BACKGROUND: Local allergic rhinitis (LAR) is a phenotype of rhinitis that has been poorly studied in children. It is characterized by the same symptoms of allergic rhinitis but with the absence of markers of systemic atopy. OBJECTIVE: To identify children affected by LAR and to analyze the pathogenesis of this disease. We chose to focus our attention on interleukin (IL) and thymic stromal lymphopoietin (TSLP). METHODS: We enrolled 20 children affected by nonallergic rhinitis (negative skin-prick test results and serum specific immunoglobulin E [sIgE] values). Each patient underwent a nasal allergen provocation test (NAPT) with dust mite and grass pollen. Before and after NAPT, nasal lavage was performed to detect sIgE, IL-5, and TSLP; anterior active rhinomanometry was used to evaluate changes in nasal obstruction. RESULTS: Two patients were positive to a nonspecific NAPT and, thus, were excluded from the study. Of the remaining 18 children, 12 (66.7%) had positive results to at least one NAPT. Among these 12 patients, nasal sIgE levels for Dermatophagoides pteronyssinus, Dermatophagoides farinae, and Lolium perenne increased significantly after NAPT (D. pteronyssinus, p < 0.005; D. farinae, p < 0.05; L. perenne, p < 0.05). Nasal IL-5 levels showed a significant increase after NAPT (p ≤ 0.006), and this increase was significantly higher in children who had positive NAPT results than in those patients with negative NAPT results (p ≤ 0.03). Among the 12 children who had a positive NAPT result, nasal TSLP was detected in 4 patients (33.3%) and its levels showed a relevant increase after NAPT, even though the difference did not reach statistical significance (p ≤ 0.061). CONCLUSION: Observed results raise the importance of better refining the diagnostic protocol for LAR in children. Nasal TSLP and IL-5 levels offer new insights concerning localized allergic inflammation, although the role of nasal sIgE has still to be clarified.

Local allergic rhinitis in children: novel diagnostic features and potential biomarkers / Zicari, Anna Maria; Occasi, Francesca; Di Fraia, Marco; Mainiero, Fabrizio; Porzia, Alessandra; Galandrini, Ricciarda; Giuffrida, Anna; Bosco, Daniela; Bertin, Serena; Duse, Marzia. - In: AMERICAN JOURNAL OF RHINOLOGY & ALLERGY. - ISSN 1945-8924. - STAMPA. - 30:5(2016), pp. 329-334. [10.2500/ajra.2016.30.4352]

Local allergic rhinitis in children: novel diagnostic features and potential biomarkers

ZICARI, Anna Maria
Primo
;
OCCASI, FRANCESCA
Secondo
;
DI FRAIA, MARCO;MAINIERO, Fabrizio;PORZIA, Alessandra;GALANDRINI, Ricciarda;GIUFFRIDA, Anna;BOSCO, Daniela;DUSE, MARZIA
Ultimo
2016

Abstract

BACKGROUND: Local allergic rhinitis (LAR) is a phenotype of rhinitis that has been poorly studied in children. It is characterized by the same symptoms of allergic rhinitis but with the absence of markers of systemic atopy. OBJECTIVE: To identify children affected by LAR and to analyze the pathogenesis of this disease. We chose to focus our attention on interleukin (IL) and thymic stromal lymphopoietin (TSLP). METHODS: We enrolled 20 children affected by nonallergic rhinitis (negative skin-prick test results and serum specific immunoglobulin E [sIgE] values). Each patient underwent a nasal allergen provocation test (NAPT) with dust mite and grass pollen. Before and after NAPT, nasal lavage was performed to detect sIgE, IL-5, and TSLP; anterior active rhinomanometry was used to evaluate changes in nasal obstruction. RESULTS: Two patients were positive to a nonspecific NAPT and, thus, were excluded from the study. Of the remaining 18 children, 12 (66.7%) had positive results to at least one NAPT. Among these 12 patients, nasal sIgE levels for Dermatophagoides pteronyssinus, Dermatophagoides farinae, and Lolium perenne increased significantly after NAPT (D. pteronyssinus, p < 0.005; D. farinae, p < 0.05; L. perenne, p < 0.05). Nasal IL-5 levels showed a significant increase after NAPT (p ≤ 0.006), and this increase was significantly higher in children who had positive NAPT results than in those patients with negative NAPT results (p ≤ 0.03). Among the 12 children who had a positive NAPT result, nasal TSLP was detected in 4 patients (33.3%) and its levels showed a relevant increase after NAPT, even though the difference did not reach statistical significance (p ≤ 0.061). CONCLUSION: Observed results raise the importance of better refining the diagnostic protocol for LAR in children. Nasal TSLP and IL-5 levels offer new insights concerning localized allergic inflammation, although the role of nasal sIgE has still to be clarified.
2016
immunology and allergy; otorhinolaryngology; pathology and forensic medicine
01 Pubblicazione su rivista::01a Articolo in rivista
Local allergic rhinitis in children: novel diagnostic features and potential biomarkers / Zicari, Anna Maria; Occasi, Francesca; Di Fraia, Marco; Mainiero, Fabrizio; Porzia, Alessandra; Galandrini, Ricciarda; Giuffrida, Anna; Bosco, Daniela; Bertin, Serena; Duse, Marzia. - In: AMERICAN JOURNAL OF RHINOLOGY & ALLERGY. - ISSN 1945-8924. - STAMPA. - 30:5(2016), pp. 329-334. [10.2500/ajra.2016.30.4352]
File allegati a questo prodotto
File Dimensione Formato  
Zicari_Local-allergic-rhinitis_2016.pdf

solo gestori archivio

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 275.65 kB
Formato Adobe PDF
275.65 kB Adobe PDF   Contatta l'autore

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/896619
Citazioni
  • ???jsp.display-item.citation.pmc??? 9
  • Scopus 43
  • ???jsp.display-item.citation.isi??? 43
social impact