hth官方网页版中国有限公司Release date：2020-05-22
JACI：
https://doi.org/10.1016/j.jaci.2020.02.024
Abstract:
Abstract
Background
The direct-instillation nasal allergen challenge (NAC) and the environmental exposure chamber (EEC) are two methods of conducting controlled allergen provocations. The clinical and biological comparability of these methods has not been thoroughly investigated.
Objective
To compare clinical and immunologic responses to cat allergen in NAC versus EEC.
Methods
Twenty-four participants were randomized to receive either NAC followed by a two-day challenge in an EEC or a two-day challenge in EEC followed by NAC. Challenges were separated by 28-day washout periods. We measured total nasal symptom scores (TNSS), peak nasal inspiratory flow (PNIF), nasal (0-8hours) and serum cytokines, serum antibodies, peripheral blood antigen-specific T-lymphocytes, and gene expression in nasal scrapings. The primary outcome was the TNSS area under the curve for the first 3 hours after allergen exposure in NAC or after initiation of exposure in EEC.
Results
Both challenges increased IL-5 and IL-13 in nasal fluids and serum and resulted in altered nasal cell expression of gene modules related to mucosal biology and transcriptional regulation. Changes in gene modules, more so than cytokine measurements, showed significant associations with TNSS and PNIF. Overall, EEC exposure generated larger responses and more early terminations compared to NAC. Although the two challenges did not correlate in symptom magnitude or temporality, striking correlations were observed in cytokine levels.
Conclusion
Although clinical outcomes of NAC and EEC were temporally different and non-equivalent in magnitude, immunologic responses were similar. Selection of a particular allergen challenge method should depend on considerations of study objectives and cost.
All Author:David Larson PiyushPate Anne MarieSalapatek PeterCouroux Don Whitehouse AdelaPina Jacqueline L.Johnson Michelle L.Sever SrinathSanda JulianPoyser, MS5TheresaAllio Guy W.Scadding TielinQin Mohamed H.Shamji William W.Kwok Eddie A.JamesDeanna French AlinaLelic …Stephen R.Durham
[IF:13.1]
Nasal Allergen Challenge and Environmental Exposure Chamber Challenge: A Randomized Trial Comparing Clinical and Biological Responses to Cat Allergenhttps://doi.org/10.1016/j.jaci.2020.02.024
Abstract:
Abstract
Background
The direct-instillation nasal allergen challenge (NAC) and the environmental exposure chamber (EEC) are two methods of conducting controlled allergen provocations. The clinical and biological comparability of these methods has not been thoroughly investigated.
Objective
To compare clinical and immunologic responses to cat allergen in NAC versus EEC.
Methods
Twenty-four participants were randomized to receive either NAC followed by a two-day challenge in an EEC or a two-day challenge in EEC followed by NAC. Challenges were separated by 28-day washout periods. We measured total nasal symptom scores (TNSS), peak nasal inspiratory flow (PNIF), nasal (0-8hours) and serum cytokines, serum antibodies, peripheral blood antigen-specific T-lymphocytes, and gene expression in nasal scrapings. The primary outcome was the TNSS area under the curve for the first 3 hours after allergen exposure in NAC or after initiation of exposure in EEC.
Results
Both challenges increased IL-5 and IL-13 in nasal fluids and serum and resulted in altered nasal cell expression of gene modules related to mucosal biology and transcriptional regulation. Changes in gene modules, more so than cytokine measurements, showed significant associations with TNSS and PNIF. Overall, EEC exposure generated larger responses and more early terminations compared to NAC. Although the two challenges did not correlate in symptom magnitude or temporality, striking correlations were observed in cytokine levels.
Conclusion
Although clinical outcomes of NAC and EEC were temporally different and non-equivalent in magnitude, immunologic responses were similar. Selection of a particular allergen challenge method should depend on considerations of study objectives and cost.
All Author:David Larson PiyushPate Anne MarieSalapatek PeterCouroux Don Whitehouse AdelaPina Jacqueline L.Johnson Michelle L.Sever SrinathSanda JulianPoyser, MS5TheresaAllio Guy W.Scadding TielinQin Mohamed H.Shamji William W.Kwok Eddie A.JamesDeanna French AlinaLelic …Stephen R.Durham
2020-3-13 Article
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