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. 2020 Sep 28;13(9):100461.
doi: 10.1016/j.waojou.2020.100461. eCollection 2020 Sep.

Nasal specific IgE to Der p is not an acceptable screening test to predict the outcome of the nasal challenge test in patients with non-allergic rhinitis

Luis Santamaría  1 , Ana Calle  1 , Manuela Tejada-Giraldo Biol  1 , Victor Calvo  1 , Jorge Sánchez  1 , Ricardo Cardona  1
Affiliations

Nasal specific IgE to Der p is not an acceptable screening test to predict the outcome of the nasal challenge test in patients with non-allergic rhinitis

Luis Santamaría et al. World Allergy Organ J. .

Abstract

Objectives: Nasal specific IgE (NsIgE) is the most common marker to identify type-2 inflammation in local allergic rhinitis (LAR). However, the comparison of NsIgE in different types of rhinitis, its frequency in tropical countries, and its diagnostic performance for predicting the outcome of a nasal challenge test (NCT) has had limited study. The main objective of this study was to explore the diagnostic performance of NsIgE to Dermatophagoides pteronyssinus (Der p) among different types of rhinitis and control subjects in a tropical population.

Methods: We evaluated the frequency of NsIgE, systemic atopy (serum sIgE and Skin Prick Test), and nasal eosinophils, and we performed nasal challenge tests (NCTs) with Der p in 3 groups of patients; rhinitis without atopy (RWoA) (n = 25), rhinitis with atopy (RWA) (n = 25), and control subjects (n = 18).

Results: NsIgE had a low sensitivity and specificity to predict a positive NCT in the RWoA group: 48% had NsIgE, but only 28% had a positive NCT. Among the RWA group 84% had NsIgE and 80% had a positive NCT; the association of NsIgE and positive NCT was high (>80%). In the control group 27.8% had NsIgE, but none had a positive NCT.

Conclusions: NsIgE performs poorly in predicting NCT results in patients with non-allergic rhinitis. More methodical investigations are needed in this complex area of rhinitis. In patients with allergic rhinitis, NsIgE was useful in predicting a positive nasal challenge, but not superior to the systemic atopic test.

Keywords: AR, Allergic Rhinitis; Atopy; Immunoglobulin E; LAR, Local Allergy Rhinitis; Mites; NCT, Nasal Challenge Test; Nasal challenge test; NsIgE, Nasal Specific IgE; RWA, Rhinitis With Systemic Atopy; RWoA, Rhinitis Without Systemic Atopy; Rhinitis; SPT, Skin Prick Test; sIgE, Specific Immunoglobulin E.

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Conflict of interest statement

The authors declare they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Proportion of positive NCTs and NsIgE. The bars represent the frequency of NsIgE and positive NCTs in each group. The circles represent the number of patients with both positive tests (black numbers) or one of the two (white numbers). RWoA: rhinitis without atopy. RWA: rhinitis with atopy. HS: healthy subjects. ∗p <0.05, ∗∗ p <0.01
Fig. 2
Fig. 2
Levels of nasal sIgE for Der p. The NsIgE levels of each subject in each group and group median and confidence interval 95% are represented with circles (RWoA group), squares (RWA group), and triangles (control group). RWoA: rhinitis without atopy. RWA: rhinitis with atopy. HS: healthy subjects. ∗p <0.05
Fig. 3
Fig. 3
Diagnostic performance of NsIgE in the RWA and RWoA groups. RWoA: rhinitis without atopy. RWA: rhinitis with atopy
See this image and copyright information in PMC

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