Nasal Provocation Tests With Allergens: Just a Research Tool or Suitable for Everyday Clinical Practice?

Opinion statement

Nasal provocation test (NPT) with allergens is a simple and safe technique recommended in different diagnostic and research settings. In the daily practice, NPT has proved to be very useful when there are discrepancies between patient's symptoms and the results of skin or blood testing, for confirming the clinical relevance of a certain allergen in polysensitized patients and also for the diagnosis of new rhinitis phenotypes such as local allergic rhinitis (LAR). In the research field, nasal provocation test with allergens has been widely used in the study of mechanisms of inflammation and allergic response in subjects with allergic rhinitis (AR) and LAR and the study of pathophysiological mechanisms of response allergens to evaluate the therapeutic effect of drugs or immunotherapy in controlled clinical trials. There are key aspects necessary to achieve the best safety and reproducibility of the test, such as the characteristics of the allergen, application techniques, and measurement of the response that must be as objective as possible. The use of short protocols and simple methods of measurement allows the use of NPT in the daily practice as a diagnostic aid and not only a research tool reserved for clinical trials.

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