title: Nasal provocation test using allergen extract versus cold dry air provocation test: which and when?
abstract: BACKGROUND
  Nasal provocation tests (NPTs) are useful for evaluation of patients with allergic rhinitis. The cold dry air (CDA) provocation test is useful for evaluation of patients with nonspecific nasal hyperreactivity (NHR). This study aimed to determine whether the NPT or CDA provocation would be more useful for patients with different clinical pictures.
  
  
  METHODS
  We evaluated changes in nasal symptoms (visual analog scale [VAS]) and acoustic parameters after NPT or CDA provocation in healthy volunteers (group A, n = 27), patients with allergic rhinitis (group B, n = 20), and subjects with nonallergic rhinitis (group C, n = 26). According to their subjective cold hyperresponsiveness (SCH), we compared changes in VAS and acoustic parameters after each protocol. The correlation between results of the skin-prick test (SPT) and changes in VAS after each protocol was analyzed. Finally, we performed an analysis of correlation between NPT and CDA provocation.
  
  
  RESULTS
  After NPT, group B showed a larger change in VAS for rhinorrhea, sneezing, and itching (p < 0.01). After CDA challenge, the change in VAS for nasal obstruction was larger in group C (p < 0.05). Changes in acoustic parameters were larger in groups B and C after NPT (p < 0.01). After CDA challenge, the SCH(+) group (n = 49) showed a larger decrease of acoustic parameters than the SCH(-) group (n = 24; p < 0.01). Significant correlation was observed between the size of SPT and degree of change in VAS after NPT. No significant correlation was observed between NPT and CDA.
  
  
  CONCLUSIONS
  CDA could be an adjunct tool for evaluating NHR in patients with self-reported SCH.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Inha University College of Medicine, Incheon, Republic of Korea.
authors.forename: Young Hyo
authors.initials: YH
authors.lastname: Kim
authors.forename: Tae Young
authors.initials: TY
authors.lastname: Jang
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens; D001249:Asthma / Q000175:diagnosis*; D001985:Bronchial Provocation Tests; D002457:Cell Extracts / Q000008:administration & dosage; D003080:Cold Temperature; D003937:Diagnosis, Differential; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000175:diagnosis*; D009299:Nasal Provocation Tests; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis*; D012882:Skin Tests; D055815:Young Adult
chemical_list: D000485:Allergens; D002457:Cell Extracts