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Allergen-Specific Nasal Provocation Testing: Review by the Rhinoconjunctivitis Committee of the Spanish Society of Allergy and Clinical Immunology


MT Dordal,1 M Lluch-Bernal,2 MC Sánchez,3 C Rondón,4 A Navarro,5 J Montoro,6 V Matheu,7 MD Ibáñez,8 B Fernández-Parra,9 I Dávila,10 J Conde,11 E Antón,12 C Colás,13 A Valero14,15 (SEAIC Rhinoconjunctivitis Committee)

1Department of Allergology, Sant Pere Claver Fundació Sanitària, Barcelona, Spain
2Department of Allergology, Complejo Hospitalario de Toledo, Toledo, Spain
3Department of Allergology, CE Virgen de la Cinta, Hospital Juan Ramón Jiménez, Huelva, Spain
4Department of Allergology, Hospital Carlos Haya, Málaga, Spain 5UGC Alergología Valme-Rocío, Hospital el Tomillar, Sevilla, Spain
6Department of Allergology, Hospital La Plana, Villarreal, Castellón, Spain
7Department of Allergology, Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain
8Department of Allergology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
9Department of Allergology, Hospital El Bierzo, Ponferrada, León, Spain
10Department of Allergology, Hospital Universitario, Salamanca, Spain
11Department of Allergology, Hospital Virgen Macarena, Sevilla, Spain
12Department of Allergology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
13Department of Allergology, Hospital Clínico Universitario, Zaragoza, Spain
14Allergy Unit, Department of Pneumology, Hospital Clínic i Universitari, Barcelona, Spain
15Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Respiratorias, Barcelona, Spain

J Investig Allergol Clin Immunol 2011; Vol. 21(1): 1-12



Specific nasal provocation testing (NPT) consists of eliciting a response from the nasal mucosa by controlled exposure to allergens. It is indicated in the diagnostic confirmation of allergic rhinitis and when discrepancies arise or difficulties exist in the assessment of a patient’s medical history and the results of skin and/or serological tests. The technique is also applied to evaluate sensitivity to the allergen, the efficacy and safety profile of treatment, and in research on the pathophysiological mechanisms of nasal response to allergens. NPT also provides information on the etiology of occupational respiratory diseases of allergic origin. Although there have been many studies and
publications on the use and standardization of bronchial provocation tests with allergen, few analyze specific NPT. In this review, the Rhinoconjunctivitis Committee of the Spanish Society of Allergy and Clinical Immunology discuss the methodology, monitoring, and assessment of allergen-specific NPT in order to provide a practical and up-to-date review of the technique.

Key words: Nasal provocation test. Allergen-specific. Allergic rhinitis. Acoustic rhinometry. Rhinomanometry. Nasal nitric oxide. Nasal peak inspiratory flow.