Sacchetti Marta, Lambiase Alessandro, Aronni Silvia, Griggi Tamara, Ribatti Valentina, Bonini Stefano, Bonini Sergio
Department of Ophthalmology, University of Rome, Campus Bio-Medico, Italy.
J Allergy Clin Immunol. 2006 Oct;118(4):872-7. doi: 10.1016/j.jaci.2006.06.022. Epub 2006 Aug 7.
Tissue hyperreactivity of target organs to nonspecific stimuli is known to be an important factor in influencing the clinical picture of allergic disease.
To identify the sensitivity and specificity of a hyperosmolar conjunctival provocation test in predicting conjunctival hyperreactivity and to relate this reactivity to the presence of ocular discomfort in subjects with and without allergy.
In 50 healthy patients and 19 patients with allergic conjunctivitis during remission phase, symptoms of ocular discomfort triggered by nonspecific stimuli were identified and graded with a discomfort score. Subjects were then challenged with a glucose solution at increasing concentrations (from 10% to 50%). The glucose concentration that elicited 2+ conjunctival hyperemia was considered the provoking dose. The response to this hyperosmolar provocation in subjects with ocular discomfort was compared with that of asymptomatic subjects. Sensitivity and specificity of the test in predicting conjunctival hyperreactivity were analyzed.
Six of 50 healthy subjects and 12 of 19 subjects with allergy complained of ocular discomfort after exposure to nonspecific stimuli. The hyperosmolar provocation test discriminated between subjects with and without ocular discomfort (mean provoking dose: 39.5% +/- 5% and 47.5% +/- 5% glucose, respectively; P < .001). Forty percent glucose was the optimal threshold dose that demonstrated the highest sensitivity and specificity for prediction of conjunctival hyperreactivity. Discomfort scores were significantly related to provoking dose values (P < .05).
This study provides a standardized procedure to detect nonspecific conjunctival hyperreactivity independent of underlying atopy.
Hyperosmolar provocation test may be useful for identifying conjunctival hyperreactivity in subjects with and without allergy with a history of ocular discomfort.
已知靶器官对非特异性刺激的组织高反应性是影响过敏性疾病临床表现的一个重要因素。
确定高渗性结膜激发试验在预测结膜高反应性方面的敏感性和特异性，并将这种反应性与有或无过敏的受试者眼部不适的存在情况相关联。
在50名健康患者和19名处于缓解期的过敏性结膜炎患者中，识别由非特异性刺激引发的眼部不适症状，并用不适评分进行分级。然后让受试者用浓度递增（从10%至50%）的葡萄糖溶液进行激发。引起结膜充血2+的葡萄糖浓度被视为激发剂量。将有眼部不适的受试者对这种高渗激发的反应与无症状受试者的反应进行比较。分析该试验在预测结膜高反应性方面的敏感性和特异性。
50名健康受试者中有6名，19名过敏受试者中有12名在接触非特异性刺激后出现眼部不适。高渗激发试验区分了有或无眼部不适的受试者（平均激发剂量分别为：葡萄糖39.5%±5%和47.5%±5%；P<.001）。40%葡萄糖是显示出预测结膜高反应性的最高敏感性和特异性的最佳阈值剂量。不适评分与激发剂量值显著相关（P<.05）。
本研究提供了一种标准化程序，以检测与潜在特应性无关的非特异性结膜高反应性。
高渗激发试验可能有助于识别有或无过敏且有眼部不适病史的受试者的结膜高反应性。
