[The NTP in allergy research : open questions regarding nasal provocation tests using allergens]

[Molecular component-resolved allergy diagnostics in ENT]

Molecular component-resolved diagnostics (CRD) are, in addition to its research applications, being increasingly used in daily allergological routine. CRD offers improved diagnostic accuracy via a better understanding of the underlying allergen causing symptoms and helps to distinguish between true sensitization and cross reactions in polysensitized patients, thereby providing an approach for individual personalized therapy. Particularly in food allergies and anaphylaxis, CRD can stratify risks for the recurrence of reactions and their severity. The education and extended vocational training of clinical allergologists has to keep pace with the tremendous increase of knowledge in the field of molecular allergology.

[Relevance of nasal provocation testing in house dust mite allergy]

Patients with house dust mite allergies frequently exhibit very different symptoms to those allergic to other inhalant allergens. The frequency of comorbid allergic asthma in these patients is increased. Therefore, diagnosing patients with suspected house dust mite allergies can be difficult. It is important to distinguish between sensitization to an allergen and a clinically relevant allergy. Nasal provocation testing (NPT) is a reliable method to identify patients suitable for a causal treatment (specific immunotherapy). Position papers on methodology and interpretation of NPT data are available. Skin prick and allergen-specific IgE tests reveal a reasonable correlation with NPT results, although this is inexact to some extent. Performance of NPT in patients with suspected house dust mite allergy is important in individuals with questionable symptoms and unclear skin and blood test results, particularly prior to initiation of allergen immunotherapy.