title: The importance of mold sensitivity in nonallergic rhinitis patients.
abstract: In recent studies, local specific immunoglobulin E (sIgE) production against allergens in nasal mucosa and a positive response to a nasal allergen provocation test (NAPT) have been demonstrated in some patients initially diagnosed as nonallergic rhinitis (NAR) or idiopathic rhinitis (IR). The aim of this study was to evaluate the presence of local allergic rhinitis (LAR) in patients who experience rhinitis symptoms in indoor and outdoor moldy conditions and to investigate the role of the NAPT in diagnosis.
  
  
  
  A total of 40 NAR patients with a history of persistent rhinitis and who had negative skin-prick tests (SPTs) and serum sIgE levels to common aeroallergens, as well as 20 healthy subjects were included in the study. NAPTs were performed with Aspergillus fumigatus (group 1) or a mixture of Alternaria alternata and Cladosporium herbarum extracts (group 2).
  
  
  
  In patient nasal lavage fluids, tryptase and mold sIgE levels were not significantly different from the control group. NAPT with Aspergillus fumigatus was positive in 8 of 12 NAR patients (66.6%) in group 1 and NAPT with the mixture of extracts was positive in 9 of 13 NAR patients (69.2%) in group 2.
  
  
  
  This study suggests that LAR may exist in a significant number of the persistent rhinitis patients who were previously considered as NAR based on negative SPTs or serum sIgE tests. To the best of our knowledge, this is the first study evaluating a nasal local allergic response to both indoor and outdoor molds.
authors.affiliation: Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Allergy, Istanbul University, Istanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Demirtürk
authors.affiliation: Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Allergy, Istanbul University, Istanbul, Turkey.
authors.forename: Aslı
authors.initials: A
authors.lastname: Gelincik
authors.affiliation: Istanbul Faculty of Medicine, Department of Ear, Nose and Throat, Istanbul University, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Ulusan
authors.affiliation: Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Allergy, Istanbul University, Istanbul, Turkey.
authors.forename: Belkıs
authors.initials: B
authors.lastname: Ertek
authors.affiliation: Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Allergy, Istanbul University, Istanbul, Turkey.
authors.forename: Suna
authors.initials: S
authors.lastname: Büyüköztürk
authors.affiliation: Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Allergy, Istanbul University, Istanbul, Turkey.
authors.forename: Bahattin
authors.initials: B
authors.lastname: Çolakoğlu
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology*; D000528:Alternaria / Q000276:immunology*; D001232:Aspergillus fumigatus / Q000276:immunology*; D002963:Cladosporium / Q000276:immunology*; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D008297:Male; D008875:Middle Aged; D017817:Nasal Lavage Fluid / Q000276:immunology; D009299:Nasal Provocation Tests; D012220:Rhinitis / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D012882:Skin Tests; D053802:Tryptases / Q000276:immunology; D055815:Young Adult
chemical_list: D000485:Allergens; D007073:Immunoglobulin E; D053802:Tryptases
keywords: inflammatory mediators; local allergic rhinitis; nasal allergen provocation test; nonallergic rhinitis; skin-prick test