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Role of aeroallergen nasal challenge in asthmatic children
D Hervás1, R Rodriguez, J Garde
1Department of Pediatric Allergy, General Hospital of Elche, Spain. dhmdhm@hotmail.com
Insights
Aeroallergen nasal challenge effectively identifies relevant allergens in children with asthma, even without rhinitis symptoms. This safe method aids in selecting appropriate immunotherapy for allergic asthma patients.
Area of Science:
- Allergy and Immunology
- Pediatric Pulmonology
- Diagnostic Techniques
Background:
- Most allergic asthma patients react to multiple airborne allergens.
- Accurate allergen identification is crucial for effective immunotherapy.
Purpose of the Study:
- To evaluate aeroallergen nasal challenge for identifying clinically relevant allergens in asthmatic children.
- To assess the utility of nasal challenge in children with and without rhinitis.
Main Methods:
- Aeroallergen nasal challenge performed on 125 children across five groups: asthma, asthma with rhinitis, rhinitis, atopic controls, and non-atopic controls.
- Evaluated group differences using spirometry and acoustic rhinometry post-challenge.
Main Results:
- Positive immediate nasal responses were observed in 21 asthma-only, 18 asthma-and-rhinitis, and 19 rhinitis patients.
- No significant differences in response were found between asthma and rhinitis groups.
- Asthma without rhinitis showed a significantly higher risk of positive challenge compared to atopic controls (OR 29.57).
Conclusions:
- Aeroallergen nasal challenge is a safe diagnostic tool for asthmatic children.
- This method can identify clinically relevant allergens, including in children without concurrent rhinitis.
- Nasal challenge supports targeted immunotherapy selection in pediatric allergic asthma.
Background:
The majority of allergic asthmatic patients are sensitised to several aeroallergens. Discrimination of the clinically relevant allergen is essential for the correct use of immunotherapy.
Objective:
To investigate nasal challenge and its role in screening clinically relevant allergens in asthmatic children.
Methods:
Aeroallergen nasal challenge was performed in five different groups of patients (asthma; asthma & rhinitis; rhinitis; atopic controls; and non-atopic controls). Differences between groups after challenge were evaluated by means of spirometry and acoustic rhinometry.
Results:
Nasal challenge was performed in 125 patients, 25 per group. The positive nasal response of immediate type was recorded in 21 patients with asthma only (P<0.001), 18 with asthma and rhinitis (P<0.001), 19 with rhinitis (P<0.001), two atopic control patients and in no healthy control patients. However, no differences were observed between the asthma group and the groups with rhinitis symptoms. The risk of a positive challenge was much higher in the asthma without rhinitis group compared to atopic controls (OR 29.57; 95%CI: 5.47-159.97).
Conclusion:
Aeroallergen nasal challenge is a safe technique in asthmatic children and could be useful in establishing the clinically relevant allergen even in the absence of rhinitis.
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