Higher Wheal Sizes of Dermatophagoides farinae Sensitization Exhibit Worse Nasal Symptoms in Allergic Rhinitis Patients

Abstract

Allergic rhinitis (AR) is a global health burden and it manifests in both nasal and non-nasal symptoms. Skin prick test (SPT) is a routine procedure to diagnose AR sensitized to common allergens including house dust mites (HDMs). The degree of sensitivity of a patient toward allergens is determined by the size of the wheal formed by SPT procedure. SPT wheal sizes are influenced by recent anti-histamine usage, however it remains unclear if SPT wheal sizes are also influenced by other factors. In this study, we set out to investigate the association between SPT wheal sizes with the demographical, clinical and environmental characteristics, as well as nasal and non-nasal symptoms severity scores, of AR patients (n = 30) sensitized to common HDMs (i.e., Dermatophagoides pteronyssinus, Dermatophagoides farinae, and Blomia tropicalis). We showed that SPT wheal sizes of HDM allergens were not associated with clinical, demographical and environmental characteristics examined. Nonetheless, significant correlations were observed between SPT wheal sizes of D. farinae sensitization with worse severity scores of all five nasal symptoms examined (i.e., sneezing, runny nose, itchy nose, congestion and postnasal drip) and four of the six non-nasal symptoms examined (i.e., throat symptoms, ear symptoms, headache and mental function). Such relationships were not observed in SPT wheal sizes of D. pteronyssinus and B. tropicalis sensitization. We suggest that increased SPT wheal sizes for D. farinae sensitization may predict the likelihood of more severe nasal and, to a lesser extent, non-nasal manifestations in AR patients.

Allergic Rhinitis: A Clinical and Pathophysiological Overview

“…In skin tests, positive result is considered when the wheal-and-flare reaction occurs on the skin test site after 20 min of exposure to allergens. For SPT, positive result must demonstrate wheal (i.e., a red and itchy raised bump with surrounding inflammation that indicates the presence of allergic antibodies) size in diameter of ≥4 mm ( 46 , 47 ). Figure 1 shows a positive SPT on house dust mite (HDM) allergens ( Dermatophagoides pteronyssinus, Dermatophagoides farinae and Blomia tropicalis ) tested on an AR patient who attended the ORL-HNS clinic of Hospital Universiti Sains Malaysia, and each wheal size was greater than 4 mm.…”

IL-4/IL-13 axis as therapeutic targets in allergic rhinitis and asthma

“…Allergic rhinitis (AR) is an upper airway disorder due to contact of nasal mucosa with allergens that trigger IgE-mediated inflammation, leading to symptoms such as sneezing, coughing, nasal congestion and rhinorrhea. Asthma, on the other hand, is a lower airway disorder caused by various triggers such as allergies, smoking, air pollution or sinusitis, resulting in airway muscles spasms and inflammation, airway obstruction, wheezing and dyspnea ( Azid et al, 2019 ; Eguiluz-Gracia et al, 2020 ; Meng, Wang & Zhang, 2020 ; Nur Husna et al 2022a ; Nur Husna et al 2021b ; Sani et al, 2019 ). AR and asthma prevalence worldwide has seen a rapid increase where approximately 40% and 334 million people worldwide have been affected with AR and asthma, respectively ( Bousquet et al, 2008 ; Network GAJA, New Zealand, 2014 ).…”