Allergy Asthma Immunol Res.  2017 Mar;9(2):152-157. 10.4168/aair.2017.9.2.152.

Usefulness of House Dust Mite Nasal Provocation Test in Asthma

• Choi IS
• Kim SJ
• Won JM
• Park MS

• KMID: 2413389
• DOI: http://doi.org/10.4168/aair.2017.9.2.152

Abstract

PURPOSE
We previously reported that the skin prick test was sensitive and the serum specific immunoglobulin E test was specific for predicting positive airway responses to house dust mites (HDMs) in patients with asthma. Because the nose and bronchus are one airway, the nasal provocation test would be more specific for predicting the bronchial responses to HDM than the skin test.
METHODS
The allergy skin prick test and nasal and bronchial provocation tests using HDM (Dermatophagoides farinae) were performed in 41 young men (age, 19-28 years) who wanted military certification for asthma. The nasal responses to HDM was scored according to the severity of rhinorrhea, sneezing, and nose itching.
RESULTS
The prevalence of a positive skin prick test to HDM did not significantly differ between patients with (n=24) and without (n=17) an early airway reaction (EAR; 79.2% vs 70.6%, P=0.534). However, the prevalence of a positive nasal test was significantly higher in the airway responders than in the others (37.5% vs 0%, P=0.005). The concordance of a positive response to the nasal test (κ=0.332, P=0.004) but not to the skin prick test (κ=0.091, P=0.529) was significant with an EAR. The diagnostic sensitivity of the nasal test (37.5%) was lower than that of the skin prick test (79.2%), but the specificity was higher (100% vs 29.4%).
CONCLUSIONS
The skin prick test is more sensitive, whereas the nasal test is more specific and accurate, for predicting an EAR to HDM in patients with asthma.

Keyword

Asthma; Dermatophagoides farinae; nasal provocation test

MeSH Terms

Asthma*
Bronchial Provocation Tests
Certification
Dermatophagoides farinae
Dust*
Ear
Humans
Hypersensitivity
Immunoglobulin E
Immunoglobulins
Male
Military Personnel
Nasal Provocation Tests
Nose
Prevalence
Pruritus
Pyroglyphidae*
Sensitivity and Specificity
Skin
Skin Tests
Sneezing
Dust
Immunoglobulin E
Immunoglobulins

Figure

• 

  Figure Comparison of the proportion of asthmatic subjects with a positive skin prick test response (≥100% of Dermatophagoides farinae/histamine wheal size ratio in prick test; left panel) and that with a positive nasal test response (≥2 of severity score grading to 0-2 of rhinorrhea, sneezing, and nose itching, respectively; right panel) between absence and presence of early or late airway reaction to D. farinae inhalation challenge.

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