Abstract：
Atopy has been long used as the screening method for airway allergy. Nevertheless, aeroallergens can trigger respiratory symptoms not only in atopic patients (atopic respiratory allergy, ARA), but also in non-atopic subjects (local respiratory allergy, LRA). Moreover, ARA and LRA can coexist in the same patient, and this clinical scenario has been called dual respiratory allergy (DRA). When the clinical history cannot determine the relevance of sensitizations in ARA patients, nasal, conjunctival or bronchial allergen challenges (NAC, CAC, and BAC, respectively) should be conducted. Moreover, these tests are required to identify patients with LRA and DRA. The clarification of the allergic triggers of airway diseases has a profound impact on the management strategies the patients can be offered. Importantly, allergen immunotherapy (AIT) remains as the only disease-modifying intervention for ARA. Recent data indicate that AIT might have a similar effect on LRA patients. Nevertheless, AIT success relies largely on the correct phenotyping of allergic individuals, and NAC, CAC, and BAC are very helpful tools in this regard. In this review, we will summarize the main indications and methodology of CAC, NAC, and BAC. Importantly, the clinical implementation of these tests might translate into precision medicine approaches and better health outcomes for patients with airway allergy.
摘要：
特应性已被用作气道过敏的筛查方法。然而，空气过敏原不仅可以在特应性患者中引发呼吸道症状(特应性呼吸道过敏，ARA),而且在非特应性受试者中(局部呼吸道过敏，上帝抵抗军）。此外，ARA和LRA可以在同一患者中共存，这种临床情况被称为双重呼吸道过敏（DRA）。当临床病史无法确定ARA患者致敏的相关性时，鼻部,结膜或支气管过敏原挑战(NAC，CAC,还有BAC,分别)应该进行。此外，这些检测是确定LRA和DRA患者所必需的.气道疾病的过敏性触发因素的澄清对患者可以提供的管理策略具有深远的影响。重要的是,过敏原免疫疗法（AIT）仍然是ARA唯一的疾病改善干预措施。最近的数据表明，AIT可能对LRA患者具有类似的作用。然而，AIT的成功很大程度上取决于过敏个体的正确表型，NAC,CAC,和BAC在这方面是非常有用的工具。在这次审查中,我们将总结CAC的主要适应症和方法论，NAC,和BAC。重要的是,这些测试的临床实施可能会转化为精准医学方法，并为气道过敏患者带来更好的健康结果。
