"Nasal Allergen Challenge (NAC): Practical Aspects and Applications from an EU/US perspective: A Workgroup Report of the AAAAI Rhinitis, Rhinosinusitis and Ocular Allergy Committee"

Seong H. Cho, Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida Morsani College of Medicine and James A. Haley Veterans' Affairs Hospital, Tampa, Florida.
Anil Nanda, Asthma and Allergy Center, Lewisville and Flower Mound, Texas. Division of Allergy and Immunology, University of Texas Southwestern Medical Center, Dallas, Texas.
Anjeni Keswani, Division of Allergy/Immunology, George Washington University School of Medicine and Health Sciences.
Allen Adinoff, Colorado Allergy and Asthma Centers. University of Colorado School of Medicine, Denver, Colorado.
Fuad M. Baroody, Section of Otolaryngology-Head and Neck Surgery, University of Chicago, Chicago, Illinois.
Jonathan A. Bernstein, University of Cincinnati College of Medicine, Cincinnati, OH.
Alina Gherasim, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
Joseph K. Han, Division of Rhinology and Endoscopic Sinus Surgery, Division of Allergy, Department of Otolayrngology Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, Virginia.
Jerald W. Koepke, Colorado Allergy and Asthma Centers. University of Colorado School of Medicine, Denver, Colorado.
Dennis K. Ledford, Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida Morsani College of Medicine and James A. Haley Veterans' Affairs Hospital, Tampa, Florida.
Amber N. Pepper, Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida Morsani College of Medicine and James A. Haley Veterans' Affairs Hospital, Tampa, Florida.
Carmen Rondón, Allergy Unit, Hospital Regional Universitario de Málaga, IBIMA, ARADyAL, Málaga, Spain.
Amy Schiffman, Allergy, Asthma and Immunology Specialists. Boca Raton, Florida.
Martin Wagenmann, Department of Otorhinolaryngology, Düsseldorf University Hospital (UKD), Düsseldorf, Germany.
Paloma Campo, Allergy Unit, Hospital Regional Universitario de Málaga, IBIMA, ARADyAL, Málaga, Spain. Electronic address: campomozo@gmail.com.

Document Type

Journal Article

Publication Date

2-22-2023

Journal

The Journal of allergy and clinical immunology

DOI

10.1016/j.jaci.2023.02.014

Keywords

Allergen; challenge; nasal; obstruction; symptoms

Abstract

Nasal allergen challenge (NAC) is applied in a variety of settings (research centres, specialty clinics and hospitals) as a useful diagnostic and research tool. NAC is indicated for diagnosis of seasonal and perennial allergic rhinitis, local allergic rhinitis, occupational rhinitis, to design the composition of allergen immunotherapy in polysensitized patients and to investigate the physio-pathological mechanisms of nasal diseases. NAC is currently a safe and reproducible technique, although it is time and resource consuming. NAC can be performed by a variety of methods, but the lack of a uniform technique for performing and recording the outcomes, represents a challenge for those considering NAC as a clinical tool in the office. The availability of standardized allergens for NAC is also different in each country. The objective of this workgroup report is to review the current information about NAC, focusing on the practical aspects and application for diagnosis of difficult rhinitis phenotypes (e.g. local allergic rhinitis, occupational rhinitis), taking into account the particular context of practice in the United States and the European Union.

Department

Medicine

Link to Full Text

Share

COinS