Journal of asthma and allergy · 2026
Nasal Secretion Der p-Specific IgE as a Potential Non-Invasive Diagnostic Biomarker for House Dust Mite-Related Allergic Rhinitis: A Single-Center Cross-Sectional Diagnostic-Accuracy Study.
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Ye Fei, Ni Mei, Shen Qiuyan, Xu Zhihui, Rong Jiance, Wang Ji, Gan Hui
Аннотация
BACKGROUND: Nasal secretion specific IgE (sIgE) may reflect local mucosal reactivity in allergic rhinitis (AR), but its diagnostic performance against nasal provocation remains uncertain.
OBJECTIVE: To evaluate nasal secretion Dermatophagoides pteronyssinus-specific IgE (Der p sIgE) for house dust mite (HDM)-related AR and its associations with nasal sensitivity and systemic sensitization.
METHODS: In this single-center cross-sectional diagnostic-accuracy study, 139 consecutive participants referred for suspected HDM-related AR underwent standardized HDM nasal provocation testing (NPT); after exclusion of 24 participants, 115 were included and classified as AR (positive NPT: Lebel score ≥ 5 with typical perennial rhinitis; n = 88) or non-AR controls (negative NPT, no typical history; n = 27). Nasal secretions were collected non-invasively with sterile cotton wool in one nostril for 15 min, and Der p sIgE was quantified in the eluate by chemiluminescent immunoassay (NOVEOS), with serum IgE on the same platform. Diagnostic accuracy was assessed by the area under the ROC curve (AUC).
RESULTS: Nasal Der p sIgE was higher in AR than controls (1.14 vs 0.03 kUA/L; P < 0.001); AUC was 0.84 (95% CI 0.76-0.91). At ≥ 0.1 kUA/L, sensitivity was 80.7% and specificity 66.7%; at ≥ 3.5 kUA/L, observed specificity was 100.0% (95% CI 87.5-100.0). Systemic HDM sensitization was present in 88/88 AR participants and 10/27 controls. Nasal Der p sIgE rose with nasal sensitivity (P < 0.001) and correlated with NPT score (ρ = 0.37), serum total IgE (ρ = 0.47), and serum Der p sIgE (ρ = 0.42; all q < 0.001).
CONCLUSION: Non-invasively collected nasal Der p sIgE distinguished HDM-related AR from non-AR controls and tracked the intensity of local nasal reactivity. It may serve as a potential non-invasive adjunct to NPT, pending prospective validation.
OBJECTIVE: To evaluate nasal secretion Dermatophagoides pteronyssinus-specific IgE (Der p sIgE) for house dust mite (HDM)-related AR and its associations with nasal sensitivity and systemic sensitization.
METHODS: In this single-center cross-sectional diagnostic-accuracy study, 139 consecutive participants referred for suspected HDM-related AR underwent standardized HDM nasal provocation testing (NPT); after exclusion of 24 participants, 115 were included and classified as AR (positive NPT: Lebel score ≥ 5 with typical perennial rhinitis; n = 88) or non-AR controls (negative NPT, no typical history; n = 27). Nasal secretions were collected non-invasively with sterile cotton wool in one nostril for 15 min, and Der p sIgE was quantified in the eluate by chemiluminescent immunoassay (NOVEOS), with serum IgE on the same platform. Diagnostic accuracy was assessed by the area under the ROC curve (AUC).
RESULTS: Nasal Der p sIgE was higher in AR than controls (1.14 vs 0.03 kUA/L; P < 0.001); AUC was 0.84 (95% CI 0.76-0.91). At ≥ 0.1 kUA/L, sensitivity was 80.7% and specificity 66.7%; at ≥ 3.5 kUA/L, observed specificity was 100.0% (95% CI 87.5-100.0). Systemic HDM sensitization was present in 88/88 AR participants and 10/27 controls. Nasal Der p sIgE rose with nasal sensitivity (P < 0.001) and correlated with NPT score (ρ = 0.37), serum total IgE (ρ = 0.47), and serum Der p sIgE (ρ = 0.42; all q < 0.001).
CONCLUSION: Non-invasively collected nasal Der p sIgE distinguished HDM-related AR from non-AR controls and tracked the intensity of local nasal reactivity. It may serve as a potential non-invasive adjunct to NPT, pending prospective validation.