Positive Nasal Allergen Provocation Test and Nasal Specific-IgE to Grass Pollen in Patients with Idiopathic Rhinitis

2007 ◽  
Vol 119 (1) ◽  
pp. S314 ◽  
Author(s):  
C. Rondon ◽  
J.J. Romero ◽  
S. Lopez ◽  
R. R-Pena ◽  
J.L. Rodriguez-Bada ◽  
...  
Keyword(s):  
Grass Pollen ◽  
Provocation Test ◽  
Specific Ige ◽  
Idiopathic Rhinitis ◽  
Allergen Provocation

Nasal reactivity evaluation in children with allergic rhinitis receiving grass pollen sublingual immunotherapy

2020 ◽  
Vol 41 (5) ◽  
pp. 357-362
Author(s):  
Laura Schiavi ◽  
Giulia Brindisi ◽  
Giovanna De Castro ◽  
Valentina De Vittori ◽  
Lorenzo Loffredo ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Grass Pollen ◽  
Sublingual Immunotherapy ◽  
Provocation Test ◽  
Allergic Diseases ◽  
Treated Group ◽  
Specific Ige ◽  
Patient Comfort ◽  
Control Group ◽  
Nasal Function

Background: The European Academy of Allergy and Clinical Immunology guidelines, strongly recommended allergen immunotherapy (AIT) as an effective treatment to achieve long-term clinical benefits and to modify the natural history of allergic diseases. Sublingual immunotherapy (SLIT) offers the possibility of home administration, which improves patient comfort and compliance. Objective: The primary outcome of this study was to assess the change in nasal reactivity after grass-pollen AIT treatment. Methods: This was a monocentric, prospective, observational study conducted in Rome from September 2016 to June 2018, in the Pediatric Department of Policlinico Umberto I. We enrolled children, ages between 6 and 12 years, with persistent allergic rhinitis (AR), sensitized to grass pollen. At the first visit (V0, September 2016), one group received the first dose of oral immunotherapy for grass-pollen spray buccal and the other group continued only standard therapy. All the patients had nasal specific immunoglobulin I (IgE) assay (Phl p1, Phl p5), active anterior rhinomanometry with a nasal provocation test (NPT), and spirometry. The patients attended two follow-up visits, in May 2017 (V1) and May 2018 (V2), with the same examinations as at V0. Results: During the treatment, we observed, in the treated group, a significant increase in the mean nasal flow compared with untreated children (p < 0.001). In the AIT group, we found an improvement of nasal function and only 21.05% of all the children in the active group with a positive NPT result at V2. In the control group, we found, at V2, a worsening of nasal function, with 89.47% of the children with a positive NPT result. Furthermore, we found a significant reduction of nasal specific IgE levels at the end of the observation period in the treated group. Conclusion: Analysis of our data provided evidence for a clinical effect of SLIT in inducing clinical changes and allergen tolerance in children with AR.

Possibility of Local Allergic Rhinitis in Japan

2019 ◽  
Vol 34 (1) ◽  
pp. 26-34 ◽  
Author(s):  
Mariko Ishida ◽  
Shoji Matsune ◽  
Nozomu Wakayama ◽  
Ryuji Ohashi ◽  
Kimihiro Okubo
Keyword(s):  
Allergic Rhinitis ◽  
Provocation Test ◽  
Japanese Cedar ◽  
Inferior Turbinate ◽  
Specific Ige ◽  
House Dust Mites ◽  
Total Ige ◽  
Local Allergic Rhinitis ◽  
Allergen Provocation ◽  
Cedar Pollen

Background The concept of local allergic rhinitis (LAR) has been advocated recently. Allergic rhinitis in Japan is characterized by house dust mites (HDMs) and Japanese cedar pollen (JCP). To investigate LAR in Japan, total IgE and antigen-specific IgE (sIgE) were measured in inferior turbinate mucosa and their relationships with skin test (ST) and nasal allergen provocation test (NAPT) and as well as serum IgE levels were examined. Methods Subjects were 50 rhinosinusitis patients for surgery. ST was performed and serum total IgE and sIgE levels were measured preoperatively. Patients with class-0 serum anti-HDM or anti-JCP sIgE levels were subjected to NAPT with HDM or JCP, respectively, or both. In all patients, inferior turbinate mucosa was weighed and mashed, and total IgE and sIgE levels were then measured as local mucosal date per gram and per milligram. Because there is no clinical consensus how to evaluate nasal sIgE yet, both positive NAPT and detectable sIgE in obtained nasal mucosa were adopted as the diagnostic criteria of LAR in order to strictly elucidate the possibility of presence of LAR in Japan. Results JCP LAR was definitely diagnosed in 2 of 14 patients (14.3%) and HDM LAR in 5 of 21 (23.8%) in cases with rhinosinusitis symptoms in the absence of positive ST nor serum sIgE. Conclusion The present results positively support LAR by HDM or JCP being present in Japan.

scholarly journals Prospective study of 5-day challenge with penicillins in children

2020 ◽  
Vol 4 (1) ◽  
pp. e000734
Author(s):  
Birgitte Tusgaard Petersen ◽  
Josefine Gradman
Keyword(s):  
Prospective Study ◽  
Children And Adolescents ◽  
Provocation Test ◽  
Specific Ige ◽  
Hypersensitivity Reactions ◽  
Skin Reactions ◽  
Full Dose ◽  
Culprit Drug ◽  
Drug Provocation Test ◽  
Registration Number

ObjectivesTo examine if a 5-day challenge with penicillin improves the diagnostic sensitivity compared with a single full dose in children with mild skin reactions.DesignSubjects referred with suspected allergy to penicillin were consecutively included. Irrespectively of the morphology of the index reaction and the result of specific IgE, all subjects underwent a two-step titrated drug provocation test (DPT) with the culprit drug followed by a 5-day challenge at home.ParticipantsChildren and adolescents aged 0–18 years referred to allergic workup for penicillin hypersensitivity at two paediatric Danish centres. Only subjects with non-severe skin reactions were included.ResultsA total of 305 subjects were included and 22 (7%) of the DPTs were positive. Three subjects reacted within 1 hour of the first full dose and nine reacted 1–8 hours after the first full dose. Additional 10 positive reactions were observed during the prolonged provocation. Seven subjects reacted after the second full dose and three reacted after 3–6 days. Only mild skin rashes were observed. Eighteen subjects had a specific IgE to a penicillin >0.1 kU/L. Only one of these had a positive DPT.ConclusionIn children, a DPT with penicillins should include at least two full doses. In children with mild hypersensitivity reactions it may be safe to perform DPTs despite a low specific IgE.Trial registration numberNCT04331522

Potential Differences between Local and Systemic Allergic Rhinitis Induced by Birch Pollen

2020 ◽  
Vol 181 (11) ◽  
pp. 831-838
Author(s):  
Andrzej Bozek ◽  
Jolanta Zalejska Fiolka ◽  
Anna Krajewska Wojtys ◽  
Beata Galuszka ◽  
Anna Cudak
Keyword(s):  
Allergic Rhinitis ◽  
Birch Pollen ◽  
Provocation Test ◽  
Basophil Activation Test ◽  
Specific Ige ◽  
Immunological Parameters ◽  
Local Allergic Rhinitis ◽  
Before And After ◽  
Intermittent Allergic Rhinitis ◽  
Bet V1

<b><i>Introduction:</i></b> Different endotypes of rhinitis are known, but its pathomechanism has not been conclusively established. For example, the precise difference between systemic allergic rhinitis (SAR) and local allergic rhinitis (LAR) is still being checked. Comparison of patients with LAR and with allergies to birch of those with intermittent allergic rhinitis, same allergy, or with non-allergic rhinitis (NAR) was the purpose of this study. <b><i>Methods:</i></b> Twenty-six patients with LAR, 18 with SAR and allergy to birch, and 21 with NAR were included. Patients who met the inclusion criteria were selected to undergo the following procedures at baseline: medical examinations, nasal provocation test (NPT), detection of nasal-specific IgE to birch as well as basophil activation test (BAT). All immunological parameters were detected before and after NPT. <b><i>Results:</i></b> Concentration of nasal IgE to Bet v1 increased comparably in the LAR and SAR groups after NPT to birch as follows: in 21 (81%) patients with LAR, 14 (78%) with SAR, and in everyone in the NAR group. Serum concentration of allergen-specific IgE to Bet v1 increased significantly from a median of 20.7 (25–75% interval: 11.2–35.6) IU/mL to 29.9 (13.6–44.1) (<i>p</i> = 0.028) after NPT in patients with SAR. Allergen-specific IgE to Bet v1 was absent in all patients with LAR and NAR before and after NPT. BAT with Bet v1 was positive in 22 (85%) patients with LAR, in 14 (78%) with SAR, and 2 (9.5%) with NAR. <b><i>Conclusion:</i></b> These obtained data suggest there are no potential mechanisms that could explain LAR compared to SAR.

scholarly journals Sensitization to cereals and peanut evidenced by skin prick test and specific IgE in food-tolerant, grass pollen allergic patients

2011 ◽  
Vol 1 (1) ◽  
pp. 15 ◽  
Author(s):  
Maria Martens ◽  
Heidi J Schnoor ◽  
Hans-Jørgen Malling ◽  
Lars K Poulsen
Keyword(s):  
Skin Prick Test ◽  
Grass Pollen ◽  
Specific Ige ◽  
Prick Test

The Effects of Short-Term Immunotherapy Using Molecular Standardized Grass and Rye Allergens Compared with Symptomatic Drug Treatment on Rhinoconjunctivitis Symptoms, Skin Sensitivity, and Specific Nasal Reactivity

2005 ◽  
Vol 133 (4) ◽  
pp. 538-543 ◽  
Author(s):  
L. Klimek ◽  
T. Mewes ◽  
H. Wolf ◽  
I. Hansen ◽  
J. Schnitker ◽  
...  
Keyword(s):  
Drug Treatment ◽  
Grass Pollen ◽  
Randomized Study ◽  
Provocation Test ◽  
Treated Group ◽  
Short Term ◽  
Skin Sensitivity ◽  
Double Blind ◽  
Nasal Provocation ◽  
Significant Difference

BACKGROUND: The efficacy and safety of short-term immunotherapy with molecular standardized allergens (STI) has been demonstrated by double-blind placebo-controlled clinical trials. The aim of this study was to compare STI with symptomatic drug treatment. METHODS: Forty-eight patients with rhinoconjunctivitis to grass and/or rye pollen were treated either with STI (ALK7, n = 24) plus anti-allergic drugs or anti-allergic drugs, alone (n = 24) in a prospective, randomized study. Symptoms and use of drugs were reported in patient diaries and titrated nasal provocation and skin prick tests were performed at baseline, before, and after season. RESULTS: Median overall symptom ( P = 0.022, U test) and medication scores ( P = 0.003) were significantly lower in the STI group, as was the result for a simultaneous analysis of conjunctival, nasal, and bronchial symptom scores and medication ( P = 0.005). Sensitivity in the nasal provocation test decreased in the STI group but not in the drug-treated group. These differences became significant directly after STI ( P = 0.027) as well as after the grass pollen season ( P < 0.001). Skin sensitivity did not change in the STI group but increased in the drug-treated group after season, with a significant difference between the two groups for the erythema ( P < 0.001). CONCLUSIONS: STI reduces grass pollen-induced rhinoconjunctivitis symptoms and drug use, and specific nasal reactivity and skin sensitivity, more efficiently than a standard symptomatic treatment.

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