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Keywords:

  • allergy testing;
  • mucosal brush biopsy;
  • nonallergic rhinitis;
  • inferior turbinate;
  • IgE

Background

This study investigates the prevalence of local, antigen-specific immunoglobulin E (IgE) from mucosal brush biopsy (MBB) of the inferior turbinates in people diagnosed with chronic, idiopathic, nonallergic rhinitis (NAR) based on negative skin and/or in vitro testing.

Methods

A standard cytology brush was used to harvest epithelial cells from the inferior turbinates of 20 adults. These cells were then processed and tested for the presence of total and antigen-specific IgE to 9 common aeroallergens using immunofluorescence. The relationships between detectable IgE and quality of life (QOL), self-reported seasonal symptoms and season of specimen collection were determined.

Results

Antigen-specific IgE for at least 1 antigen was detected on MBB in all of 20 (100%) study participants with a mean of approximately 3 sensitizations per participant. IgE to cockroach was present in 18 of 20 (90%) participants. There was no significant association noted between QOL scores or self-reported seasonal symptoms and the presence of specific IgE to any of the study antigens, although the presence of white oak and ragweed IgE was significantly higher in patients tested during the pollen season.

Conclusion

This study demonstrated that, using MBB of the inferior turbinates, antigen-specific IgE to at least 1 airborne allergen is detectable in 100% of the idiopathic, NAR study population. This rate of sensitization is notably higher than previous reports, suggesting that the prevalence of atopic disease in the general population may be higher than current estimates. Testing for local sensitization should be considered as part of the complete evaluation for atopic disease.