Nasal Provocation Test in the Diagnosis of Allergic Rhinitis

The specific provocation tests, since its introduction by Blackley in 1853, have been widely used in the investigation of pathophysiological mechanisms, immunological and therapeutic aspects of allergic disease, as they mimic the response to allergen exposure, under controlled conditions. However, it has not been broadly used in the diagnosis of allergic disease in clinical practice, because of the lack of standardization of the methodology and the need of other complementary diagnostic tests for monitoring specific provocation tests. Nevertheless, the importance of such test is enormous in many circumstances, since it is the only method that can establish the exact etiology of allergic disease. Although the usefulness of these tests has not been questioned, the need to standardize the methodology for monitoring the response has been stressed. In this review, these aspects will be discussed.