This differential diagnosis of allergic vs non-allergic asthma is typically made on the basis of sensitization to allergens, such that absence of sensitization could result in a patient being managed as having non-allergic asthma. In Germany, the number of specific allergen tests is limited and non-standardized (across clinicians and laboratories), with the potential for false negative diagnoses. IDENTIFY aimed to gain data on sensitizations toward aeroallergens in patients with severe asthma who had tested negative to perennial aeroallergens in previous tests. This was a single visit, non-randomized, non-interventional study conducted in 87 centers across Germany. The only inclusion criteria were that patients had to be adults (at least 18 years of age) with a diagnosis of severe asthma (receiving at least Global Initiative for Asthma Step IV therapy), and who had previously tested negative to perennial aeroallergens. Patients were then tested for sensitization to a panel of 35 perennial aeroallergens, with positive sensitization indicated by CAP ≥ 0.35 kU/L. Of 588 patients recruited, 454 had complete and valid data, and had previously tested negative to perennial aeroallergens. Overall, 43.6% of the analyzed patients tested positive for at least one of the included aeroallergens, with 18.7% testing positive for three or more, and 4.2% positive for more than ten. The five most common sensitizations were to Staphylococcus aureus enterotoxin B, Aspergillus fumigatus, Candida albicans, Dermatophagoides farinae, and Rhizopus nigricans, each of which tested positive in at least 9.7% of the population. In this group of patients being managed as having non-allergic asthma (and who had all previously tested negative to perennial aeroallergens), a high proportion tested positive to a broad panel of aeroallergens. A diagnosis of allergic asthma therefore cannot be excluded purely on the basis of standard aeroallergen panels.

中文翻译：

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非过敏性严重哮喘：真的真的总是非过敏性吗？IDENTIFY项目

过敏性哮喘与非过敏性哮喘的这种鉴别诊断通常是基于对过敏原的致敏性，因此，致敏性的缺乏会导致患者被治疗为非过敏性哮喘。在德国，特定的变应原测试数量有限且未标准化（跨临床医生和实验室），有可能导致假阴性诊断。IDENTIFY的目的是获得在先前测试中对常年性气敏原呈阴性的重度哮喘患者对气敏原的敏感性数据。这是在德国的87个中心进行的单次访问，​​非随机，非干预性研究。唯一的入选标准是患者必须是诊断为严重哮喘的成人（至少18岁）（至少接受全球哮喘第四步治疗倡议），并且以前对常年性气敏原测试为阴性。然后测试患者对一组35种常年性气敏原的致敏性，CAP≥0.35 kU / L表示阳性致敏性。在招募的588名患者中，有454名具有完整和有效的数据，并且以前对常年性气变应原测试呈阴性。总体而言，有43.6％的被分析患者至少对其中一种气敏原呈阳性，其中18.7％的三个或更多呈阳性，而4.2％的十个呈阳性。最常见的五种致敏作用是对金黄色葡萄球菌肠毒素B，烟曲霉，白色念珠菌，至少有9.7％的人口中的Dermatophagoides farinae和Rhizopus nigricans呈阳性。在这组被治疗为非过敏性哮喘的患者中（并且以前所有患者对常年性过敏原的检测均为阴性），其中很大一部分患者对多种过敏原呈阳性。因此，不能仅基于标准的空气过敏原检测板就排除过敏性哮喘的诊断。