Allergen Skin Test Research Articles

Cluster immunotherapy with a glutaraldehyde‐modified mixture of grasses results in an improvement in specific nasal provocation tests in less than 2.5 months of treatment

Cluster immunotherapy is becoming increasingly used. It allows for a rapid build up phase and the administration of higher doses of allergen in a shorter period of time. To evaluate the effect of short-term pre-seasonal immunotherapy using a glutaraldeyde-modified allergen vaccine in reducing specific nasal hyperreactivity in nasal challenge tests. Thirty-three patients were selected. All patients had a positive history of allergic rhinitis and skin tests to grass pollen, although most of them (72.7%) were sensitized to other allergens as well. The study was conducted outside of the pollen season and the patients did not receive any pharmacological treatment during this period of time. Two randomized groups of patients were established; Group A: 22 patients (13 females and nine males) and Group B, 11 control patients (seven females and four males). Patients in Group A received immunotherapy with a vaccine containing 50% of the wild grasses Trisetum paniceum and Dactylis glomerata. All patients underwent titrated nasal provocation tests (NPT) before and after completion of the study (2.3 and 2.8 months for Groups A and B, respectively). The administration schedule consisted of 0.1 and 0.2 mL at day 1, followed by 0.3 and 0.5 mL at day 7, 0.5 mL after 2 weeks followed by 0.5 mL monthly. A single vial was used containing an allergen concentration of 10 000 TU/mL (105 microg of total protein and 24.6 microg of Group 1 plus 5 allergens/mL). A mean of 6.5 injections were administered to Group A patients between NPTs. There were no significant differences between both groups at the beginning of the study (P=0.48). At the end, only Group A patients needed significant greater threshold concentrations for a positive NPT than at the beginning (P=0.002). A short-term cluster pre-seasonal inmunotherapy with a modified vaccine containing a mixture of grass pollen is effective as determined by an objective measure after only a mean 2.3 months of treatment.

Urban/rural differences in diet and atopy in South Africa

There are large differences in the prevalence of atopic disease between urban and rural areas of developing countries, without good explanation. Diet has been associated with atopic disease, but studies of specific nutrients are contradictory, cross-sectional studies often being unsupported by trials. We investigated diet as an explanation for the difference in the prevalence of atopy between urban and rural areas in South Africa. A cross-sectional analysis of food frequency questionnaires and allergen skin tests from 698 children aged 8-13 years, recruited from 24 schools in Cape Province, South Africa, who were taking part in a case-control study of exercise-induced bronchospasm. Food frequency data were analysed with a principal components analysis (PCA). The first two principal components of diet explained 25% of the variance, and discriminated almost perfectly between urban and rural subjects. The 'urban' component of diet was strongly associated with positive skin tests even after adjusting for urban residence. There were no significant associations between individual foods or nutrients and positive skin tests, allowing for multiple testing. Diet explains part of the difference in prevalence between urban and rural areas. The ability to demonstrate this using PCA, but not by exhaustive analysis of all foods, reflects the value of reducing the number of dietary dimensions. The number of foods and nutrients which can be assessed, and the possibility of confounding and effect modification, make it difficult to identify the features of diet most directly implicated in disease. This may explain inconsistencies in dietary studies.

No reduction in risk in childhood asthma/allergy symptoms found with longer breast-feeding

No reduction in risk in childhood asthma/allergy symptoms found with longer breast-feeding

Allergen skin tests and free IgE levels during reduction and cessation of omalizumab therapy

The recombinant humanized anti-IgE antibody omalizumab rapidly reduces serum free IgE concentrations and alleviates allergic airway disease. It is not known whether stopping or reducing the dose of omalizumab maintains adequate suppression of free IgE levels and IgE-mediated mast cell activation. To determine the effects of omalizumab on serum free IgE and immediate allergen skin test reactivity during initial therapy followed by treatment reduction and cessation. Forty patients with perennial allergic rhinitis were randomized to receive 0.015 or 0.030 mg/kg/IU/mL open-label intravenous omalizumab every 2 weeks for 28 weeks, followed by 0.0015 or 0.0050 mg/kg/IU/mL every 2 weeks for 18 weeks. Serum free IgE levels were measured and titrated dust mite allergen skin tests conducted throughout. At day 98, serum free IgE concentrations were decreased by 96% to 99%, and wheal-and-flare reactions to skin tests were markedly suppressed. After reduced omalizumab doses (day 322), serum free IgE and allergen skin test reactivity increased significantly. On complete discontinuation of therapy (day 378), serum free IgE levels and skin test reactivity returned to baseline levels. Patients with lower initial levels of IgE had significantly less suppression of skin test reactivity. Omalizumab reduced serum free IgE and immediate skin test reactivity to allergen during initial, high-dose administration. These effects were not fully maintained during dose reduction and returned to baseline after cessation of chronic treatment.

Duration of the Inhibition of Histamine- and Allergen-Induced Wheal-and-Flare Responses After Discontinuation of Desloratadine and Levocetirizine

Inhibition of the wheal-and-flare response to allergens by H1-receptor antagonists can impair allergen skin testing results. This study was designed to determine the time periods required for disappearance of the inhibitory effects of the H1-receptor antagonists desloratadine and levocetirizine on histamine- and allergen-induced wheal-and-flare responses.

Allergen immunotherapy for allergic rhinitis

Introduction Allergic rhinitis—the most common allergic disease—is characterized by sneezing, clear rhinorrhea, nasal itching, congestion, and itchy, watery eyes [1]. Despite advances in immunology, allergic rhinitis remains a significant health issue affecting approximately 30% of adults and 40% of children [2]. Its prevalence is increasing, especially in Western countries [3]. The morbidity of allergic rhinitis is significant, inflicting high costs on society through lost work and school time. Allergic rhinitis “is a symptomatic disorder of the nose induced by an IgE [immunoglobulin E]-mediated inflammation after allergen exposure of the membranes lining the nose” [4]. In an atopic individual, allergen exposure causes specific IgE production, which binds to mast cell surfaces. Upon reexposure, the allergen crosslinks IgE on the mast cells, leading to degranulation and release of histamine and other inflammatory mediators [3]. Recommended treatments depend on severity of the disease [4]. Treatments include allergen avoidance, antihistamines, intranasal steroids, antileukotriene receptor antagonists, mast cell stabilizers, and decongestants. Despite treatment, many patients continue to exhibit symptoms. In addition, these treatments offer only symptomatic relief; none has been shown to abate disease activity. However, immunotherapy has been used with success and is the only treatment that may alter disease activity. Subcutaneous immunotherapy (SCIT) requires injections one to three times a week of extracts at increasing concentrations until a maintenance dose is reached. Then, the maintenance dose is given for 3 to 5 years. Reactions to SCIT, which range from mild erythema surrounding the injection site to anaphylaxis, resulted in a search for alternative routes of delivery. Consequently, sublingual immunotherapy (SLIT) has been suggested as an alternative, and is already used routinely in European countries [5]. SCIT has been shown to alter levels of antibodies in the blood, decrease reactions to specific allergen skin testing, and alter the immune response from T helper (Th) 2 (allergic) to Th1 (nonallergic) [6]. The immunologic effect of sublingual immunotherapy is less clear. This review examines SCIT and SLIT as treatments for allergic rhinitis when compared with placebo.

Effect of Azelastine Nasal Spray on Histamine-and Allergen-Induced Skin Wheal Response in Patients with Allergic Rhinitis

Effect of azelastine nasal spray on histamine-and allergen-induced skin test response in patients suffering with allergic rhinitis was evaluated. Baseline cutaneous response to histamine and 18 common allergen extracts were recorded by skin prick tests on 10 patients. The patients were then advised to take azelastine nasal spray (1 spray per nostril, twice daily; 0.28 mg/dose). This pediatric dose is reported to be effective also in adults (age ≥ 12 years) with improved tolerability as compared with usually recommended adult dose of 2 sprays per nostril twice daily. Skin tests were repeated 2 and 6 hours after single dose, as well as after 6 days of continuous treatment. We did not find any significant difference in skin wheal response with single dose and 6 days' treatment of azelastine nasal spray (p > 0.05). It is concluded that diagnostic allergen skin tests may be performed on patients undergoing azelastine nasal spray treatment (0.28 mg/dose, twice a day) during their symptomatic period.

Hauttestung auf Nahrungsmittelallergie nach Allergenkarenz

Some authors argue that food allergy will be lost after years of allergen avoidance. Patients with severe systemic anaphylactic reactions are reluctant to consent to a double blind placebo controlled oral provocation test to prove or disprove tolerance. We studied the persistence of positive skin test results for food allergies after 3 years of allergen avoidance. 45 out of 157 patients with systemic anaphylactic reactions grade III and IV consented to be retested by prick/scratch test. 20 (44.4 %) of the retested patients continued to test positive to the same food allergen as before, 14 (29.9 %) tested positive not to all, but to some of the former allergens and 11 (31.1 %) showed a negative skin test to the former allergen. In the repeat tests we detected a loss of allergic skin test reactions primarily towards the allergens found in fish, crustaceans and exotic fruits, whereas the skin test continued to be positive especially for spices, nuts, vegetables and regional fruits. Allergen avoidance in food allergy leads to a negative skin test in about one third of patients. We recommend the performance of double-blind, placebo controlled food challenges in order to prove conclusively that the allergy has been lost.

A profile of US asthma centers, 2006

Asthma is a significant public health problem that results in 1.8 million annual emergency department (ED) visits. Many ED visits may be prevented with specialized asthma care. To describe US asthma centers with a long-term goal of exploring their potential role in improving outcomes for ED patients with acute asthma. We conducted initial online surveys in 2004. One survey identified asthma centers and their directors through reports by emergency medicine researchers and fellowship directors (allergy/immunology, pulmonary, and critical care) at US hospitals. A second survey asked asthma center directors to describe their asthma center. Follow-up surveys were conducted 2 years later in 2006. Eighty-seven (49%) of the 177 hospitals surveyed have asthma clinics. Although spirometry was available on the day of the visit at all asthma centers surveyed in 2006, only 21% (95% confidence interval, 11 %-34%) of sites reported that at least 90% of visits per week included a spirometry test. Only one quarter (26%; 95% confidence interval, 15%-40%) of asthma centers reported that at least 90% of patients undergo a skin or blood test for environmental allergens during 1 of their visits. Half of center directors (53%) were unsure of the approximate number of annual ED visits for acute asthma at their hospital. No significant measured changes were noted in asthma centers between 2004 and 2006. Asthma centers are heterogenous, with different services available. Although challenges remain, collaboration between EDs and asthma centers may contribute to improved asthma outcomes and merits further study.

Correlation between fungus-specific IgE and skin test for fungus allergens in patients with chronic cough or bronchial asthma

Correlation between fungus-specific IgE and skin test for fungus allergens in patients with chronic cough or bronchial asthma

Skin Testing and Immunotherapy: Standardization in the Seattle Area

Guidelines for the standardization of skin testing and subcutaneous allergen immunotherapy practice have been updated and published by the American Academy of Allergy, Asthma and Immunology, the American College of Allergy, Asthma and Immunology, and the Joint Council of Allergy, Asthma and Immunology over the past 4 years. Goals of standardization include uniformity in the practice of skin testing and documentation, consistency in terminology used in allergen immunotherapy vaccine labeling, and improved efficacy of allergen immunotherapy vaccines. The allergen skin test form should include sufficient information for physicians other than the prescribing physician to understand what tests were performed, how they were performed, and how to correctly imterpret results. Important factors to consider when formulating an imunotherapy vaccine include: crossreactivity of allergens, optimal dose of each consistuent allergen, and possible enzymatic degradation of allergens by proteolytic enzymes. In an effort to ...

Current practice of antibiotics allergic skin testing in Korea

Current practice of antibiotics allergic skin testing in Korea

Anti-IgE treatment of eosinophil-associated gastrointestinal disorders

Eosinophil-associated gastrointestinal disorders (EGIDs) are commonly associated with atopy and are being recognized with increasing frequency. Current therapy for EGIDs is inadequate. We sought to determine the efficacy of anti-IgE therapy in EGIDs and investigate the role of IgE in disease pathogenesis. Nine subjects with EGIDs received omalizumab every 2 weeks for 16 weeks while other therapy was held constant. Blood absolute eosinophil counts, tissue eosinophil counts, symptom scores, and free IgE levels were serially measured. Allergen skin testing and flow cytometry for basophil activation and FcepsilonRI were determined at baseline and at week 16. Omalizumab was associated with a decrease in absolute eosinophil count at both the week 16 (34%, P = .004) and combined weeks 12 to 16 (42%, P = .012) time points. Tissue eosinophils decreased in the duodenum (59%) and gastric antrum (69%) but did not reach statistical significance (P = .074 and .098, respectively). Esophageal eosinophil counts remained unchanged. Basophil and dendritic cell FcepsilonRI expression and free IgE levels were all significantly decreased (P < .005). Omalizumab increased the concentration of allergen required to trigger half-maximal basophil activation by 170-fold. Allergen skin test wheal and erythema responses decreased by 78% and 82%, respectively. Symptom scores were decreased at both the midstudy (63%) and end of study (70%) time points (P < .005 for both). These results demonstrate that IgE-mediated processes contribute to the generation of eosinophilic inflammation in EGIDs and suggest that anti-IgE therapy might be effective in these disorders. Anti-IgE might be a potential therapy for EGIDs.

CBP015 Allergic disorders and skin test positivity in autistic children

CBP015 Allergic disorders and skin test positivity in autistic children

Asthma in American Indian Adults: The Strong Heart Study

Despite growing recognition that asthma is an important cause of morbidity among American Indians, there has been no systematic study of this disease in older adults who are likely to be at high risk of complications related to asthma. Characterization of the impact of asthma among American Indian adults is necessary in order to design appropriate clinical and preventive measures. A sample of participants in the third examination of the Strong Heart Study, a multicenter, population-based, prospective study of cardiovascular disease in American Indians, completed a standardized respiratory questionnaire, performed spirometry, and underwent allergen skin testing. Participants were > or = 50 years old. Of 3,197 participants in the third examination, 6.3% had physician-diagnosed asthma and 4.3% had probable asthma. Women had a higher prevalence of physician-diagnosed asthma than men (8.2% vs 3.2%). Of the 435 participants reported in the asthma substudy, morbidity related to asthma was high: among those with physician-diagnosed asthma: 97% reported trouble breathing and 52% had severe persistent disease. The mean FEV(1) in those with physician-diagnosed asthma was 61.3% of predicted, and 67.2% reported a history of emergency department visits and/or hospitalizations in the last year, yet only 3% were receiving regular inhaled corticosteroids. The prevalence of asthma among older American Indians residing in three separate geographic areas of the United States was similar to rates in other ethnic groups. Asthma was associated with low lung function, significant morbidity and health-care utilization, yet medications for pulmonary disease were underutilized by this population.

Combining skin prick, immediate skin application and specific‐IgE testing in the diagnosis of peanut allergy in children

Previous studies have suggested various diagnostic cut-offs of allergy tests for the diagnosis of clinical peanut allergy in children. There are few data relating to the use of combinations of these tests in children. We aimed to determine the validity of previously reported diagnostic cut-off levels of peanut allergen skin tests and peanut specific-immunoglobulin (Ig) E, as well as the usefulness of combinations of these, for predicting clinical peanut allergy in our Allergy Clinic. Children attending the Allergy Clinic with a positive peanut skin prick test (SPT; n = 84) were included in the study. Immediate skin application food tests (I-SAFT) using 1 g of peanut butter (positive if any wheals were detected at 15 min), peanut specific-IgE levels and open-label peanut food challenges were performed. Fifty-two of 85 peanut challenges were positive. Skin prick test specificity was 67% at >or=8 mm and 100% at >or=15 mm. The I-SAFT was 82% specific. A peanut specific-IgE level of 0.37 kU/l was 98% sensitive but 33% specific. A level of 10 kU/l was 100% specific. Combinations of a SPT of >or=8 mm with a positive I-SAFT and a peanut specific-IgE >or=0.37 kU/l were 88% specific with a sensitivity of 38%. Using challenge outcomes as the standard, available in vitro and in vivo diagnostic tests for peanut allergy have poor sensitivity and specificity and combining them does not significantly improve their clinical usefulness. Previously described diagnostic cut-off levels do not have general applicability. Allergy practitioners may need to interpret results of allergy tests in the context of their own practices.

Volatile Organic Compounds Contribute to Airway Hyperresponsiveness

BackgroundVolatile organic compounds (VOCs) in concentrations found in both the work and home environments may influence lung function. We investigated the prevalence of airway responsiveness in workers exposed to VOCs.MethodsWe used allergic skin tests, nonspecific airway hyperresponsiveness testing and questionnaires to study twenty exposed workers and twenty-seven control subjects. Atopy was defined as a reactor who showed >3+ response to one or more allergens on the skin prick tests. Airway hyperresponsiveness (BRindex) was defined as log [% fall of FEV1/ log (last concentration of methacholine) +10].ResultsThe VOC exposed workers, in comparison with the control subjects, tended to have a higher BRindex (1.19±0.07 vs. 1.15±0.08, respectively). Workers exposed to VOCs with atopy or smoker, as compared with the workers exposed to VOCs with non-atopy and who were non-smokers and the control subjects with non-atopy and who were non-smokers, had a significantly higher BRindex (1.20±0.05 vs. 1.14±0.06 vs. 1.10±0.03, respectively p<0.05). The BRindex was not correlated with atopy, the smoking status or the duration of VOC exposure.ConclusionsThese findings suggest that VOCs may act as a contributing factor of airway hyperresponsiveness in workers exposed to VOCs.

Allergic Rhinitis May Be Important in Snoring Infants

We read with interest the article by Kalra et al, 1 Kalra M LeMasters G Bernstein D et al. Atopy as a risk factor for habitual snoring at age 1 year. Chest. 2006; : 942-946 Abstract Full Text Full Text PDF PubMed Scopus (38) Google Scholar who found that the prevalence of habitual snoring for 1-year-old children was 15% in a high-risk group for atopy,ie, children born to atopic parents. This prevalence was significantly higher than that reported in older children, 10.9% in 6- to 12-year-old children in Hong Kong, 2 Ng DK Kwok KL Cheung JM et al. Prevalence of sleep problems in Hong Kong primary school children: a community-based telephone survey. Chest. 2005; 128: 1315-1323 Abstract Full Text Full Text PDF PubMed Scopus (110) Google Scholar and 10 to 14% in < 6-year-olds in Europe and the United States. 3 Young T Peppard PE Gottlieb DJ Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med. 2002; 162: 1217-1239 Crossref Scopus (3328) Google Scholar This higher prevalence is most likely due to the fact that 29% of this group of infants were atopic, and it is not surprising that Kalra et al 1 Kalra M LeMasters G Bernstein D et al. Atopy as a risk factor for habitual snoring at age 1 year. Chest. 2006; : 942-946 Abstract Full Text Full Text PDF PubMed Scopus (38) Google Scholar found that the presence of atopy increased the risk of habitual snoring (odds ratio, 2.0; 95% confidence interval, 1.2 to 3.0), a common symptom of obstructive sleep apnea syndrome (OSAS). 4 Chau KW Ng DKK Kwok CKL et al. Clinical risk factors for obstructive sleep apnea in children. Singapore Med J. 2003; 44: 570-577 PubMed Google Scholar This was similar to previous findings in Hong Kong, 2 Ng DK Kwok KL Cheung JM et al. Prevalence of sleep problems in Hong Kong primary school children: a community-based telephone survey. Chest. 2005; 128: 1315-1323 Abstract Full Text Full Text PDF PubMed Scopus (110) Google Scholar when we found allergic rhinitis to be a significant risk factor for witnessed apnea with an adjusted odds ratio of 2.19, another symptom of OSAS as well as in the United States. 5 McColley SA Carroll JL Curtis S et al. High prevalence of allergic sensitization in children with habitual snoring and obstructive apnea. Chest. 1997; 111: 170-173 Abstract Full Text Full Text PDF PubMed Scopus (172) Google Scholar It is unfortunate that Kalra et al 1 Kalra M LeMasters G Bernstein D et al. Atopy as a risk factor for habitual snoring at age 1 year. Chest. 2006; : 942-946 Abstract Full Text Full Text PDF PubMed Scopus (38) Google Scholar did not report the prevalence of nasal symptoms in their cohort, as the data would have shed light on the mechanisms that link habitual snoring and atopic status, possibly allergic rhinitis. Other important data that were not reported were the parts played by individual allergens, especially the airborne allergens vs food allergen. These data would help determine whether the inhaled route or the ingested route is important in the habitual snoring infants. In the study of Kalra et al, 1 Kalra M LeMasters G Bernstein D et al. Atopy as a risk factor for habitual snoring at age 1 year. Chest. 2006; : 942-946 Abstract Full Text Full Text PDF PubMed Scopus (38) Google Scholar the definition of positive atopic status for egg white and whole milk was wheal ≥ 3 cm than the negative control, and this would be associated with a high false-positive rate. 6 Sporik R Hill DJ Hosking CS Specificity of allergen skin testing in predicting open food challenges to milk, egg and peanut in children. Clin Exp Allergy. 2000; 30: 1495-1498 Crossref PubMed Scopus (472) Google Scholar ResponseCHESTVol. 131Issue 1PreviewWe thank Ng et al for their interest in our article.1They raise concern about lack of data on nasal symptoms and our definition for positive skin-prick test results. Using the rhinitis definition of a positive parent report to the question “In the past 12 months, has your child ever had a problem with sneezing, or a runny, or a blocked nose when he/she did not have a cold or flu?” we found a strong association between rhinitis and habitual snoring (p < 0.001) in our cohort of 681 infants. In multivariate logistic regression model with habitual snoring as the dependent variable, the adjusted odds ratio for rhinitis was 2.5 (confidence interval, 1.7 to 4.0) and atopy (defined as positive skin-prick test result to an aeroallergen or food allergen was 1.9 (confidence interval, 1.2 to 2.9). Full-Text PDF

Evaluation of atopy among mouth-breathing pediatric patients referred for treatment to a tertiary care center

A mouth breather is someone who uses his/her oral cavity as the main airway during breathing. This is a syndrome with several etiologies, but allergic rhinitis plays a key role due to its high prevalence. The aim of this study was to assess the presence of atopy among mouth-breathing patients referred to a tertiary care center in the metropolitan region of Belo Horizonte, Brazil. Cross-sectional, descriptive study carried out at Hospital das Clínicas of Universidade Federal de Minas Gerais. Patients aged 2 to 12 years, admitted between November 2002 and April 2004, were included. Parents or surrogates completed a comprehensive questionnaire, and patients were submitted to a skin test for inhalant allergens. A total of 140 patients participated in the study. Those with a positive result for at least one allergen were regarded as atopic. The statistical analyses were made using SPSS, with univariate analyses followed by logistic regression. Of 140 patients, 44.3% (62/140) obtained positive results on the allergic test. Mites were the most predominant allergens, with a positive rate of 100% among atopic patients. In the multivariate analysis, atopy was significantly associated with the male sex (p = 0.05), presence of asthma (p = 0.014), lower number of people sleeping in the same room with the patient (p = 0.005), absence of passive smoking (p = 0.005) and absence of sleep apnea (p = 0.003). The high prevalence of positive results on the allergic test highlights the importance of allergologic investigation in mouth-breathers, since allergy has specific treatments that may reduce morbidity in these patients when properly used.

Avaliação de atopia em crianças respiradoras bucais atendidas em centro de referência

OBJETIVO: Respirador bucal é o indivíduo que utiliza a cavidade oral como principal via aérea durante a respiração. Trata-se de síndrome de múltiplas etiologias, dentre as quais a rinite alérgica merece destaque por sua alta prevalência. Este trabalho teve como objetivo avaliar a presença de atopia entre respiradores bucais encaminhados a serviço de referência da região metropolitana de Belo Horizonte. MÉTODOS: Estudo transversal e descritivo, realizado no Hospital das Clínicas da Universidade Federal de Minas Gerais. Foram incluídos pacientes de 2 a 12 anos de idade, com período de admissão entre novembro de 2002 e abril de 2004. Os responsáveis responderam a um questionário completo, e os pacientes foram submetidos a teste alérgico cutâneo para inalantes. Houve 140 participantes do estudo. Foram classificados como atópicos aqueles que apresentaram teste positivo para, no mínimo, um alérgeno. As análises estatísticas foram feitas no programa SPSS, usando análises univariadas seguidas pela regressão logística. RESULTADOS: Entre os 140 pacientes, 44,3% (62/140) tiveram teste alérgico positivo. Ácaros foram os alérgenos predominantes, apresentando positividade em 100% dos atópicos. Em análise multivariada, atopia esteve significativamente associada ao sexo masculino (p = 0,05), presença de asma (p = 0,014), menor número de pessoas dormindo no mesmo cômodo que o paciente (p = 0,005), ausência de tabagismo passivo (p = 0,005) e ausência de apnéia noturna (p = 0,003). CONCLUSÃO: A alta prevalência de positividade no teste alérgico enfatiza a importância da investigação alergológica em respiradores bucais, pois a alergia tem formas específicas de tratamento que podem reduzir a morbidade desses pacientes quando adequadamente utilizadas.