Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China.
Beijing Key Laboratory of nasal diseases, Beijing Institute of Otolaryngology, Beijing 100005, China.
Rhinology. 2019 Aug 1;57(4):313-320. doi: 10.4193/Rhin18.292.
The diagnostic value of serum specific Immunoglobulin E (sIgE) and nasal allergen provocation test (NAPT) has been well investigated in local allergic rhinitis (LAR). We hypothesized that nasal local sIgE could be used for the diagnosis of LAR instead of NAPT.
This was a prospective single center study. Overall, 212 chronic rhinitis patients were screened, of whom 73 were recruited based on negative findings for serum IgE and positive findings for local eosinophils. Ten healthy subjects were also recruited as controls. All participants completed questionnaires at recruitment to record their demographic data, nasal symptom severity, and physician-diagnosed comorbid asthma. Symptom severity was recorded using a visual analogue scale (VAS) of 10 cm and allergic status was assessed by serum sIgE. Nasal secretions were collected for analysis of local sIgE and eosinophils, and NAPT was performed for confirmation of LAR.
Overall, 14 patients demonstrated positive local sIgE results. Twelve of these patients had significantly higher local sIgE levels compared to controls, and also demonstrated positive NAPT results. The VAS scores, nasal airway resistance measured by active rhinomanometry, and the levels of local sIgE, ECP, histamine and leukotriene C4 were significantly increased from baseline values following NAPT. Sensitivity, specificity, and diagnostic accuracy of local sIgE for diagnosis of LAR were 91.7% respectively.
The measurement of local sIgE levels in nasal secretion is a reliable and effective diagnostic method for LAR.
血清特异性免疫球蛋白 E（sIgE）和鼻变应原激发试验（NAPT）的诊断价值已在局部过敏性鼻炎（LAR）中得到充分研究。我们假设鼻局部 sIgE 可用于 LAR 的诊断，而不是 NAPT。
这是一项前瞻性单中心研究。共筛选出 212 例慢性鼻炎患者，其中 73 例基于血清 IgE 阴性和局部嗜酸性粒细胞阳性而被纳入。还招募了 10 名健康受试者作为对照。所有参与者在招募时都填写了问卷，记录他们的人口统计学数据、鼻症状严重程度和医生诊断的哮喘合并症。症状严重程度使用 10cm 的视觉模拟量表（VAS）记录，过敏状态通过血清 sIgE 评估。收集鼻分泌物进行局部 sIgE 和嗜酸性粒细胞分析，并进行 NAPT 以确认 LAR。
共有 14 例患者表现出阳性的局部 sIgE 结果。其中 12 例患者的局部 sIgE 水平明显高于对照组，且 NAPT 结果也为阳性。NAPT 后，VAS 评分、主动鼻阻力测量的鼻气道阻力以及局部 sIgE、ECP、组胺和白三烯 C4 的水平均显著高于基线值。局部 sIgE 诊断 LAR 的敏感性、特异性和诊断准确性分别为 91.7%。
鼻分泌物中局部 sIgE 水平的测量是 LAR 的一种可靠有效的诊断方法。
