J Rhinol.  2024 Mar;31(1):29-36. 10.18787/jr.2024.00004.

Chronic Rhinosinusitis With Nasal Polyps Does Not Affect the Association Between the Nasal Provocation Test and Serum Allergen-Specific Immunoglobulin E Levels

• Yoon H
• Kwak IY
• Kim K
• Min HJ

• KMID: 2554088
• DOI: http://doi.org/10.18787/jr.2024.00004

Abstract

Background and Objectives
This study compared nasal provocation test (NPT) results between groups with and without chronic rhinosinusitis with nasal polyps (CRSwNP) to investigate whether CRSwNP affects the response to the intranasal allergen challenge.
Methods
We reviewed the medical records of patients who had undergone the NPT, multiple allergen simultaneous test (MAST), and paranasal sinus computed tomography. Patients were diagnosed with CRSwNP based on findings from nasal endoscopy and paranasal sinus computed tomography. The NPT for house dust mites was conducted, and a positive MAST diagnosis was determined when the levels of immunoglobulin E specific to Dermatophagoides farinae and Dermatophagoides pteronyssinus were equal to or greater than 2 positives or at least 0.70 IU/mL. We statistically analyzed the NPT results and their correlation with MAST outcomes, comparing the CRSwNP group to the non-CRSwNP group.
Results
Out of 99 participants, 30 had CRSwNP and 69 did not. There were no significant differences between the groups regarding MAST positivity, eosinophil count, eosinophil cationic protein levels, or responses to intranasal house dust mite challenges. The presence of CRSwNP did not significantly influence the correlation between NPT outcomes and MAST results.
Conclusion
The presence of CRSwNP did not influence the outcomes of the NPT or its correlation with the results of the MAST. Additional large-scale, longitudinal studies are warranted to validate these findings.

Keyword

Nasal provocation test; Multiple allergen simultaneous test; Chronic sinusitis

Figure

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  Fig. 1. Receiver operating characteristic (ROC) curve result for the nasal provocation test (NPT), eosinophil cationic protein (ECP) level, and eosinophil count in patients without chronic rhinosinusitis with nasal polyp (CRSwNP). A: ROC curve result for the NPT, ECP level, and eosinophil count. B: ROC curve result for subjective symptoms during the nasal provocation test (NPT). The area under the curve (AUC) was measured and compared with the results of the multiple allergen simultaneous test (MAST). An AUC >0.5 signifies a significant association, in line with the Wilcoxon rank-sum test. *p<0.05.

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  Fig. 2. Receiver operating characteristic (ROC) curve result for the nasal provocation test (NPT), eosinophil cationic protein (ECP) level, and eosinophil count in patients with chronic rhinosinusitis with nasal polyp (CRSwNP). A: ROC curve result for the NPT, ECP level, and eosinophil count. B: ROC curve result for subjective symptoms during the NPT. The area under the curve (AUC) was measured and compared with the results of the multiple allergen simultaneous test (MAST). An AUC >0.5 signifies a significant association, in line with the Wilcoxon rank-sum test. *p<0.05.

Reference

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