Cold Dry Air Provocation and Immunoglobulin E in Nasal Fluid for Diagnosing Nonspecific Hyper-Reactivity / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: We aimed to evaluate the usefulness of cold dry air (CDA) provocation test in patients with non-allergic or allergic rhinitis. SUBJECTS AND METHOD: Twenty-one patients (13 males and 8 females, mean age 36.9±17.6 years) with symptoms of rhinitis were enrolled. We classified patients into groups A (control group, n=9) and B (allergic group, n=12) according to their skin prick test results. Before and after CDA provocation (0℃, relative humidity<10%, total 400 liters during 6 minutes), we evaluated changes in nasal symptoms. We collected serum, and nasal fluid before and after CDA provocation using the filter paper method. We measured serum and nasal fluid IgE levels, compared them between the groups, and evaluated the correlation between serum and nasal fluid IgE. RESULTS: After the CDA provocation, group B had more aggravation of symptoms than group A, with a statistical significance (for nasal obstruction, group A: 3.0±2.4, group B: 5.8±3.4, p=0.049; for itching, group A: 1.0±1.6, group B: 3.8±3.4, p=0.045). The level of serum total IgE was significantly higher in group B (group A: 152.7±67.3 ng/mL, group B: 612.1±291.4 ng/mL, p=0.001). The titer of nasal fluid IgE was higher in group B, before and after the CDA challenge (before CDA, group A: 91.7±52.6 ng/mL, group B: 810.0±1042.3 ng/mL, p=0.029, after CDA, group A: 55.8±43.8 ng/mL, group B: 354.9±236.7 ng/mL, p=0.003). There was a significant correlation between the serum IgE and nasal fluid IgE levels after the CDA provocation test (R2=0.749, p<0.001). CONCLUSION: The CDA provocation test and measurement of nasal fluid IgE level could be useful for the evaluation of nonspecific hyper-reactivity.