1 Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia.
2 Department of Otorhinolaryngology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Am J Rhinol Allergy. 2019 Mar;33(2):178-183. doi: 10.1177/1945892418825224. Epub 2019 Jan 18.
Specific immunoglobulin E (sIgE) within the nasal airway is likely to be the most ideal marker of allergic status, but little is known of the normative values in asymptomatic patients and those with rhinitis.
The aim of this study was to assess the diagnostic characteristics of inferior turbinate tissue biopsy sIgE in asymptomatic and rhinitic patients.
A diagnostic cross-sectional study was undertaken, involving patients who underwent inferior turbinate surgery with or without other surgical interventions. Inferior turbinate tissue biopsy was performed during surgery and was assessed for allergen sIgE (dust mite, grass [temperate or subtropical], and animal epithelium) using an automated immunoassay. Tissue sIgE was assessed among asymptomatic patients and those with nasal symptoms. Data were presented as median (interquartile range). A receiver operating curve was used to predict the diagnostic utility of turbinate tissue sIgE in determining allergic rhinitis.
A total of 160 patients (41.89 ± 14.65 years, 36.9% females) were included. The median tissue sIgE concentration among the asymptomatic nonatopic group of patients was 0.09 (0.08-0.10) kUA/L and tissue sIgE > 0.10 kUA/L was determined as a positive threshold. Inferior turbinate tissue sIgE was shown to be a predictive test for allergic rhinitis (area under curve: 0.87, 95% confidence interval: 0.84-0.90) with 90% sensitivity and 89% negative predictive value.
Inferior turbinate tissue biopsy sIgE is a sensitive tool to predict allergic rhinitis. The threshold value of 0.1 kUA/L corresponded well with the asymptomatic nonatopic group of patients. This method detects sIgE in the nasal mucosa and may be a useful test for allergic rhinitis in future research.
鼻气道中的特异性免疫球蛋白 E（sIgE）可能是过敏状态最理想的标志物，但无症状患者和鼻炎患者的 sIgE 正常值知之甚少。
本研究旨在评估下鼻甲组织活检 sIgE 在无症状和鼻炎患者中的诊断特征。
进行了一项诊断性横断面研究，涉及接受下鼻甲手术和/或其他手术干预的患者。在手术过程中下鼻甲组织活检，并使用自动免疫测定法评估过敏原 sIgE（尘螨、草（温带或亚热带）和动物上皮）。评估无症状患者和有鼻症状患者的下鼻甲组织 sIgE。数据以中位数（四分位距）表示。使用接收者操作曲线预测下鼻甲组织 sIgE 对确定变应性鼻炎的诊断效用。
共纳入 160 例患者（41.89±14.65 岁，36.9%为女性）。无症状非特应性患者下鼻甲组织 sIgE 浓度中位数为 0.09（0.08-0.10）kUA/L，将 sIgE>0.10 kUA/L 定义为阳性阈值。下鼻甲组织 sIgE 是变应性鼻炎的预测性检测（曲线下面积：0.87，95%置信区间：0.84-0.90），具有 90%的敏感性和 89%的阴性预测值。
下鼻甲组织活检 sIgE 是预测变应性鼻炎的敏感工具。0.1 kUA/L 的阈值与无症状非特应性患者组吻合良好。该方法检测鼻黏膜中的 sIgE，可能是未来研究中变应性鼻炎的有用检测方法。
