EAACI Position paper on the standardization of nasal allergen challenges
Language English Country Denmark Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
29377177
DOI
10.1111/all.13416
Knihovny.cz E-resources
- Keywords
- allergic rhinitis, diagnostic tools, nasal allergen challenge, nasal provocation test,
- MeSH
- Allergens administration & dosage MeSH
- Rhinitis, Allergic diagnosis MeSH
- Anaphylaxis MeSH
- Administration, Intranasal MeSH
- Immunoglobulin E blood MeSH
- Skin Tests MeSH
- Sneezing immunology MeSH
- Humans MeSH
- Aftercare MeSH
- Nasal Obstruction immunology MeSH
- Nasal Provocation Tests methods standards trends MeSH
- Nasal Mucosa immunology MeSH
- Nasal Sprays MeSH
- Advisory Committees * MeSH
- Pruritus immunology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Germany MeSH
- Names of Substances
- Allergens MeSH
- Immunoglobulin E MeSH
- Nasal Sprays MeSH
Nasal allergen challenge (NAC) is an important tool to diagnose allergic rhinitis. In daily clinical routine, experimentally, or when measuring therapeutic success clinically, nasal allergen challenge is fundamental. It is further one of the key diagnostic tools when initiating specific allergen immunotherapy. So far, national recommendations offered guidance on its execution; however, international divergence left many questions unanswered. These differences in the literature caused EAACI to initiate a task force to answer unmet needs and find a consensus in executing nasal allergen challenge. On the basis of a systematic review containing nasal allergen challenges of the past years, task force members reviewed evidence, discussed open issues, and studied variations of several subjective and objective assessment parameters to propose a standardized way of a nasal allergen challenge procedure in clinical practice. Besides an update on indications, contraindications, and preparations for the test procedure, main recommendations are a bilaterally challenge with standardized allergens, with a spray device offering 0.1 mL per nostril. A systematic catalogue for positivity criteria is given for the variety of established subjective and objective assessment methods as well as a schedule for the challenge procedure. The task force recommends a unified protocol for NAC for daily clinical practice, aiming at eliminating the previous difficulty of comparing NAC results due to unmet needs.
Alergologie a klinická imunologie Nemocnice na Homolce Prague Czech Republic
Allergy and Clinical Immunology Imperial College NHLI London UK
Allergy Unit IBIMA Regional University Hospital of Málaga ARADyAL Málaga Spain
Center for Rhinology and Allergology Wiesbaden Germany
Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias Barcelona Spain
Department of ENT Azienda Ausl di Imola Imola Italy
Department of ORL Hospital Clínic de Barcelona Universitat de Barcelona Barcelona Spain
Department of Otorhinolaryngology Cliniques Universitaires Saint Luc Brussels Belgium
Department of Otorhinolaryngology Düsseldorf University Hospital Düsseldorf Germany
Department of Otorhinolaryngology Medical Faculty Kirikkale University Kirikkale Turkey
ENT Department Faculty of Medicine Eskisehir Osmangazi University Eskisehir Turkey
Faculty of Medicine University of Latvia Riga Latvia
Health and Work Ability Finnish Institute of Occupational Health Helsinki Finland
Kharkiv National Medical University Kharkiv Ukraine
London Allergy and Immunology Centre London UK
Otorhinolaryngology Academic Medical Centre Amsterdam The Netherlands
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