Department of Internal Diseases, Asthma and Allergy, Medical University of Lodz, Poland.
J Investig Allergol Clin Immunol. 2012;22(2):102-8.
Several objective methods are used to assess the result of nasal allergen challenge.
The aim of this study was to compare the diagnostic value of nasal nitric oxide (nNO) measurements with that of peak nasal inspiratory flow (PNIF), nasal lavage fluid beta-tryptase levels, and changes in cell count after nasal challenge with grass pollen.
The study population comprised 24 patients allergic to grass pollen and 24 healthy controls. All participants underwent grass allergen challenge preceded by administration of placebo. A visual analog scale was administered. nNO and PNIF were determined, and nasal lavage fluid was collected before and 30 minutes after administration of placebo and allergen. The study was performed outside the pollen season.
Significant changes in nNO, PNIF, nasal lavage fluid beta-tryptase level, and cell count were observed only in allergic patients after administration of the allergen. Receiver operating characteristic (ROC) curves were drawn for each determination. A change in nNO levels of -11.987% was indicated as the best cutoff point for differentiating between allergic patients and healthy participants with a sensitivity of 60.9%, specificity of 100%, negative predictive value of 71%, and positive predictive value of 100%. Comparison of the area under the ROC curve did not show significant differences between the diagnostic value of changes in nNO levels and other objective methods of assessing the outcome of the challenge.
Changes in nNO levels do not differ significantly from other methods used to objectively assess the outcome of nasal challenge. Given their insufficient sensitivity, nNO measurements have limited value as the sole diagnostic tool when assessing the outcome of nasal challenge.
有几种客观方法可用于评估鼻变应原激发的结果。
本研究旨在比较鼻一氧化氮（nNO）测量值与峰流速（PNIF）、鼻灌洗液β-胰蛋白酶水平以及花粉变应原激发后细胞计数变化在诊断鼻激发中的价值。
研究人群包括 24 例花粉过敏患者和 24 例健康对照者。所有参与者均在接受安慰剂激发前进行了草花粉变应原激发。采用视觉模拟评分（VAS）进行评估。nNO 和 PNIF 在给予安慰剂和变应原前及 30 分钟后进行测定，同时采集鼻灌洗液。研究在花粉季节之外进行。
仅在给予变应原后，过敏患者的 nNO、PNIF、鼻灌洗液β-胰蛋白酶水平和细胞计数才发生显著变化。为每种测定方法绘制了受试者工作特征（ROC）曲线。nNO 水平下降 11.987%被认为是区分过敏患者和健康参与者的最佳截断点，其敏感性为 60.9%，特异性为 100%，阴性预测值为 71%，阳性预测值为 100%。ROC 曲线下面积的比较并未显示 nNO 水平变化与评估激发结果的其他客观方法之间的诊断价值存在显著差异。
nNO 水平的变化与其他用于客观评估激发结果的方法无显著差异。由于其敏感性不足，nNO 测量值作为评估鼻激发结果的唯一诊断工具的价值有限。
