A new, faster, and safe nasal provocation test method for diagnosing mite allergic rhinitis.
BACKGROUND
Diagnosing house dust mite (HDM) allergic rhinitis is difficult. The nasal provocation test (NPT) has been shown to be the most pertinent, but several methods are available. According to guidelines, the NPT requires a skin end-point titration and an objective measurement of nasal patency. Hence, NPT is time consuming and its use is limited.


OBJECTIVE
To evaluate the sensitivity, specificity, and safety of a new, more rapid, and simple alternative NPT (NPT-R) to HDM.


METHODS
Eighty-eight patients with from rhinitis (49 allergic to HDM and 39 controls with and without atopy) were included. Allergic rhinitis to HDM was confirmed by a "classic" NPT based on the Lebel score and rhinomanometry. After a period of 4 weeks, NPT-R was performed and only the clinical score was measured.


RESULTS
The study population was young (mean ± SD, 27.7 ± 8.5 years old), composed mostly of women (61 vs 27 men), and 24% reported asthma. The sensitivity and specificity of NPT-R were 83.7% and 100%, respectively. The correlation between the NPTs was statistically significant (0.833, P < .0001, n = 88) and the 2 NPTs were completely safe. Performing NPT-R was more rapid (mean ± SD, 22 ± 8 minutes) than the classic NPT (97 ± 20 minutes).


CONCLUSIONS
The NPT-R is safe and easier and faster than the classic NPT. This new method appears to be a very useful tool in the diagnosis of HDM allergic rhinitis when the diagnosis is uncertain or before initiating immunotherapy.


BACKGROUND
ClinicalTrials.gov, identifier NCT01485523.
Chest Diseases Department, Strasbourg University Hospital; Federation of Translational Medicine, University of Strasbourg, Strasbourg, France.
Frédéric
F
de Blay
Immuno-Allergology Clinic, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium. Electronic address: virginie.doyen@ulb.ac.be.
Virginie
V
Doyen
Chest Diseases Department, Strasbourg University Hospital; Federation of Translational Medicine, University of Strasbourg, Strasbourg, France.
Céline
C
Lutz
Statistics Department, Strasbourg University Hospital, Strasbourg, France.
Julien
J
Godet
Chest Diseases Department, Strasbourg University Hospital; Federation of Translational Medicine, University of Strasbourg, Strasbourg, France.
Cindy
C
Barnig
Chest Diseases Department, Strasbourg University Hospital; Federation of Translational Medicine, University of Strasbourg, Strasbourg, France.
Shanshan
S
Qi
Chest Diseases Department, Strasbourg University Hospital; Federation of Translational Medicine, University of Strasbourg, Strasbourg, France.
Jean-Jacques
JJ
Braun
D000328:Adult; D000485:Allergens / Q000276:immunology; D000818:Animals; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D009299:Nasal Provocation Tests / Q000379:methods*; D011446:Prospective Studies; D039981:Pyroglyphidae / Q000276:immunology*; D065631:Rhinitis, Allergic / Q000175:diagnosis* / Q000276:immunology*; D012680:Sensitivity and Specificity; D012882:Skin Tests / Q000379:methods
D000485:Allergens