Recent advances in the diagnosis of allergic rhinitis

Wang, Xiangdong; Du, Kun; She, Wenyu; Ouyang, Yabo; Sima, Yutong; Liu, Chengyao; Zhang, Luo

doi:10.1080/1744666x.2018.1530113

Cited by 36 publications

(20 citation statements)

References 88 publications

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“…Although advanced diagnostic tools in allergy might improve the selection of patients for AIT (17), SPT, is highly specific (79-86%) and sensitive (18). A positive immediate skin reaction at the threshold of a 3 mm wheal of the longest (19) or mean diameter (6) is a widely accepted criterion.…”

Section: Discussionmentioning

confidence: 99%

Which skin prick test wheal size detects true allergy to Salsola kali?

Al‐Ahmad

Jusufović

Arifhodžić

2021

Eur Ann Allergy Clin Immunol

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Background: Sensitization to Salsola kali (Sk) weed pollen allergen is the most common cause of seasonal allergic rhinitis (SAR) in Middle East countries. Aim: To identify Salsola kali skin prick test (SkSPT) wheal size cutoff , able to determine true allergy among adult patients with moderate to severe SAR, who are in need of Salsola kali allergen specific immunotherapy (SkAIT). Methods: In 151 adults with moderate to severe SAR, mean age 32.79 ± 10.79 years, of both gender (females: 43.05%), with a positive SkSPT, (i.e. cut off wheal longest diameter of 3 mm) and one or more other local weed pollens, Salsola kali nasal provocation test (SkNPT) was carried out. Response was assessed both subjectively, with scores, and objectively, by measuring peak nasal inspiratory flow (PNIF). Safety profile of SkNPT was assessed using peak expiratory flow rate (PEF) measurements. Results: SkNPT positive response was found in 125 patients (82.78%). Mean skin prick test (SPT) wheal size to Sk was bigger in the nasal provocatin test (NPT) positive group (9 mm) compared to the NPT negative patients (5 mm), p<0.0001. ROC analysis showed that a SPT wheal size to Sk at the threshold of >7.5 mm enabled identification of SkNPT positivity with a sensitivity of 73.6% and specificity of 100.0% (area under the curve 0.9498, standard error 0.01808; 95% confidence interval (CI): 0.9144 to 0.9853; p<0.0001). Conclusion: SPT wheal size of 3 mm might overestimate the presence of real allergy to Sk in a desert environment. A SPT wheal size >7.5 mm for Sk appears to distinguish individuals who develop disease from those who does not. Physicians should select the proper SPT wheal size value as an appropriate criterion according to the allergen than using a uniform cut off value in patients eligible for SkAIT.

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Section: Discussionmentioning

confidence: 99%

Which skin prick test wheal size detects true allergy to Salsola kali?

Al‐Ahmad

Jusufović

Arifhodžić

2021

Eur Ann Allergy Clin Immunol

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“…In recent years, the prevalence of AR has increased significantly, and its diagnosis is more based on symptom evaluation and allergen detection, but due to the lack of effective and reliable diagnostic tests, the diagnosis requires experts to verify the final results based on experience [23,24]. In order to help junior physicians and clinicians diagnose allergic diseases, this work uses AI methods to extract new information from previous data for training [25,26].…”

Section: Discussionmentioning

confidence: 99%

Artificial Intelligence Applications in allergic rhinitis diagnosis: Focus on Ensemble Learning

Dai¹,

Meng

Tan

et al. 2020

Preprint

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Background and purpose: Artificial intelligence is an important product of the rapid development of computer technology today. This study intends to propose an intelligent diagnosis and detection method for AR based on ensemble learning. Method: This study collectedAR cases and other 7 types of diseases with similar symptoms:Rhinosinusitis, Chronic rhinitis, upper respiratory tract infection etc.) and collected clinical data such as medical history, clinical symptoms, allergen detection and imaging. Multiple models are used to train the classifier for the same batch of data, and the final ensemble classifier is obtained by using the ensemble learning algorithm. 5 common machine learning classification algorithms were selected for comparative experiments, including Naive Bayes (NB), Support Vector Machine (SVM), Logistic Regression (LR), Multilayer Perceptron (MLP), Deep Forest (GCForest), eXtreme Gradient boosting (XGBoost). In order to evaluate the prediction results of AR samples, parameters such as Precision, Sensitivity, Specificity, G-Mean, F1-Score, and AUC under the ROC curve are jointly used as prediction evaluation indicators. Results: 7 classification models are used for comparison, covering probability model, tree model, linear model, ensemble model and neural network models, and the comprehensive classification evaluation index is lower than the ensemble classification algorithms ARF-OOBEE and GCForest. Compared with other algorithms, the accuracy of G-Mean and AUC parameters is improved nearly 2%, and it has good comprehensive classification characteristics for massive large data and unbalanced samples. Conclusion: The ensemble learning ARF-OOBEE model has good generalization performance and comprehensive classification ability to be used for diagnosis of AR.

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“…The diagnosis of AR was made based on the combined evaluation of patients’ clinical history, results of skin prick test, and allergen-specific IgE findings in the serum. 19 Selected AR patients underwent endoscopic Vidian neurectomy. Those in the control group had no history of AR and no evidence of sinonasal mucosal inflammation under endoscopic examination but instead received endoscopic surgeries for other indications such as nasal septoplasty and optic nerve decompression.…”

Section: Methodsmentioning

confidence: 99%

Protease-Activated Receptor-2 Decreased Zonula Occlidens-1 and Claudin-1 Expression and Induced Epithelial Barrier Dysfunction in Allergic Rhinitis

Wang

Xue

Huang

et al. 2020

Am J Rhinol�Allergy

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Background Protease-activated receptor-2 (PAR-2)-modulated tight junctions (TJs) have been suggested to be involved in the pathogenesis of chronic inflammatory diseases. However, immunopathogenesis remains to be investigated among patients with allergic rhinitis (AR). Objective This study sought to investigate the role of PAR-2 in the modulation of epithelial barrier function and the expression of TJs in the nasal mucosa of AR patients. Methods The expression of TJs and PAR-2 of the nasal mucosa in AR patients and control subjects by immunohistochemistry, quantitative real-time polymerase chain reaction (qRT-PCR), and western blotting. In vitro, Primary human nasal epithelial cells (pHNECs) of AR patients were stimulated by Der p1 to analyze the correlation between PAR-2 and TJs expression. Der p1-induced pHNECs were treated with the PAR-2 agonist SLIGRL-NH2 and antagonist FSLLRY-NH2. Fluorescein isothiocyanate–dextran 4 kDa detection was employed as an indicator of epithelial permeability. Results Lower expression levels of TJs in the nasal epithelium of AR patients were observed in comparison with that in control subjects. The PAR-2 level was markedly increased following treatment with 1,000 ng/mL of Der p1 for 24 hours in a cellular model of AR. The expression of PAR-2 was increased in Der p1-induced pHNECs of AR patients and correlated inversely with zonula occlidens (ZO)-1 and claudin-1. Treatment with Der p1 further downregulated TJs expression and promoted an increased epithelial permeability in Der p1-induced pHNECs. Conclusions PAR-2 could downregulate the expression of ZO-1 and claudin-1, which is involved in epithelial barrier dysfunction in AR.

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Recent advances in the diagnosis of allergic rhinitis

Cited by 36 publications

References 88 publications

Which skin prick test wheal size detects true allergy to Salsola kali?

Which skin prick test wheal size detects true allergy to Salsola kali?

Artificial Intelligence Applications in allergic rhinitis diagnosis: Focus on Ensemble Learning

Protease-Activated Receptor-2 Decreased Zonula Occlidens-1 and Claudin-1 Expression and Induced Epithelial Barrier Dysfunction in Allergic Rhinitis

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