IGHE and asthma: The finding of the LAR cluster was interesting because none of these patients had a history of asthma, but demonstrated high levels of local eosinophils and local production of specific IgE (local IgE), of which the latter has been used in studies of LAR over the last few years.131, 132, 133 Indeed, another study by Meng and colleagues has suggested that local IgE is a reliable noninvasive alternative to serum IgE for the diagnosis of AR,134 and there is emerging evidence that local IgE could also be used instead of nasal allergen provocation test (NAPT) for the diagnosis of LAR.