Reactivity of nasal cavity mucosa in the nasal cow’s milk allergen provocation test

Introduction:
The nasal allergen provocation test plays an important role in differential diagnostics of rhinitis. Due to its informative potential, the test is also becoming increasingly used in other areas of diagnostics, including the diagnostics of food allergies.

Aim:
To assess the reactivity of nasal mucosa to the cow’s milk protein allergens (as being widely used in powdered form in the food industry).

Material and methods:
The study material consisted of a group of 31 healthy subjects not sensitized to environmental allergens including cow’s milk protein allergens. The study method involved an incremental nasal provocation test with cow’s milk protein evaluated using the visual analog scale and acoustic rhinometry.

Results:
A total of 29 out of 31 volunteers presented with a significant decrease in nasal patency (control solution: 1.112 ±0.161 vs. local allergen application 1.005 ±0.157; p < 0.004) as measured by acoustic rhinometry following the allergen dose of 12.5 µg. Slight changes in complaints were observed using the visual analog scale. Exposure to the widespread food allergens (including powdered cow’s milk allergens) presents a potential risk of positive response in non-sensitized individuals.

Conclusions:
Further studies on dose standardization are necessary in the study area.