Specific nasal provocation tests in patients hypersensitive to mould allergens.
BACKGROUND
In the case of allergies to outdoor mould spores and plant pollen allergens, which are often concomitant, doubts may arise as to the role of mould allergens in inducing specific clinical manifestations. Establishing their significance is crucial for qualifying the patient for specific immunotherapy. This information also helps to reduce the percentage of therapeutic failures.


METHODS
The study population comprised 31 patients with seasonal allergic rhinitis who were allergic to both plant pollen allergens and mould spores. In each patient we performed a skin prick test, sIgE level determination, and a specific nasal provocation test using mould allergens, according to standard allergological diagnostic procedure, and the results were objectified using acoustic rhinometry.


RESULTS
Positive NPT results were obtained in 22 patients. The positive results were more frequent in persons allergic to Cladosporium herbarum (92.3%) than in those allergic to Alternaria alternata (55.5%); these differences were statistically significant (p = 0.039). No differences were found between the two subgroups in terms of the sIgE levels (p = 0.13). In the study group as a whole, a high correlation between the results of acoustic rhinometry and the intensity of clinical manifestations was observed after administration of the NPT (correlation coefficient of 0.9). The correlation between the sIgE levels and the results of the skin prick tests and the NPT was much lower (0.48 and 0.66, respectively).


CONCLUSIONS
The specific nasal provocation test is a safe and easy diagnostic modality, and acoustic rhinometry provides a good method of measuring it.
Modrzyński
Marek
M
Euromedica Regional Outpatient Allergology Clinic, Grudziadz, Poland. euromedica@lekarz.net
Zawisza
Edward
E
D000328:Adult; D000485:Allergens / Q000276:immunology*; D000528:Alternaria / Q000276:immunology; D002963:Cladosporium / Q000276:immunology; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D009299:Nasal Provocation Tests / Q000379:methods*; D011058:Pollen / Q000276:immunology; D012221:Rhinitis, Allergic, Perennial / Q000276:immunology; D023842:Rhinometry, Acoustic / Q000379:methods; D012882:Skin Tests / Q000379:methods
D000485:Allergens; D007073:Immunoglobulin E