Do skin prick and conjunctival provocation tests predict symptom severity in seasonal allergic rhinoconjunctivitis?
BACKGROUND
In the investigation of seasonal allergic rhinoconjunctivitis (SAR), quantitative skin and conjunctival allergen challenge tests are used to measure individual allergen sensitivity. These tests are reproducible and relate well to prevalence but their relationship to symptom severity is less well established.


OBJECTIVE
We wished to determine if quantitative skin prick tests (QSPT) and conjunctival provocation tests (CPTs) using a single grass pollen allergen extract are reproducible and predict symptom severity in SAR.


METHODS
We retrospectively analysed data from 91 participants in a previously published randomized placebo controlled study of low dosage allergen immunotherapy who were randomized to receive placebo treatment. We examined the relationship between pre-seasonal QSPT, CPT and SAR symptoms.


RESULTS
We found a high level of reproducibility when repeated measures were compared for both the QSPT (P < 0.001) and the CPT (P < 0.001) and moderate correlation (0.49) between the standard skin prick test (SPT) and the QSPT (P < 0.001). We found weak negative correlation (-0.27) between the QSPT and the CPT (P < 0.001). We found no correlation between seasonal symptom, use of rescue medication or quality of life (QOL) scores and pre-seasonal QSPT or CPT. Conclusion In the assessment of seasonal rhinoconjunctivitis, quantitative skin and conjunctival allergen challenge tests are strongly reproducible, although there is no correlation between these tests and seasonal symptom, use of rescue medication or QOL scores.
Radcliffe
Michael J
MJ
Infection Inflammation and Repair Research Division, School of Medicine, Southampton General Hospital, University of Southampton, Southampton, UK. mjr3@soton.ac.uk
Lewith
George T
GT
Prescott
Philip
P
Church
Martin K
MK
Holgate
Stephen T
ST
D000293:Adolescent; D000328:Adult; D000485:Allergens; D019540:Area Under Curve; D003228:Conjunctiva / Q000276:immunology*; D003233:Conjunctivitis, Allergic / Q000175:diagnosis*; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D007428:Intradermal Tests / Q000379:methods*; D008297:Male; D008875:Middle Aged; D006109:Poaceae; D011058:Pollen; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D012867:Skin / Q000276:immunology
D000485:Allergens