BACKGROUND AND OBJECTIVES: We investigated the seasonal variation of nonspecific hyperreactivity by performing the cold dry air (CDA) provocation test in both summer and winter in patients with rhinitis. SUBJECTS AND METHOD: We performed the CDA provocation test in 57 patients with allergic rhinitis (AR) or non-allergic rhinitis (NAR). Depending on the season and the type of rhinitis, we divided patients into four groups (Summer AR group, n=17; Winter AR group, n=15; Summer NAR group, n=18 and Winter NAR group, n=7) and compared the changes in nasal symptoms, total nasal volume (TNV), and minimal cross-sectional area (MCA) measured by acoustic rhinometry after CDA provocation in each group. RESULTS: When the CDA provocation was performed for AR patients in summer, nasal symptoms improved slightly, which was significantly different from those shown in winter (Summer AR vs. Winter AR, p=0.012). In addition, there was a significant difference in symptom change between AR and NAR patients in the summer (Summer AR vs. Summer NAR, p=0.033). There was no significant difference in TNV or MCA changes after CDA provocation depending on the type of rhinitis and season (p>0.05). CONCLUSION: When performing CDA provocation in AR patients in summer, the examiner should pay attention to the possible paradoxical response.
Humans ; Methods ; Nasal Provocation Tests ; Rhinitis ; Rhinitis, Allergic ; Rhinometry, Acoustic ; Seasons

Objective:To compare the clinical value of visual analogue scale （VAS）, Lebel scale and total nasal symptom scores （TNSS） in evaluating nasal allergen provocation test （NAPT）. Methods:A total of 151 patients suspected of allergic rhinitis admitted to the Department of Otolaryngology-Head and Neck Surgery of our hospital from April 2020 to September 2020 were included, of which 76 were positive for house dust mites and 75 were negative for allergens. Nasal airway resistance（NAR） was measured by active anterior nasal manometry. Nasal symptoms were evaluated by VAS, Lebel and TNSS. House dust mite allergen was used for NAPT by spray method. An increase≥40% in NAR was used as the gold standard for objective evaluation of NAPT. ROC curves of VAS, Lebel and TNSS were drawn to compare the evaluation effectiveness of different subjective evaluation methods, and the optimal critical point of each ROC curve was obtained. Results:With NAR increased by ≥40% as the gold standard, the area under ROC curve of VAS was 0.884, and the sensitivity and specificity were 97.75% and 80.65%, respectively. The area under ROC curve of Lebel was 0.773, and the sensitivity and specificity were 68.54% and 75.81%, respectively. The area under ROC curve of TNSS was 0.792, and the sensitivity and specificity were 68.54% and 79.03%, respectively. There was no significant difference between Lebel and TNSS（P>0.05）. The VAS differed significantly from Lebel and TNSS（P<0.05）. The Kappa values of VAS, Lebel, TNSS and NAR were 0.803, 0.432 and 0.459, respectively. Conclusion:The VAS, Lebel, TNSS subjective scale and NAR are consistent in evaluating the efficacy of NAPT, with the VAS assessment showing highest consistency with NAR. As objective assessment instruments are not widely used in China, subjective assessment method could be adopted to evaluate the efficacy of NAPT in clinical practice, and VAS scale is recommended as a priority.
Animals ; Humans ; Allergens ; Nasal Provocation Tests/methods* ; Rhinitis, Allergic/diagnosis* ; Nose ; Pyroglyphidae

Adult ; Denervation ; methods ; Female ; Humans ; Male ; Middle Aged ; Nasal Provocation Tests ; Nose ; innervation ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the efficacy and safety of rush immunotherapy (RIT) for patients with persistent allergic rhinitis (AR).

METHODSIn this study, a total number of thirty three (33) patients who suffered mite allergic rhinitis were included. These patients completed one year subcutaneous immunotherapy (SCIT). Using RIT, the patients underwent the incremental dose phase in a week instead of 15 weeks in a conventional treatment procedure. The symptom scores, visual analog scale (VAS), appropriate medication score, total blood serum IgE, dermatophagoides pteronyssinus specificity IgG4, mite allergy skin prick test (SPT), dermatophagoides farinae nasal provocation test (NPT) and the incidence of adverse reactions were used to evaluate the efficiency and safety of RIT.

RESULTSAfter one year SCIT treatment, the symptom score and VAS scores were significantly decreased, the corresponding medication usage was significantly reduced (8.91 ± 1.84, 20.64 ± 6.99 vs. 4.97 ± 2.92, 11.94 ± 7.21, t value was 9.15, 7.11, both P < 0.001) and the cutaneous reactions to mite allergen were significantly decreased (P < 0.001) as well. However, dermatophagoides pteronyssinus-specific serum IgG4 increased significantly (Z = -4.517, P < 0.001). The concentration of dermatophagoides farinae nasal provocation test (NPT) was significantly increased. After the treatment, the number of patients who had positive reactions to high concentration nasal provocation test (NPT) increased (χ² = 1.93, P = 0.38). During the treatment, all the patients experienced local reactions, and specifically there were four patients got general reactions.

CONCLUSIONRIT is safe and effective. It shortened the incremental dose phase remarkably. NPT is a good indicator for diagnosing allergic rhinitis and evaluating the efficacy of the treatment.

Allergens ; immunology ; Animals ; Antigens, Dermatophagoides ; immunology ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Humans ; Immunoglobulin G ; blood ; Immunotherapy ; adverse effects ; methods ; Injections, Subcutaneous ; Nasal Provocation Tests ; Pyroglyphidae ; Rhinitis, Allergic ; therapy ; Sensitivity and Specificity ; Skin Tests ; Treatment Outcome