When compared with local allergic rhinitis (LAR) from D. pteronyssinus (DR) or grass and/or olive allergens, LAR driven by the mold Alternaria alternata (AA) had a higher association with persistent and severe forms of rhinitis, as well as conjunctivitis, polyallergy, and asthma, than the other factors studied that were connected to the localized allergic response, according to a study published in The Journal of Allergy and Clinical Immunology.

In addition, study authors found that basophil activation test [BAT] is “a useful tool for AA-LAR diagnosis.”

The study was designed to look at AA, which has been connected to persistent and severe forms of allergic rhinitis and asthma in atopic patients. “In this study, we aimed to evaluate the clinical impact of local respiratory allergic sensitization of AA in non-patients with local allergic rhinitis,” researchers explain.


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They looked at the clinical phenotype of 39 adult patients with LAR (14 AA-LAR, 11 perennial LAR from DP, and 14 seasonal LAR due to grass and/or olive pollens). The majority of patients were female (67%) at a mean age of 31 years.

Researchers analyzed the frequency and severity of nasal symptoms, presence of comorbidities, and pattern of allergen nasal specific hyper-responsiveness determined by nasal allergen challenge, and used the BAT in 10 AA-LAR patients and 10 LAR individuals non-allergic to AA. 

They found that LAR-AA patients, when compared with LAR no-allergic to AA, had a higher proportion of persistent (91% vs. 73%) and severe rhinitis (29% vs. 9%), asthma symptoms (64% vs. 40%), conjunctivitis (64% vs. 48%), and polyallergy (46% vs. 24%). In addition, they learned that the BAT had a high sensitivity (60%) and specificity (90%) for diagnosing AA-LAR.

Reference

Testera-Montes A, Eguiluz-Gracia I, Veguillas AA, et al. Clinical phenotype of local allergic driven by alternaria alternata allergen rhinitis. J Allergy Clin Immunol. 2021;147(2):AB238. doi:10.1016/j.jaci.2020.12.014.