Measurement of Tryptase and CC16/Albumin in Nasal Lavage Fluid as a Screening Tool of Allergic Rhinitis

Abstract

Background There is no trial to make a diagnostic tool of allergic rhinitis (AR) utilizing biomarkers from nasal fluid. Base on previous studies, we selected following five biomarkers in nasal fluids that represent the characteristics of allergic reactions: tryptase, eosinophil cationic protein (ECP), interleukin 5 (IL-5), Clara cell protein 16 (CC16) and CC16-to-albumin ratio. Objective This study aimed to identify biomarkers in nasal discharge that may be used in biosensors to diagnose AR as an additional diagnostic tool. Methods Patients showed rhinorrhea and tested positive on allergic skin and specific immunoglobulin E (IgE) tests were included in the AR group. The non-AR group included individuals no dominant nasal symptoms and tested negative on allergy tests. Nasal lavage fluid samples were collected from all participants. Biomarkers in the samples were quantified using enzyme-linked immunosorbent assay. Results Forty-five patients with AR and 28 non-AR subjects were enrolled in this study. Comparing the concentrations of biomarkers, the concentrations of tryptase and IL-5 were significantly higher in the AR group than in the NAR group. And CC16 level and CC16-to-albumin ratio were significantly lower in the AR group. In the combination of tryptase or CC16-to-albumin ratio, the sensitivity was 90.7% and the specificity was 64.3% ( p = 0.013). Conclusion The combination of “tryptase or CC16-to-albumin” could be used as a screening tool for AR. Although this diagnostic method could not replace conventional diagnostic tools, we could consider the method we proposed as an additional screening tool for patients who could not undergo allergy tests.

To Think Outside the Box Requires Stepping Outside of Your Comfort Zone

“…Park and co-workers provided a nice example of this in their study of nasal lavage biomarkers in allergic rhinitis patients. 8 Biological changes in the global environment have occurred rapidly in the COVID-19 pandemic and Sehanobish and colleagues add to this growing literature. 9 Ultimately, as the global population increases and urbanization continues, a more detailed understanding of the pathophysiology of sinus disease, the impact of changing environmental factors, and exploring easier and less invasive diagnostic strategies will be critical to effectively manage sinus diseases.…”