Sensitization to Cat: When Is Nasal Challenge Needed?

Al‐Ahmad, Mona; Jusufović, Edin; Arifhodžić, Nermina; Nurkić, Jasmina; Hanoun, Abdul Latif

doi:10.1159/000496835

Cited by 10 publications

(5 citation statements)

References 22 publications

(39 reference statements)

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“…In a different study in which 3068 patients, 16% of whom were pediatric patients, were evaluated, a 7 mm wheal size was determined for the development of allergic symptoms in cats with 80% PPV [ 21 ]. In a study evaluating 60 adult patients with AR, it was reported that a cut-off value of >6.5mm for cat allergy could avoid nasal provocation tests, which are often demanding and time-consuming [ 22 ]. While food provocation tests are the gold standard diagnostic method for food allergies, provocation tests for inhaled allergens are of limited practical use.…”

Section: Discussionmentioning

confidence: 99%

The importance of skin prick test in differentiating cat sensitivities and allergies in children

KAYA,

ATAY,

HACI

et al. 2023

Turkish Journal of Medical Sciences

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Background/aim The incidence of cat allergies in children has increased over the years. Children with cat allergies have mostly reported respiratory symptoms. The skin prick test (SPT) is the most preferred method to demonstrate sensitization to allergens. However, not all children who develop cat sensitization due to environmental exposure become allergic to cats. In our study, we aimed to determine the frequency of sensitization to cat and cat allergy, cat-related symptoms, and the cut-off value for the SPT that may indicate cat allergy. Materials and methods Patients aged 2–18 years, who applied to the Health Sciences University İzmir Dr Behçet Uz Pediatrics and Surgery Training and Research Hospital and Balıkesir University Application and Research Hospital Pediatric Allergy outpatient clinics between January 01, 2019 and December 31, 2020, were included in the study. Patients who underwent SPT and found to be sensitized to cat allergen, were evaluated retrospectively. Clinical and laboratory findings of the patients were recorded. Receiver operating characteristics (ROC) analysis was performed to determine the cut-off value for the SPT. Results Sensitization to cat was detected in 140 (4%) out of 3499 patients who underwent SPT. The median age of the patients was 12 years (min–max: 5–18) and 67.1% were male. Eighty-eight (62.9%) patients were symptomatic upon contact with cats, predominantly with nasal symptoms. These patients had significantly larger cat SPT wheal size than asymptomatic patients. The cut-off value was determined as 5.5 mm with a sensitivity of 72.7% and a specificity of 61.5% (95% CI, 60.5%–78.4%). Symptoms resolved in about half of our patients by reducing contact with cats. Conclusion The present study is the first to report the frequency and clinical findings of cat sensitizations and allergies in Turkish children. For effective treatment, cat allergy must be diagnosed. In this regard, the use of a practical, readily accessible 5.5 mm cut-off point on the SPT may be helpful.

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Section: Discussionmentioning

confidence: 99%

The importance of skin prick test in differentiating cat sensitivities and allergies in children

KAYA,

ATAY,

HACI

et al. 2023

Turkish Journal of Medical Sciences

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“…Allergen avoidance or exposure reduction, where possible, is regarded as fundamental to managing allergies, 7,23,88,95,97…”

Section: Methods For Managing Cat Allergymentioning

confidence: 99%

“…Sensitisation (production of allergen-specific IgE9) is necessary for signs of respiratory allergy to develop, but not all sensitised individuals develop allergy symptoms since this depends on many factors, including the level of sensitisation (amount of allergen-specific IgE produced), the ‘allergenicity’ and amount of exposure to the antigen, and other environmental factors. 1 , 7 , 9 , 12 – 14 Cat allergy is reported to be approximately twice as common as dog allergy, 10 and many studies have reported a higher prevalence of sensitisation and/or allergy to cats. 4 , 15 – 21 Even in studies showing similar rates of sensitisation to dogs and cats, 7 , 11 cats may still be a more important cause of allergic symptoms due to quantitative and qualitative differences in the level of sensitisation, the allergenicity of cat antigens, and in exposure to allergens (which may be influenced by pet populations and differences in the physicochemical properties of the allergens).…”

Section: Prevalence Of Human Allergy To Catsmentioning

confidence: 99%

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Human allergy to cats: A review for veterinarians on prevalence, causes, symptoms and control

Sparkes

2021

Journal of Feline Medicine and Surgery

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Practical relevance: Human allergy to cats affects a substantial and growing proportion of the global population, and cat allergy is regarded as the third most common cause of human respiratory allergies, and the second most common indoor cause. Veterinarians will frequently encounter owners who are cat-allergic, and having an understanding of this disease and the methods available to help control the allergy will assist them in giving appropriate advice, alongside human healthcare professionals. Aim: The aim of this review is to summarise currently available data on the prevalence, causes, symptoms and control of human allergy to cats. In terms of managing cat allergy, the emphasis is on reviewing current and emerging modalities to reduce environmental exposure to cat allergens rather than on pharmacotherapy or immunotherapy, as it is in these areas in particular that the veterinarian may be able to offer help and advice to complement that of human healthcare professionals. Evidence base: The information in this review is drawn from the current and historical literature on human allergy to cats, and approaches to reduce exposure to cat allergens and manage symptoms of cat allergy.

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“…It is a safe and reasonably priced technique that replicates an allergic reaction in the nose under standardised and controlled conditions [19]. NPT aims to demonstrate the causal role of an allergen [23], to diagnose local allergic rhinitis [24], and to identify the clinically relevant allergen(s) in polysensitised subjects [25]. Therefore, it could lead to the application of stratified and personalised medicine in rhinitis patients [26].…”

Section: Introductionmentioning

confidence: 99%

Clinical Relevance of Lepidoglyphus destructor Sensitisation in Allergic Rhinitis: Nasal Provocation Test as in vivo Assessment

Matos Semedo,

Martins,

Tomaz

et al. 2024

Int Arch Allergy Immunol

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Background: Dust mites are the leading cause of respiratory allergic diseases worldwide. Allergy to storage mites (SMs) has mostly been related to occupational exposures. However, recent studies have shown that sensitisation to SM, such as Lepidoglyphus destructor (Lep d), is of considerable importance also in urban populations, with high prevalence in dust samples of domestic environments. Co-sensitisation between house dust mites (HDMs) and SM is now regarded as very frequent in some regions, and cross-reactivity between them seems to be narrow. Therefore, SM allergenic capacity is increasingly a subject of study. The nasal provocation test (NPT), as an in vivo technique, could be considered the gold standard for the clinical relevance assessment of an allergen, in polysensitised rhinitis patients. Objective: The objective of this study was to analyse the clinical relevance of the SM Lep d, by assessing the relationship between in vivo sensitisation and expression of allergic respiratory disease in an urban setting. Patients and Methods: In our study, we enrolled a total of 32 allergic patients with rhinitis (with or without asthma) with proven sensitisation by skin prick test (SPT) and specific IgE (sIgE) to HDMs and/or SM. Patients underwent NPT with Lep d using subjective (Lebel Symptom Score Scale) and objective measurements (peak nasal inspiratory flow [PNIF]) for assessment of nasal response. Results: Most of the patients with positive SPT and sIgE to Lep d had a positive NPT (24/27; 89%). True Lep d allergy, assessed by a positive NPT, could be predicted by a SPT wheal size >9.7 mm and a sIgE >0.42 kUA/L, with 100%/95.7% sensitivity and 75.0%/83.3% specificity, respectively. Co-sensitisation between Lep d and Der p was high, 75.0%. Asthma was more frequent in the positive Lep d NPT group (54 vs. 12%, p < 0.05). Significantly more patients from this group reported physical exercise, nonspecific irritants, and respiratory infections as relevant triggers of respiratory symptoms (p < 0.01–p < 0.05). Conclusions: To our knowledge, this is the first study to show that sensitisation to Lep d may have clinical relevance in a non-occupational setting. In this group, there seems to be a relationship between allergy to Lep d and severity of respiratory disease, with more bronchial inflammation, when comparing with mite-allergic patients sensitised only to HDM. Therefore, the authors consider that sensitisation to Lep d should be considered when assessing and treating allergic respiratory disease in urban environments.

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Sensitization to Cat: When Is Nasal Challenge Needed?

Cited by 10 publications

References 22 publications

The importance of skin prick test in differentiating cat sensitivities and allergies in children

The importance of skin prick test in differentiating cat sensitivities and allergies in children

Human allergy to cats: A review for veterinarians on prevalence, causes, symptoms and control

Clinical Relevance of <i>Lepidoglyphus destructor</i> Sensitisation in Allergic Rhinitis: Nasal Provocation Test as in vivo Assessment

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