{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T23:32:45Z","timestamp":1778110365790,"version":"3.51.4"},"reference-count":56,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,7,20]],"date-time":"2017-07-20T00:00:00Z","timestamp":1500508800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The diagnosis of allergic rhinitis (AR) is based on cutaneous and serological assessment to determine immunoglobulin E (IgE)\u2010mediated disease. However, discrepancies between these tests and nasal provocation exist. Patients diagnosed as non\u2010allergic rhinitis (NAR) but with positive nasal allergen provocation test (NAPT) may represent a local allergic condition or entopy, still suitable to allergy interventions. The objective of this study was to determine the frequency of nasal reactivity toward allergens among AR and NAR patients, and to describe the diagnostic characteristics of NAPT methodologies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>EMBASE (1947\u2013) and Medline (1946\u2013) were searched until December 8, 2015. A search strategy was used to identify studies on AR or NAR patients subjected to diagnostic local nasal provocation. All studies providing original NAPT data among the AR or NAR population were included. Meta\u2010analysis of proportion data was presented as a weighted probability % (95% confidence interval [CI]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The search yielded 4504 studies and 46 were included. The probability of nasal allergen reactivity for the AR population was 86.3% (95% CI, 84.4 to 88.1) and in NAR was 24.7% (95% CI, 22.3 to 27.2). Reactivity was high with pollen for both AR 97.1% (95% CI, 94.2 to 99.2) and NAR 47.5% (95% CI, 34.8 to 60.4), and lowest with dust for both AR 79.1% (95% CI, 76.4 to 81.6) and NAR 12.2% (95% CI, 9.9 to 14.7). NAPT yielded high positivity when defined by subjective end\u2010points: AR 91.0% (95% CI, 86.6 to 94.8) and NAR 30.2% (95% CI, 22.9 to 37.9); and lower with objective end\u2010points: AR 80.8% (95% CI, 76.8 to 84.5) and NAR 14.1% (95% CI, 11.2 to 17.2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Local allergen reactivity is demonstrated in 26.5% of patients previously considered non\u2010allergic. Similarly, AR, when defined by skin\u2010prick test (SPT) or serum specific IgE (sIgE), may lead to 13.7% of patients with inaccurate allergen sensitization or non\u2010allergic etiologies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.21988","type":"journal-article","created":{"date-parts":[[2017,7,20]],"date-time":"2017-07-20T16:08:43Z","timestamp":1500566923000},"page":"868-877","source":"Crossref","is-referenced-by-count":52,"title":["Positive allergen reaction in allergic and nonallergic rhinitis: a systematic review"],"prefix":"10.1002","volume":"7","author":[{"given":"Aneeza W.","family":"Hamizan","sequence":"first","affiliation":[{"name":"Rhinology and Skull Base Research Group St Vincent's Centre for Applied Medical Research University of New South Wales  Sydney Australia"},{"name":"Department of Otolaryngology and Head and Neck Surgery Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janet","family":"Rimmer","sequence":"additional","affiliation":[{"name":"St Vincent's Clinic St Vincent's Hospital  Sydney Australia"},{"name":"The Woolcock Institute Sydney University  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raquel","family":"Alvarado","sequence":"additional","affiliation":[{"name":"Rhinology and Skull Base Research Group St Vincent's Centre for Applied Medical Research University of New South Wales  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William A.","family":"Sewell","sequence":"additional","affiliation":[{"name":"St Vincent's Clinical School University of New South Wales  Sydney Australia"},{"name":"Garvan Institute  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larry","family":"Kalish","sequence":"additional","affiliation":[{"name":"Sydney Medical School University of Sydney  Sydney Australia"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Concord General Hospital University of Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raymond","family":"Sacks","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Concord General Hospital University of Sydney  Sydney Australia"},{"name":"Faculty of Medicine and Health Sciences Macquarie University  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard J.","family":"Harvey","sequence":"additional","affiliation":[{"name":"Rhinology and Skull Base Research Group St Vincent's Centre for Applied Medical Research University of New South Wales  Sydney Australia"},{"name":"Faculty of Medicine and Health Sciences Macquarie University  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,7,20]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.it.2014.11.002"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLG.0000149682.56426.6B"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.2010.03536.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_6_6_1","volume-title":"Cochrane handbook for systematic reviews of diagnostic test accuracy version 1.0.0","author":"Deeks J","year":"2009"},{"key":"e_1_2_6_7_1","first-page":"1","article-title":"Allergen\u2010specific nasal provocation testing: review by the rhinoconjunctivitis committee of the Spanish Society of Allergy and Clinical Immunology","volume":"21","author":"Dordal M","year":"2011","journal-title":"J Investig Allergol Clin Immunol"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2007.01409.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-3-25"},{"key":"e_1_2_6_10_1","volume-title":"Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. 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