This study demonstrates the detection of NsIgE to DP in LAR by using a simple, commercial device with high specificity.
Allergic mechanisms account for most cases of chronic rhinitis. This condition is associated with significant impairment of quality of life and high indirect costs. The identification of the allergic triggers of rhinitis has been historically based on the performance of atopy test [skin prick test (SPT) and serum allergen-specific (s)IgE]. Nevertheless, these tests only denote sensitization, and atopy and allergy represent two different phenomena. It is now clear that allergic phenotypes of rhinitis can exist in both atopic (allergic rhinitis, AR) and non-atopic (local allergic rhinitis, LAR) individuals. Moreover, both allergic phenotypes can coexist in the same rhinitis patient (dual allergic rhinitis, DAR). Therefore, a diagnostic approach merely based on atopy tests is associated with a significant rate of misdiagnosis. The confirmation of the allergic etiology of rhinitis requires the performance of in vivo test like the nasal allergen challenge (NAC). NAC is mandatory for the diagnosis of LAR and DAR, and helps decide the best management approach in difficult cases of AR. Nevertheless, NAC is a laborious technique requiring human and technical resources. The basophil activation test (BAT) is a patient-friendly technique that has shown promising results for LAR and DAR diagnosis. In this review, the diagnostic usefulness for chronic rhinitis of SPT, NAC, olfactory tests, serum sIgE, BAT and the quantification of inflammatory mediators in nasal samples will be discussed. The accurate performance of an etiologic diagnosis of rhinitis patients will favor the prescription of specific therapies with disease-modifying potential like allergen immunotherapy.
which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Introduction: There are few data available regarding natural history of local allergic rhinitis (LAR). We previously reported the results of the first 5-years of follow-up observing a similar rate of development of systemic allergic rhinitis (AR) in both LAR patients and healthy controls. Objective: To explore the natural history of a population with LAR and the development of AR and comorbidities over a 10 year period. Methods: A cohort of 194 patients with LAR of recent onset (<18 months) and 130 age-and sex-matched healthy controls were prospectively evaluated in a 10-year follow-up study (2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016). All participants provided informed consent and ethic committee of the hospital approved the study. Clinical-demographic questionnaire, spirometry, SPT and specific IgE (sIgE) to aeroallergens were evaluated yearly. Nasal allergen provocation tests (NAPT) with D. pteronyssinus (DP), Alternaria, Olea europea, and grass pollen were performed at baseline, and after 5 and 10 years. Results: A total of 151 patients (78%) and 90 controls (69%) completed the study. At baseline, most patients had moderate-tosevere persistent-perennial rhinitis. Conjunctivitis (52%) and asthma (19%) were the main comorbidities, and DP the most frequent sensitizing aeroallergen (51.1%). During the 10 years of evaluation 21 new cases of asthma (12.5%, P = 0.007) and 17 new cases of conjunctivitis (10%, P = 0.067) were diagnosed. After 10 years of evolution a similar rate of development of AR was detected in patients and healthy controls (11.3 vs 10%, P = 0.761). In 5 patients, conversion to systemic atopy occurred in the last year of evaluation (3%). Conclusions: LAR is a well-differentiated clinical entity with a low rate of development of systemic atopy. This study was funded by the Institute of Health "Carlos III" of the Spanish Ministry of Economy and Introduction: It is well known that T helper (Th) 2 cells and group 2 innate lymphoid cells (ILC2s) contribute to allergic diseases. However, their exact role and relationship in nasal allergic disorders is unclear. We sought to investigate the cooperation of Th2 cells and ILC2s in a mouse model of nasal allergic disorder. Methods: To differentially activate Th2 cells and/or ILC2s in nasal mucosa, mice were intranasally administered ovalbumin (OVA) antigen, papain, an ILC2-activatior, or both for 2 weeks. Epithelial thickness and number of eosinophils in the nasal mucosa were evaluated at 24 h after the final challenge. Results: Intranasal administration of OVA and papain preferentially activated Th2 cells and ILC2...
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