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M Lluch-Bernal1,2,
Dordal MT3,4, Antón E5, Campo P6,
Colás C7, Dávila I8, Del Cuvillo
Bernal A9, Fernández-Parra B10,
González R11, González ML12,
Matheu V11, Montoro J13, Panizo C14,
Rondón C6,15, Sánchez MC16, Valero
A17, Vega F18, Velázquez E19,
Navarro A20 (SEAIC 2010 Rhinoconjunctivitis
Committee) |
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1Department of Allergology,
Hospital La Paz, Madrid, Spain
2Department of Allergology, Hospital Virgen
Del Valle, Toledo, Spain
3Department of Allergology, Hospital
Municipal Badalona, Spain
4Department of Allergology, Sant Pere Claver
Fundació Sanitària, Barcelona, Spain
5Department of Allergology, Hospital
Universitario Marqués de Valdecilla, Santander, Spain
6UGC Allergy IBIMA-Hospital Regional, UMA,
Malaga, Spain
7Department of Allergology, Hospital Clínico
Universitario Zaragoza, Zaragoza, Spain
8Department of Allergology, Hospital
Universitario IBSAL, Salamanca, Spain
9Asthma and Rhinitis Unit Department of
Otorhinolaryngology, Hospital de Jerez, Cadiz, Spain
10Department of Allergology, Hospital El
Bierzo, Ponferrada, León, Spain
11Department of Allergology Hospital del
Tórax/Ofra, HUNS La Candelaria, Tenerife, Spain
12Department of Allergology, Hospital Clínico
San Carlos, Madrid, Spain
13Allergy Unit, Hospital Universitario Arnau
de Vilanova Facultad de Medicina, Universidad Católica
de Valencia "San Vicente Martir," Valencia, Spain
14Department of Allergology, Hospital Nuestra
Señora del Prado, Toledo, Spain
15Department of Allergology, Hospital Carlos
Haya Málaga, Spain
16Departmentof Allergology, CE Virgen de la
Cinta Huelva, Spain
17Allergy Unit, Department of Pneumology and
Allergy, Hospital Clínic i Universitari Institut
dInvestigacions Biomèdiques August Pi i Sunyer (IDIBAPS),
CIBERES Barcelona, Spain
18Department of Allergology, Hospital de la
Princesa, Instituto de Investigación Sanitaria Princesa
(IP) Madrid, Spain
19Quiron Sagrado Corazón, Sevilla, Spain
20UGC-IC Alergología Sevilla, Hospital el
Tomillar, Sevilla, Spain |
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Abstract |
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Nasal
hyperreactivity is
the abnormal
reaction of nasal
tissue to a stimulus
that is innocuous to
most people. This
response is caused
by dysregulation of
the autonomic
nervous system at
various levels of
the nasal autonomic
reflex arc. Various
stimuli (methacholine,
histamine, adenosine
5´-monophosphate,
cold air, mannitol,
capsaicin,
phentolamine, and
distilled water)
have been used in an
attempt to find the
test that most
reliably
differentiates
between healthy
individuals and
patients and also
between different
types of rhinitis.
Despite the small
number of
publications
available, in the
present review, we
provide an update on
current nonspecific
nasal provocation
techniques.
The studies
published to date
are not comparable:
the stimuli applied
act through
different mechanisms
and are used to
assess different
pathways, and the
methodologies differ
in terms of
selection of
participants,
concentrations used,
and assessment of
response (criteria
for positivity).
Given the limited
use of nonspecific
nasal provocation
tests in routine
clinical practice,
we believe that more
studies are
warranted to address
the research issues
we present at the
end of the present
review, for example,
the need to
standardize the
methodology for each
test or even the
clinical benefits of
knowing whether or
not a patient has
nasal
hyperreactivity.
Key words:
Nasal provocation.
Nasal
hyperreactivity.
Rhinitis.
Methacholine. AMP.
Histamine. Mannitol.
Cold air. |
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