Superiority of the histamine release test above case history, prick test, and radio-allergosorbent test in predicting bronchial reagibility to the house dust mite in asthmatic children

Summary

It was suggested that 28 asthmatic children be sensitized against the house dust mite according to a positive case history and/or a positive result of the prick test and the radio-allergosorbent test (RAST). When these children underwent a bronchial provocation test with house dust mite allergen, 19 responded with a bronchoconstriction whereas nine remained unaffected. With the positive results there occurred a good correspondence with case history, prick test, and RAST, the latter being most valid in predicting results of bronchial reagibility to the house dust mite. On the other hand, those children who underwent bronchial provocation due to positive results in at least one of the allergy tests, but who did not respond with bronchoconstriction, showed no correspondence with either history or skin testing and RAST. However, when isolated basophiles from both children's groups were challenged with different house dust mite concentrations, the histamine release not only showed a good correspondence with the positive results of the bronchial provocation test, but also a correct prediction of the negative results could be made. Thus, of all allergy tests, the histamine liberation test appears to be the most valid for predicting the bronchial reagibility of asthmatic children to the house dust mite; this perhaps will allow a reduction in the frequency of inhalation challenges in those asthmatic children who are supposed to have been sensitized against house dust mite.