immunotherapy (AIT) and their clinical relevance remain unclear. Objective To investigate the variation of sIgE and sIgG4 to HDM major allergens and the correlation with clinical responses during AIT in patients with allergic rhinitis. Methods Thirty-nine patients with HDM allergy were divided into the AIT group (taking immunotherapy) and the control group (medication only use). The AIT group was subdivided into negative clinical responses to AIT (nAIT) group and positive clinical responses to AIT (pAIT) group according to symptom relief and subjective evaluation. sIgE and sIgG4 to Dermatophagoides pteronyssinus (Dp) and Dermatophagoides farinae (Df), and their group 1 and group 2 major allergens (Dp1, Df1, Dp2, and Df2) were measured before AIT, at 6 months, and at 1 year after starting AIT. Results Dp2, Df, and Df2 sIgE values decreased significantly in the pAIT group versus the nAIT group after 1 year of AIT (median values of delta change were Dp2, -10.09 versus 5.89 kU/L, p = 0.001; median values of Df were —9.69 versus 17.54 kU/L, p = 0.004; median values of Df2 were -11.06 versus 20.08 kU/L, p = 0.013). There was a robust increase in the sIgG4 values to Dp, Df, and their major allergens in both the pAIT and the nAIT groups overall after 1 year of treatment. Conclusion Patients with a positive response to AIT showed a significant reduction of HDM group 2 sIgEs compared with those with a negative response to AIT, which indicated that a decrease in group 2 sIgEs could be a marker that reflected AIT clinical efficacy.

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

10.21203/rs.3.rs-41257/v1 ◽

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.

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