Specific nasal provocation tests in patients hypersensitive to mould allergens

Area of Science:

• Allergology
• Immunology
• Otorhinolaryngology

Background:

• Concomitant allergies to outdoor mould spores and plant pollen can complicate diagnosis.
• Determining the role of mould allergens is crucial for effective patient management and immunotherapy.
• Accurate diagnosis reduces the risk of therapeutic failures in allergic rhinitis patients.

Purpose of the Study:

• To evaluate the diagnostic utility of specific nasal provocation tests (NPT) for mould allergens.
• To assess the correlation between NPT results, clinical manifestations, and other diagnostic markers.
• To determine the effectiveness of acoustic rhinometry in objectifying NPT outcomes.

Main Methods:

• 31 patients with seasonal allergic rhinitis and co-existing pollen and mould allergies were studied.
• Standard allergological diagnostics included skin prick tests and specific IgE (sIgE) level determination.
• Specific nasal provocation tests (NPT) with mould allergens were performed and objectified using acoustic rhinometry.

Main Results:

• Positive NPT results were observed in 22 patients, with higher frequency for Cladosporium herbarum (92.3%) than Alternaria alternata (55.5%).
• A strong correlation (r=0.9) was found between acoustic rhinometry measurements and clinical symptom intensity post-NPT.
• Correlations between sIgE levels and skin prick tests/NPT results were considerably lower (0.48 and 0.66).

Conclusions:

• Specific nasal provocation testing is a safe and practical method for diagnosing mould allergies.
• Acoustic rhinometry serves as a reliable tool for measuring the outcomes of NPT.
• These diagnostic approaches can improve the selection of patients for specific immunotherapy.