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nasal allergen challenge

Amber N Pepper, Dennis K Ledford
Nasal and ocular challenges facilitate the evaluation of subjective and objective responses to defined allergen or irritant exposure. Nasal and ocular allergen challenges (NACs and OACs) are the gold standard to diagnose allergic rhinitis and conjunctivitis, respectively, and aid in the evaluation of novel therapies in clinical trials. Additionally, NACs and OACs may help identify medically relevant allergens in clinical practice. Nonspecific or irritant challenges evaluate mucosal hyperreactivity. Direct mucosal challenges, which can be performed in an office or research setting, expose the participant to higher allergen doses than common in the natural environment...
February 28, 2018: Journal of Allergy and Clinical Immunology
M Al Ahmad, N Arifhodzic, J Nurkic, E Jusufovic, A L Hanoun, T Rodriguez
Introduction. Sensitization to cat allergens is common worldwide. Currently, there is a trend towards costly and often unavailable diagnostic analysis. Objectives. The aim is to assess the reliability of skin prick test (SPT) and serum specific IgE (ssIgE) to cat sensitization, by performing nasal challenge test (NCT) in a community with low cat ownership but common presence of stray cats. Patients and methods. Forty-one pa-tients with perennial allergic rhinitis (AR) who were mono or polysensitized (including cat) were included...
January 17, 2018: European Annals of Allergy and Clinical Immunology
Anne K Ellis, Mark W Tenn, Lisa M Steacy, Daniel E Adams, Andrew G Day, Terry J Walker, Hendrik Nolte
BACKGROUND: Grastek® is a standardized sublingual immunotherapy tablet(SLIT-T) approved for the treatment of grass pollen-induced allergic rhinitis(AR) and conjunctivitis. Many grass-allergic patients are also co-sensitized to birch pollen. Whether Grastek® can confer symptomatic benefits for birch pollen-induced AR symptoms is unknown. OBJECTIVE: To evaluate the treatment effect of Grastek® for birch pollen-induced AR in participants sensitized to both grass and birch pollen using the Environmental Exposure Unit(EEU)...
February 9, 2018: Annals of Allergy, Asthma & Immunology
Mena Soliman, Lisa M Steacy, Jenny Thiele, Dan E Adams, Helen L Neighbour, Anne K Ellis
BACKGROUND: Nasal Allergen Challenge(NAC) models have been used to study allergic rhinitis and new therapies. Symptoms and biological samples can be evaluated at time points following allergen exposure. OBJECTIVE: Verification of protocol repeatability and adequate interval between allergen exposures. METHODS: 10 ragweed allergic participants were exposed to incrementally increasing dosages of ragweed allergen intra-nasally until they achieved a Total Nasal Symptom Score(TNSS) of 8/12 and a Peak Nasal Inspiratory Flow(PNIF) >=50% reduction from baseline...
February 9, 2018: Annals of Allergy, Asthma & Immunology
Ryan S Thwaites, Natasha C Gunawardana, Verena Broich, Elizabeth H Mann, Josefin Ahnström, Gaynor A Campbell, Sarah Lindsley, Nehmat Singh, Tanushree Tunstall, David A Lane, Peter J Openshaw, Catherine M Hawrylowicz, Trevor T Hansel
Complement, coagulation and fibrinolysis contribute to the pathology of many respiratory diseases. Here we detail the biphasic activation of these pathways following nasal allergen challenge. Understanding these mechanisms may lead to therapeutic insight in common respiratory diseases.
February 7, 2018: Journal of Allergy and Clinical Immunology
Jean Bousquet, Eli Meltzer, Peter Couroux, Arkady Koltun, Ferdinand Kopietz, Ullrich Munzel, Hans Christian Kuhl, Duc Tung Nguyen, Anne Marie Salapatek, David Price
BACKGROUND: A fixed-dose combination of intranasal azelastine hydrochloride-fluticasone propionate (MP-AzeFlu) is the most effective treatment of allergic rhinitis (AR), but its onset of action requires further investigation. OBJECTIVES: This study compared onset of action of MP-AzeFlu with the free combination of oral loratadine and intranasal fluticasone propionate (LORA/INFP). METHODS: In this single-center randomized, placebo-controlled, double-blind, double-dummy, three-period crossover trial, AR symptoms were induced in asymptomatic patients by ragweed pollen challenge in an allergen environmental exposure chamber...
February 6, 2018: Journal of Allergy and Clinical Immunology in Practice
J Augé, J Vent, I Agache, L Airaksinen, P Campo Mozo, A Chaker, C Cingi, S R Durham, W J Fokkens, P Gevaert, A I Giotakis, P Hellings, M Herknerova, V Hox, L Klimek, C La Melia, J Mullol, N B Muluk, A Muraro, K Naito, O Pfaar, H Riechelmann, C Rondon, M Rudenko, B Samolinski, I Tasca, P V Tomazic, K Vogt, M Wagenmann, G Yeryomenko, L Zhang, R Mösges
Nasal allergen challenge (NAC) is an important tool to diagnose allergic rhinitis. In daily clinical routine, experimentally, or when measuring therapeutic success clinically, nasal allergen challenge is fundamental. It is further one of the key diagnostic tools when initiating specific allergen immunotherapy. So far, national recommendations offered guidance on its execution, however, international divergence left many questions unanswered. These differences in the literature caused EAACI to initiate a task force to answer unmet needs and find a consensus in executing nasal allergen challenge...
January 27, 2018: Allergy
Hirokuni Otsuka, Kuninori Otsuka, Shoji Matsune, Kimihiro Okubo
BACKGROUND: It is difficult to identify the onset of allergic rhinitis in infants because making a conclusive diagnosis can be challenging. OBJECTIVE: We used a combination of cell differentials in nasal swabs and immunoglobulin E (sIgE) antibody values to food and inhalant allergens to make the diagnosis and identify relevant allergens for investigation of the onset of allergic rhinitis. METHODS: We studied 302 children, 2 to 120 months old, who visited our clinic for rhinorrhea...
January 1, 2018: American Journal of Rhinology & Allergy
Lisa A Miller, Christopher M Royer, Kent E Pinkerton, Edward S Schelegle
The respiratory system consists of an integrated network of organs and structures that primarily function for gas exchange. In mammals, oxygen and carbon dioxide are transmitted through a complex respiratory tract, consisting of the nasal passages, pharynx, larynx, and lung. Exposure to ambient air throughout the lifespan imposes vulnerability of the respiratory system to environmental challenges that can contribute toward development of disease. The importance of the respiratory system to human health is supported by statistics from the Centers for Disease Control and Prevention; in 2015, chronic lower respiratory diseases were the third leading cause of death in the United States...
December 1, 2017: ILAR Journal
Anne K Ellis, Mark W Tenn
OBJECTIVE: To summarize studies highlighting recent advances in rhinitis-related research in the past 2 years. DATA SOURCES: Original research articles were procured and examined from the Rhinitis and Upper Airway Disease section of the 2015 to 2017 Annals of Allergy, Asthma & Immunology issues. Additional original research articles were identified from PubMed and Google Scholar using the following search terms: allergic rhinitis, rhinitis, chronic rhinosinusitis, environmental exposure unit, and nasal allergen challenge...
November 18, 2017: Annals of Allergy, Asthma & Immunology
Amedee Renand, Mohamed H Shamji, Kristina M Harris, Tielin Qin, Erik Wambre, Guy W Scadding, Peter A Wurtzen, Stephen J Till, Alkis Togias, Gerald T Nepom, William W Kwok, Stephen R Durham
BACKGROUND: Three years of treatment with either sublingual or subcutaneous allergen immunotherapy has been shown to be effective and to induce long-term tolerance. The Gauging Response in Allergic Rhinitis to Sublingual and Subcutaneous Immunotherapy (GRASS) trial demonstrated that 2 years of treatment through either route was effective in suppressing the response to nasal allergen challenge, although it was insufficient for inhibition 1 year after discontinuation. OBJECTIVE: We sought to examine in the GRASS trial the time course of immunologic changes during 2 years of sublingual and subcutaneous immunotherapy and for 1 year after treatment discontinuation...
November 9, 2017: Journal of Allergy and Clinical Immunology
Young Woong Kim, Amrit Singh, Casey P Shannon, Jenny Thiele, Lisa M Steacy, Anne K Ellis, Helen Neighbour, Daniel R Gliddon, Pascal L C Hickey, Mark Larché, Scott J Tebbutt
Nasal allergen challenge (NAC) is a human model of allergic rhinitis (AR) that delivers standardized allergens locally to the nasal mucosa allowing clinical symptoms and biospecimens such as peripheral blood to be collected. Although many studies have focused on local inflammatory sites, peripheral blood, an important mediator and a component of the systemic immune response, has not been well studied in the setting of AR. We sought to investigate immune gene signatures in peripheral blood collected after NAC under the setting of AR...
November 15, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
P Wild, H Mével, E Penven, D Zmirou-Navier, A Barbaud, A Bohadana, C Paris
BACKGROUND: Atopy has emerged as a major determinant of airway inflammation. OBJECTIVE: To examine whether early markers of occupational asthma increase with degree of sensitisation. METHOD: This study was a prospective follow-up study of apprentices in baking, pastry-cooking and hairdressing during their 2-year apprenticeship. Four visits were conducted to administer a standardised questionnaire, a methacholine challenge test to assess bronchial hyperresponsiveness (BHR) and to measure fractional exhaled nitric oxide (FeNO)...
November 1, 2017: International Journal of Tuberculosis and Lung Disease
Georg Boelke, Uwe Berger, Karl-Christian Bergmann, Carsten Bindslev-Jensen, Jean Bousquet, Julia Gildemeister, Marek Jutel, Oliver Pfaar, Torsten Sehlinger, Torsten Zuberbier
BACKGROUND: The GA(2)LEN chamber has been developed as a novel mobile allergen exposure chamber (AEC) allowing standardized multicenter trials in allergy. Hitherto, subjective nasal symptom scores have been the most often used outcome parameter, but in standardized modern trials objective parameters are preferred. Despite its practicability, the objective parameter peak nasal inspiratory flow (PNIF) has been rarely used for allergy trials in the setting of allergen exposure chambers. This study aims to evaluate PNIF as an outcome parameter for provocation studies in AECs...
2017: Clinical and Translational Allergy
Natasha C Gunawardana, Qing Zhao, Leonidas N Carayannopoulos, Kuenhi Tsai, Vladislav A Malkov, Diana Selverian, Graham Clarke, Tim Mant, Brent D Butts, Kaare Lund, Trevor T Hansel, Hendrik Nolte
No abstract text is available yet for this article.
September 11, 2017: Journal of Allergy and Clinical Immunology
Todor A Popov, Nils Åberg, Jean Emberlin, Peter Josling, Natalia I Ilyina, Nikolai P Nikitin, Martin Church
HPMC-p, an inert micronized powder form of hydroxy-propyl-methyl-cellulose, when insufflated nasally, provides a natural barrier against pollen allergens and noxious agents. This overview assesses the efficacy and safety of this patented powder product and delivery system without an analogue among the cellulose derivatives. Areas covered: Twenty-six studies with HPMC-p were critically appraised to obtain an updated characteristic of the product. Most studies assessed the efficacy of HPMC-p as a nasal barrier enforcing measure: one experimental setup evaluated its ability to prevent or delay the diffusion of allergen through it, two clinical studies used allergen provocation tests, and the remaining relied on clinical criteria in open real world or placebo controlled designs...
September 6, 2017: Expert Review of Respiratory Medicine
M L North, M J Jones, J L MacIsaac, A M Morin, L M Steacy, A Gregor, M S Kobor, A K Ellis
BACKGROUND: Epigenetic alterations may represent new therapeutic targets and/or biomarkers of allergic rhinitis (AR). Our aim was to examine genome-wide epigenetic changes induced by controlled pollen exposure in the environmental exposure unit (EEU). METHODS: 38 AR sufferers and eight nonallergic controls were exposed to grass pollen for 3 hours on two consecutive days. We interrogated DNA methylation at baseline and 3 hours in peripheral blood mononuclear cells (PBMCs) using the Infinium Methylation 450K array...
January 2018: Allergy
A K Ellis, D C Tsitoura, D Quint, W Powley, L A Lee
BACKGROUND: Toll-like receptor 7 (TLR7) stimulation in the airways may reduce responses to aeroallergens by induction of type 1 interferons (IFNs). GSK2245035 is a novel selective TLR7 agonist in pharmaceutical development. OBJECTIVE: Assessment of safety, pharmacodynamics and nasal allergic reactivity following repeated weekly intranasal (i.n.) GSK2245035. METHODS: This randomized, double-blind, placebo-controlled study (TL7116958) was conducted over two pollen seasons (2013-2014) and follow-up study (204509) conducted 1 year later...
July 5, 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
Maciej Kupczyk, Piotr Kuna
Prostaglandin D2 (PGD2) released by degranulating mast cells is believed to play a key role in orchestrating mechanisms of inflammation in allergies and asthma. The biological effects of PGD2 are mediated by D-prostanoid (DP1), CRTH2 (DP2), and thromboxane prostanoid (TP) receptors. The CRTH2 receptor is involved in induction of migration and activation of T helper type 2 (Th2) lymphocytes, eosinophils, and basophils; up-regulation of adhesion molecules; and promotion of pro-inflammatory Th2-type cytokines (interleukin [IL]-4, 5, 13), whereas the DP receptor is associated with relaxation of smooth muscles, vasodilation, inhibition of cell migration, and apoptosis of eosinophils...
August 2017: Drugs
M T Fernández Martín, J C Álvarez López
Multiple chemical sensitivity syndrome is a group of complex disorders that include psychiatric disorders, chronic fatigue and/or respiratory problems. This syndrome could be triggered by specific allergens and toxins that cause neurophysiological sensitization and the appearance of the clinical symptomatology. Anaesthesia for these patients always poses a challenge for the anaesthetist, because they need to find and use drugs that do not trigger or aggravate the symptoms of the disease. Therefore, sevoflurane in these circumstances might be "the ideal anaesthetic"...
May 22, 2017: Revista Española de Anestesiología y Reanimación
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