ArticleScientific reports2026
Refining the diagnosis of house dust mite-induced allergic rhinitis: optimizing SPT and sIgE cutoff values as predictors of clinically relevant allergy.
Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Skin prick testing (SPT) and serum-specific IgE (sIgE) measure sensitization rather than clinical allergic rhinitis (AR), making nasal provocation testing (NPT) the reference standard for confirming clinically relevant allergy. A cross-sectional study was conducted on 122 adult AR patients (18–60 years). Participants underwent SPT, sIgE measurement, and NPT for Der p and Der f. Correlations between SPT, sIgE, and NPT results were analyzed, and receiver operating characteristic (ROC) analysis was performed to determine optimal diagnostic cutoffs. Among participants, 106 (86.9%) were SPT-positive for Der p and 80 (65.6%) for Der f. Using the conventional screening threshold (sIgE ≥ 0.35 IU/mL), 86 (70.5%) were positive for Der p and 60 (49.2%) for Der f. NPT positivity was observed in 88 (72.1%) patients for Der p and in 68 (55.7%) patients for Der f. ROC analysis identified higher cutoffs associated with improved specificity: ≥4.2 mm mean wheal diameter (MWD) for SPT and ≥ 1.10 IU/mL for sIgE in Der p, and ≥ 3.75 mm MWD and ≥ 0.50 IU/mL for Der f. While the conventional sIgE threshold (≥ 0.35 IU/mL) remained a strong independent predictor of NPT positivity, the ROC-derived cutoffs demonstrated enhanced diagnostic precision. Our results suggest that although conventional thresholds remain appropriate for initial screening, the ROC-optimized values identified in this study provide greater diagnostic precision and may aid clinical decision-making when NPT is unavailable.
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