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

Bożek, Andrzej; Fiolka, Jolanta Zalejska; Wojtys, Anna Krajewska; Galuszka, Beata; Cudak, Anna

doi:10.1159/000509438

Cited by 3 publications

(1 citation statement)

References 24 publications

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“…It is a safe and reasonably priced technique that replicates an allergic reaction in the nose under standardised and controlled conditions [19]. NPT aims to demonstrate the causal role of an allergen [23], to diagnose local allergic rhinitis [24], and to identify the clinically relevant allergen(s) in polysensitised subjects [25]. Therefore, it could lead to the application of stratified and personalised medicine in rhinitis patients [26].…”

Section: Introductionmentioning

confidence: 99%

Clinical Relevance of Lepidoglyphus destructor Sensitisation in Allergic Rhinitis: Nasal Provocation Test as in vivo Assessment

Matos Semedo,

Martins,

Tomaz

et al. 2024

Int Arch Allergy Immunol

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Background: Dust mites are the leading cause of respiratory allergic diseases worldwide. Allergy to storage mites (SMs) has mostly been related to occupational exposures. However, recent studies have shown that sensitisation to SM, such as Lepidoglyphus destructor (Lep d), is of considerable importance also in urban populations, with high prevalence in dust samples of domestic environments. Co-sensitisation between house dust mites (HDMs) and SM is now regarded as very frequent in some regions, and cross-reactivity between them seems to be narrow. Therefore, SM allergenic capacity is increasingly a subject of study. The nasal provocation test (NPT), as an in vivo technique, could be considered the gold standard for the clinical relevance assessment of an allergen, in polysensitised rhinitis patients. Objective: The objective of this study was to analyse the clinical relevance of the SM Lep d, by assessing the relationship between in vivo sensitisation and expression of allergic respiratory disease in an urban setting. Patients and Methods: In our study, we enrolled a total of 32 allergic patients with rhinitis (with or without asthma) with proven sensitisation by skin prick test (SPT) and specific IgE (sIgE) to HDMs and/or SM. Patients underwent NPT with Lep d using subjective (Lebel Symptom Score Scale) and objective measurements (peak nasal inspiratory flow [PNIF]) for assessment of nasal response. Results: Most of the patients with positive SPT and sIgE to Lep d had a positive NPT (24/27; 89%). True Lep d allergy, assessed by a positive NPT, could be predicted by a SPT wheal size >9.7 mm and a sIgE >0.42 kUA/L, with 100%/95.7% sensitivity and 75.0%/83.3% specificity, respectively. Co-sensitisation between Lep d and Der p was high, 75.0%. Asthma was more frequent in the positive Lep d NPT group (54 vs. 12%, p < 0.05). Significantly more patients from this group reported physical exercise, nonspecific irritants, and respiratory infections as relevant triggers of respiratory symptoms (p < 0.01–p < 0.05). Conclusions: To our knowledge, this is the first study to show that sensitisation to Lep d may have clinical relevance in a non-occupational setting. In this group, there seems to be a relationship between allergy to Lep d and severity of respiratory disease, with more bronchial inflammation, when comparing with mite-allergic patients sensitised only to HDM. Therefore, the authors consider that sensitisation to Lep d should be considered when assessing and treating allergic respiratory disease in urban environments.

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Section: Introductionmentioning

confidence: 99%

Clinical Relevance of Lepidoglyphus destructor Sensitisation in Allergic Rhinitis: Nasal Provocation Test as in vivo Assessment

Matos Semedo,

Martins,

Tomaz

et al. 2024

Int Arch Allergy Immunol

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Role of autophagy and mitophagy of group 2 innate lymphoid cells in allergic and local allergic rhinitis

Wang,

Zhuo,

et al. 2024

World Allergy Organization Journal

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Local Allergic Rhinitis: A Different Rhinitis Endotype? Literature Overview

2022

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Chronic rhinitis (CR) is commonly divided into allergic rhinitis (AR) and nonallergic rhinitis (NAR). AR is triggered by the immunoglobulin E (IgE)-mediated response to allergens, whereas NAR is characterized by the absence of allergic sensitization. Previous studies have demonstrated the presence of local IgE in the nasal mucosa of patients suffering from typical allergic rhinitis (AR) symptoms but without a history of atopy and a positive response to a nasal allergen challenge (NAC). This condition was recently defined as local allergic rhinitis (LAR), which is supposed to be a different CR characterized by a type 2 (T2) inflammation response with the release of typical T2 mediators. LAR is defined as a phenotype of AR characterized by a localized nasal allergic response that is negative skin prick testing to allergens in the absence of serum-specific IgE. Diagnosis is based on a positive response to NAC. This review is an update of LAR literature, focusing on the definition of LAR as an independent endotype. LAR, AR, and NAR are characterized by the same clinical symptoms, although there are some differences between these three subtypes. However, the literature data are not yet univocal in defining LAR as an independent endotype.

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

Cited by 3 publications

References 24 publications

Clinical Relevance of <i>Lepidoglyphus destructor</i> Sensitisation in Allergic Rhinitis: Nasal Provocation Test as in vivo Assessment

Clinical Relevance of <i>Lepidoglyphus destructor</i> Sensitisation in Allergic Rhinitis: Nasal Provocation Test as in vivo Assessment

Role of autophagy and mitophagy of group 2 innate lymphoid cells in allergic and local allergic rhinitis

Local Allergic Rhinitis: A Different Rhinitis Endotype? Literature Overview

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