Endotypes of Persistent Allergic Rhinitis: Offending Allergens, Sensitivity of Diagnostic Tests and Quality of Life Differences

Background The endotype of allergic rhinitis (AR) known as local allergic rhinitis (LAR) is distinguished by localized nasal allergic reactions despite negative skin and blood tests for systemic IgE. This work aims to evaluate the offending allergens, sensitivity of diagnostic tests, and quality of life differences in different endotypes of AR. Methods A clinical study was conducted on 44 patients complaining of AR symptoms and 44 healthy controls. Three endotypes of persistent Allergic rhinitis: Type (I): (AR), Type (II): (LAR) subdivide to group (a) (LAR) with positive nasal allergen provocation test (NAPT) with elevated nasal specific IgE and group (b) LAR with positive nasal allergen provocation test (NAPT) and non-elevated nasal specific IgE. All patients were subjected to C-reactive protein, blood IgE (total and specific) and nasal IgE (total and specific), nasal allergen provocation test (NAPT) and the Mini Rhino Conjunctivitis Quality of Life Questionnaire (MINI RQLQ). Results The serum-specific IgE levels of aeroallergens, the mean of Dermatophagoides pteronyssinus (D. pteronyssinus ) and Dermatophagoides farinae (D. farinae ) was significantly higher in Type (I) patients (17.75±17.71 IU/ml (11.16 ±12.55 IU/ml), (p=0.021, p=0.030) respectively. Regarding nasal-specific IgE levels of aeroallergens, a mean of D. pteronyssinus and D. farinae were significantly higher in the Type (II) (17.25 ±7.88), (12.75 ±4.92 IU/ml) respectively, (p