Author/Editor		Zidarn, Mihaela; Robič, Maša; Krivec, Anja; Šilar, Mira; Resch, Yvonne; Vrtala, Susanne; Kopač, Peter; Bajrović, Nisera; Valenta, Rudolf; Korošec, Peter
Title		Clinical and immunological differences between asymptomatic HDM-sensitized and HDM-allergic rhinitis patients
Type		članek
Vol. and No.		Letnik 49, št. 6
Publication year		2019
Volume		str. 808-818
ISSN		1365-2222 - Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
Language		eng
Abstract		Background: Confirmation of the clinical relevance of sensitisation is important for the diagnosis of allergic rhinitis. Objective: To investigate the usefulness of an in vitro basophil activation test and component-resolved diagnosis in distinguishing between symptomatic allergic rhinitis patients and asymptomatic sensitization to house dust mites (HDMs). Methods: Thirty-six subjects with a positive skin prick test (SPT) for HDM were divided into a symptomatic (n=17) and an asymptomatic (n=19) group on the basis of their clinical history and a nasal provocation test. A basophil CD63 response to in vitro stimulation with Dermatophagoides pteronyssinus whole allergen extract and the IgE reactivity profiles for Der p 1, 2, 4, 5, 7, 10, 11, 14, 15, 18, 21, 23 were evaluated. Serum IgE and IgG specific to D. pteronyssinus whole allergen extract and total IgE were measured. Results: There were no statistically significant differences in the levels of IgE (IgE levels were higher in symptomatic patients with P=0.055) and IgG specific to D. pteronyssinus and total IgE. Symptomatic patients showed a lower threshold for in vitro basophil activation (3.33 ng/mL versus 33.3 ng/mL), a higher area under the curve (AUC) of basophil activation (171 vs. 127) (P=0.017), a higher response to positive control with anti-Fc[epsilon]RI stimulation (97% vs. 79%) (P<0.001), a recognition of more HDM allergens (4 vs. 2), and more frequent sensitization to rDer p 7 (P=0.016) and rDer p 23 compared to asymptomatic subjects (P=0.018). There was a positive correlation (r=0.63; P<0.001) between the number of recognised allergens and the AUC of basophil activation. Conclusion and clinical relevance: In the subjects studied the differences in the basophil response to D. pteronyssinus allergen extract, number of recognized HDM allergens and reactivity to rDer p 7 and rDer p 23 distinguish symptomatic from asymptomatic HDM sensitisation better than SPT or allergen extract specific IgE. Information regarding the clinical relevance of sensitization is important for the prescription of allergen-specific immunotherapy.
Descriptors		Allergy and immunology Rhinitis, allergic Basophils Mites Dermatophagoides pteronyssinus Immunotherapy Immunoglobulin E Alergija in imunologija Alergijski rinitis Bazofilci Pršice Dermatophagoides pteronyssinus Imunoterapija Imunoglobulin E Diagnosis diagnostika
Keywords		basophil activation basophil activation test CD63 house dust mite IgE aktivacija bazoflicev test aktivacije bazofilcev CD63 pršice IgE