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EAACI position paper on the standardization of nasal allergen challenges

(2018) ALLERGY. 73(8). p.1597-1608
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Abstract
Nasal allergen challenge (NAC) is an important tool to diagnose allergic rhinitis. In daily clinical routine, experimentally, or when measuring therapeutic success clinically, nasal allergen challenge is fundamental. It is further one of the key diagnostic tools when initiating specific allergen immunotherapy. So far, national recommendations offered guidance on its execution; however, international divergence left many questions unanswered. These differences in the literature caused EAACI to initiate a task force to answer unmet needs and find a consensus in executing nasal allergen challenge. On the basis of a systematic review containing nasal allergen challenges of the past years, task force members reviewed evidence, discussed open issues, and studied variations of several subjective and objective assessment parameters to propose a standardized way of a nasal allergen challenge procedure in clinical practice. Besides an update on indications, contraindications, and preparations for the test procedure, main recommendations are a bilaterally challenge with standardized allergens, with a spray device offering 0.1mL per nostril. A systematic catalogue for positivity criteria is given for the variety of established subjective and objective assessment methods as well as a schedule for the challenge procedure. The task force recommends a unified protocol for NAC for daily clinical practice, aiming at eliminating the previous difficulty of comparing NAC results due to unmet needs.
Keywords
allergic rhinitis, diagnostic tools, nasal allergen challenge, nasal provocation test, CLINICAL-IMMUNOLOGY, PROVOCATION TEST, NONALLERGIC RHINITIS, RHINOCONJUNCTIVITIS COMMITTEE, OCCUPATIONAL RHINITIS, ACOUSTIC RHINOMETRY, IDIOPATHIC RHINITIS, EUROPEAN ACADEMY, SPANISH SOCIETY, DOUBLE-BLIND

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Chicago
Augé, J, J Vent, I Agache, L Airaksinen, P Campo Mozo, A Chaker, C Cingi, et al. 2018. “EAACI Position Paper on the Standardization of Nasal Allergen Challenges.” Allergy 73 (8): 1597–1608.
APA
Augé, J., Vent, J., Agache, I., Airaksinen, L., Campo Mozo, P., Chaker, A., Cingi, C., et al. (2018). EAACI position paper on the standardization of nasal allergen challenges. ALLERGY, 73(8), 1597–1608.
Vancouver
1.
Augé J, Vent J, Agache I, Airaksinen L, Campo Mozo P, Chaker A, et al. EAACI position paper on the standardization of nasal allergen challenges. ALLERGY. 2018;73(8):1597–608.
MLA
Augé, J et al. “EAACI Position Paper on the Standardization of Nasal Allergen Challenges.” ALLERGY 73.8 (2018): 1597–1608. Print.
@article{8609398,
  abstract     = {Nasal allergen challenge (NAC) is an important tool to diagnose allergic rhinitis. In daily clinical routine, experimentally, or when measuring therapeutic success clinically, nasal allergen challenge is fundamental. It is further one of the key diagnostic tools when initiating specific allergen immunotherapy. So far, national recommendations offered guidance on its execution; however, international divergence left many questions unanswered. These differences in the literature caused EAACI to initiate a task force to answer unmet needs and find a consensus in executing nasal allergen challenge. On the basis of a systematic review containing nasal allergen challenges of the past years, task force members reviewed evidence, discussed open issues, and studied variations of several subjective and objective assessment parameters to propose a standardized way of a nasal allergen challenge procedure in clinical practice. Besides an update on indications, contraindications, and preparations for the test procedure, main recommendations are a bilaterally challenge with standardized allergens, with a spray device offering 0.1mL per nostril. A systematic catalogue for positivity criteria is given for the variety of established subjective and objective assessment methods as well as a schedule for the challenge procedure. The task force recommends a unified protocol for NAC for daily clinical practice, aiming at eliminating the previous difficulty of comparing NAC results due to unmet needs.},
  author       = {Augé, J and Vent, J and Agache, I and Airaksinen, L and Campo Mozo, P and Chaker, A and Cingi, C and Durham, S and Fokkens, W and Gevaert, Philippe and Giotakis, A and Hellings, P and Herknerova, M and Hox, V and Klimek, L and La Melia, C and Mullol, J and Muluk, NB and Muraro, A and Naito, K and Pfaar, O and Riechelmann, H and Rondon, C and Rudenko, M and Samolinski, B and Tasca, I and Tomazic, P and Vogt, K and Wagenmann, M and Yeryomenko, G and Zhang, L and Mösges, R},
  issn         = {0105-4538},
  journal      = {ALLERGY},
  keywords     = {allergic rhinitis,diagnostic tools,nasal allergen challenge,nasal provocation test,CLINICAL-IMMUNOLOGY,PROVOCATION TEST,NONALLERGIC RHINITIS,RHINOCONJUNCTIVITIS COMMITTEE,OCCUPATIONAL RHINITIS,ACOUSTIC RHINOMETRY,IDIOPATHIC RHINITIS,EUROPEAN ACADEMY,SPANISH SOCIETY,DOUBLE-BLIND},
  number       = {8},
  pages        = {1597--1608},
  title        = {EAACI position paper on the standardization of nasal allergen challenges},
  url          = {http://dx.doi.org/10.1111/all.13416},
  volume       = {73},
  year         = {2018},
}

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