Is there a role for measurement of nasal IgE antibodies in diagnosis of Alternaria-induced rhinitis in children?

• Autores: George Garas, Nick S. Jones
• Localización: Allergologia et immunopathologia: International journal for clinical and investigate allergology and clinical immunology, ISSN-e 1578-1267, ISSN 0301-0546, Vol. 40, Nº. 2, 2012, págs. 69-70
• Idioma: inglés
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• Resumen

  • Allergic rhinitis is defined as a type I hypersensitivity reaction in the nasal mucosa and its symptoms include sneezing, itching, rhinorrhoea and nasal obstruction. It occurs via an IgE-mediated Th2 cytokine pattern as a result of exposure to an inhalant allergen.1 Allergic rhinitis can be subdivided into seasonal (intermittent) and perennial (persistent), the latter presenting with symptoms throughout the year. Common perennial allergens include Der p1, animal proteins and fungal spores. One of the commonest fungal allergens is Alternaria alternata. Diagnosing an allergy to fungal spores can be difficult, as exposure to it is not readily ascertained in the history. Diagnosing allergic rhinitis involves taking a history; examination and investigations include skin prick testing (SPT), serum IgE titres, nasal provocation testing (NPT) and IgE in nasal secretions. The diagnosis is based on the presence of rhinitic symptoms in the light of objective tests as on their own these tests can give a false positive result. One example is that 15% of an asymptomatic population will have positive SPTs. Nevertheless, skin prick testing remains the most sensitive test.2, 3 In the current issue of Allergologia et Immunopathologia, Fuiano et al. found that in 56 children with suspected allergic rhinitis in a period when Alternaria was present in the air, 20 (37.5%) had a positive skin prick test to Alternaria whilst 45 (80.3%) had IgE to Alternaria in their nasal secretions.4 These findings further re-enforce the concept of local allergy5 which dates back to Huggins and Brostoff.6 Local mucosal allergy has been found in the absence...