Is the evidence of local allergic rhinitis growing?

Rondón, Carmen; Eguiluz‐Gracia, Ibon; Campo, Paloma

doi:10.1097/aci.0000000000000456

Cited by 31 publications

(25 citation statements)

References 55 publications

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“…Potentially, only those with a suggestive allergic history but negative SPTs and/or serum spIgEs, warrant further investigation in order to embark on allergen reduction interventions or immunotherapy. Prior studies have confirmed that LAR and AR share similar clinical characteristics, underlying inflammatory pattern and both respond well to intranasal steroid as well as immunotherapy (20,33) . This leads to a question whether good response to intranasal corticosteroids could differentiate LAR from AR.…”

Section: Subgroup Analysismentioning

confidence: 84%

Local specific Immunoglobulin E among patients with nonallergic rhinitis: a systematic review

Hamizan¹,

Rimmer²,

Husain³

et al. 2018

Rhin

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Section: Subgroup Analysismentioning

confidence: 84%

Local specific Immunoglobulin E among patients with nonallergic rhinitis: a systematic review

Hamizan¹,

Rimmer²,

Husain³

et al. 2018

Rhin

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“…Recent studies highlight that LAR is a common disease, affecting > 25% of nonatopic patients with rhinitis . The disease often starts during childhood and tends to worsen over time with association of comorbidities such as conjunctivitis and bronchial symptoms suggestive of asthma . To date, most studies on LAR have focused on the underlying mechanisms and the definition of the phenotype.…”

Section: Introductionmentioning

confidence: 99%

Bronchial asthma triggered by house dust mites in patients with local allergic rhinitis

Campo

Eguiluz‐Gracia

Plaza-Serón

et al. 2019

Allergy

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Background: Over 30% of local allergic rhinitis (LAR) patients self-report bronchial symptoms suggestive of asthma, but the relationship between the allergen exposure and the bronchial symptoms has not been studied.Objective: To investigate whether a bronchial counterpart of LAR exists.Methods: Patients were classified by clinical history, skin prick test/serum specific IgE (sIgE), and nasal allergen provocation test (NAPT) into the LAR, allergic rhinitis (AR), and nonallergic rhinitis (NAR) phenotypes. Twenty-eight LAR, 18 AR, and 19 NAR patients self-reporting bronchial symptoms suggestive of asthma and 8 healthy controls (HC) were subjected to a methacholine test (MT) before (Visit 1) and 24 hours after (Visit 3) a bronchial provocation test with Dermatophagoides pteronyssinus (BPT-DP) (Visit 2). Induced sputum and peripheral blood obtained after each MT were analyzed for immune cell populations, tryptase, ECP, and sIgE. Results:A positive MT was found in 50% of LAR, 83.3% of AR, 57.89% of NAR, and 0% of HC individuals (P = 0.022 AR vs LAR) at V1. BPT-DP was positive in 8 LAR and 15 AR patients (28% vs 83.3%, P < 0.001), with no positive responses in NAR and HC.All BPT-DP+ patients experienced a significant decrease of PC 20 at V3 vs V1 (P = 0.016 LAR, P ≤ 0.001 AR). BPT-DP+ patients also showed a significant increase of eosinophils, monocytes, and ECP in induced sputum at V3 compared with V1. Conclusion:The results suggest the existence of a new asthma phenotype (local allergic asthma) defined by absence of systemic atopy and positivity to BPT with allergen. K E Y W O R D Sallergic, asthma, IgE, local, rhinitis | 1503 CAMPO et Al.

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“…Moreover, local allergic rhinitis (LAR) is a nasal disorder characterized by a localized allergic response in the absence of systemic atopy . The condition is getting greater recognition in recent years, even though a population study to clarify its prevalence and incidence during childhood is lacking. In all the above‐mentioned scenarios, the nasal allergen challenge (NAC) is a helpful diagnostic tool, as it is the gold standard to establish the clinical reactivity to an allergen and to accurately identify AR and LAR individuals .…”

Section: Introductionmentioning

confidence: 99%

Safety and reproducibility of nasal allergen challenge

Eguiluz‐Gracia

Testera‐Montes

González

et al. 2019

Allergy

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Background:The nasal allergen challenge (NAC) is a useful tool for the diagnosis of allergic rhinitis (AR) and local allergic rhinitis (LAR) and might serve to design and monitor allergen immunotherapy. Nevertheless, data about its safety and reproducibility are scarce.Objective: To investigate the safety and reproducibility of NAC in pediatric and adult rhinitis patients with/without asthmatic symptoms, and in healthy controls. Methods:A retrospective evaluation of the NACs conducted in our Unit for 2005-2017 and monitored by acoustic rhinometry and nasal-ocular symptoms was performed to analyze the safety of two methods for allergen application (metered spray & micropipette) and NAC protocols (NAC with single or multiple allergens/session [NAC-S & NAC-M]). The adverse events (AEs), spirometry values, and rescue medication required for AE were recorded. The reproducibility was examined by a prospective analysis of three repeated NAC-S performed at 1-2-month interval in AR, LAR and nonallergic rhinitis patients, and in healthy controls. Results: A total of 11 499 NACs were performed in 518 children and 5830 adults.Only four local AE occurred, and 99.97% of NACs were well tolerated. The reproducibility and positive and negative predictive values of three consecutive NAC-S performed in 710 subjects were 97.32%, 100%, and 92.91%, respectively. There were no false-positive results in the 710 analyzed subjects. Safety and reproducibility were comparable between the methods of allergen application and the rhinitis phenotypes. Conclusion:The NAC is a safe and highly reproducible diagnostic test ready to be used in the clinical practice in both children and adults with or without asthma. K E Y W O R D Slocal allergic rhinitis, nasal allergen challenge, reproducibility, safety Abbreviations: AE, adverse event; AIT, allergen immunotherapy; AR, allergic rhinitis; DP, Dermatophagoides pteronyssinus; EAACI, European Academy of Allergy and Clinical Immunology; FEV1, forced respiratory volume in the first second; HC, healthy control individual; IQR, interquartile range; LAR, local allergic rhinitis; NAC-M, NAC with multiple allergens per session; NAC, nasal allergen challenge; NAC-S, NAC with a single allergen per session; NAR, nonallergic rhinitis; NHR, nasal hyperreactivity; NPV, negative predictive value; PPV, positive predictive value; sIgE, allergen-specific IgE; SPT, skin prick test; Vol 2-6 cm, volume 2-6 cm of each nostril.Eguiluz-Gracia and Testera-Montes contributed equally to this paper.

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Is the evidence of local allergic rhinitis growing?

Cited by 31 publications

References 55 publications

Local specific Immunoglobulin E among patients with nonallergic rhinitis: a systematic review

Local specific Immunoglobulin E among patients with nonallergic rhinitis: a systematic review

Bronchial asthma triggered by house dust mites in patients with local allergic rhinitis

Safety and reproducibility of nasal allergen challenge

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