Accurately fight against allergic rhinitis: start with allergen detection

Author: Zhao Jing, Chief Physician, Children's Hospital, Capital Institute of Pediatrics

Reviewer: Gu Qinglong, Chief Physician, Children's Hospital Affiliated to Capital Institute of Pediatrics

Allergic rhinitis, as the name suggests, is an inflammatory reaction of the nasal mucosa caused by allergens. Unlike ordinary rhinitis, allergic rhinitis has a clear allergic history and specific allergens.

However, since rhinitis can be caused by a variety of factors, including infection, environmental irritation, etc., confirming allergic rhinitis and conducting allergen testing have become key steps. This not only helps doctors make a clear diagnosis, but also provides important basis for formulating personalized treatment plans.

1. Common allergens of allergic rhinitis in children

There are many types of allergens for allergic rhinitis in children, which are mainly divided into two categories: inhaled allergens and food allergens. Among them, inhaled allergens are more common, mainly including indoor and outdoor categories.

Indoor allergens mainly include mites, animal fur, mold and cockroaches. With the improvement of living conditions and the increase in the number of pets in households, pet fur has become one of the most important indoor allergens. In addition, humid environments are prone to mold growth, and the activities of cockroaches may also bring allergens. The combined effect of these factors can easily cause perennial allergic rhinitis.

Outdoor allergies are mainly caused by pollen, which has distinct regional and seasonal characteristics. Common pollen allergens in China include Artemisia pollen and Humulus pollen in the north. These pollens are dispersed in large quantities in certain seasons, leading to a high incidence of seasonal allergic rhinitis. It is worth noting that there are differences in the types and distribution of pollen in different regions, so pollen allergies also show obvious regional characteristics.

Figure 1 Original copyright image, no permission to reprint

2. Importance and methods of allergen detection

In order to confirm allergic rhinitis in children and identify allergens, allergen testing is an essential step. Allergen testing is mainly divided into two categories: in vivo testing and in vitro testing.

The main method for detecting allergens in the body is to use the skin allergen prick test. This method involves dropping allergen extract on the forearm, gently piercing the skin with a pricking needle, allowing the allergen to enter the subcutaneous tissue, and observing whether an allergic reaction occurs. This method is easy to operate, the results are intuitive, and it can quickly detect allergens inhaled in the air. It is suitable for children over five or six years old. It should be noted that before performing the skin allergen prick test, antihistamines and other drugs that may affect the test results should be discontinued.

Figure 2 Original copyright image, no permission to reprint

In vitro allergen testing involves drawing blood samples and using laboratory equipment to test for allergen-specific IgE antibodies. This method can detect multiple allergens at once and has high sensitivity and specificity. However, the accuracy of in vitro test results is affected by many factors, including testing equipment, reagents, and experimental conditions. Therefore, caution is required when choosing a test method and interpreting the results.

For some children, especially those who need desensitization treatment or have more complex allergen types, it is recommended to combine in vivo and in vitro detection methods to obtain more comprehensive and accurate allergen information.

3. Preparation and precautions before allergen testing

Before conducting allergen testing, parents and children need to make appropriate preparations to ensure the accuracy of the test results.

First of all, you should understand the test methods and precautions in advance, especially the types of drugs that need to be discontinued and the time of discontinuation before the allergen test. Generally speaking, antihistamines and other anti-allergic drugs need to be discontinued for more than 3 days to avoid affecting the test results. At the same time, you should also avoid eating foods that may cause allergies or contacting allergens before the test.

Secondly, during the test, parents should cooperate with the medical staff to ensure that the child remains quiet and relaxed. For younger or emotionally unstable children, appropriate comfort measures can be taken to ensure the smooth progress of the test.

Finally, after the test results come out, parents should communicate with the doctor in time to understand the type of allergens and the degree of allergy so as to develop a targeted treatment plan. At the same time, they should also pay attention to avoiding contact with allergens in daily life to reduce the occurrence of allergic symptoms.