Conjunctival Allergen Challenge

Abelson, Mark B.; Chambers, Wiley A.; Smith, Lisa M.

doi:10.1001/archopht.1990.01070030090035

Cited by 259 publications

(65 citation statements)

References 7 publications

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“…In this system, typical symptoms and signs (redness and irritation, vasodilation and tearing, blepharospasm and tarsal conjunctival involvement, and chemosis and lid swelling) are grouped together and classified according to the strength of the response in stages 0–4. The validity and reproducibility of CPTs based on clinical score systems were demonstrated in several investigations [8, 24, 25]. Evaluation of conjunctival redness and vasodilation with image analysis systems [26]have been used in order to obtain objective measures of the response to conjunctival allergen provocation.…”

Section: Discussionsupporting

confidence: 41%

Comparison of Conjunctival and Nasal Provocation Test in Allergic Rhinitis to House Dust Mite

Riechelmann

Epple

Gropper³

2003

Int Arch Allergy Immunol

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Background: Nasal allergen provocation tests (NPTs) are useful in confirming the diagnosis of allergic rhinitis, if data obtained by clinical history, skin tests and specific IgE determinations are not conclusive. Since NPTs are laborious, conjunctival provocation tests (CPTs) appear as an attractive alternative. The concordance of CPTs and NPTs with house dust mite allergen extract in sensitized and nonsensitized subjects should be evaluated. Methods: 50 otherwise healthy subjects with self-reported house dust mite allergy and positive skin prick tests and serum specific IgE to Dermatophagoides pteronyssinus and 45 sex- and age-matched healthy controls without allergic symptoms were included. For NPTs, 100 µl allergen extract [10,000 allergy units (AU/ml)] were applied to the less congested nasal cavity. A clinical symptom score and active anterior rhinomanometry were employed to assess the response. For CPTs, 50 µl low-concentrated D. pteronyssinus extract (1,000 AU/ml), and if negative, 50 µl normally concentrated extract (10,000 AU/ml) were applied to the lower conjunctival sac. The response was assessed employing clinical symptom scores. Results: NPTs and CPTs yielded concordant results in 90% of the subjects successfully tested (Cohen’s kappa = 0.78, p < 0.0001). The diagnostic efficacy of the CPT, with the NPT as the reference method, was 89%, whether or not conjunctival symptoms had been reported in addition to rhinitis symptoms. Both techniques were judged almost equally uncomfortable. Conclusion: CPTs are an acceptable alternative to NPTs in patients with allergic rhinitis to house dust mite, even if they have no conjunctival symptoms.

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Section: Discussionsupporting

confidence: 41%

Comparison of Conjunctival and Nasal Provocation Test in Allergic Rhinitis to House Dust Mite

Riechelmann

Epple

Gropper³

2003

Int Arch Allergy Immunol

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“…In patients with contact urticaria after using latex gloves, the skin provocation test with latex gloves is an easy and safe diagnostic method [11]. The final diagnosis of latex allergy based on the above-mentioned methods is particularly difficult in patients with symptoms of conjunctivitis [19,20,21]. …”

Section: Introductionsupporting

confidence: 42%

“…Abelson et al [19] performed the conjunctival challenge using allergen extracts of grasses, weeds, animal dander and trees in 396 skin-positive subjects. In our series of 950 CACs, systemic reactions – reversible bronchoconstriction and generalized urticaria – occurred in 2 cases.…”

Section: Discussionmentioning

confidence: 46%

“…If there was no response, the examined extract was applied with stronger diluents (1:10), until the last dose (1:1) was applied. The symptoms of conjunctivitis (itching, tearing and redness) were scored as previously described [19] for both eyes, 5 min, 30 min, 6 h and 24 h after the last allergen application. Each symptom (tearing, itching, redness) was graded on a scale from 0 to 2 (0 – no symptoms, 1 – moderate symptoms and 2 – severe symptoms); thus, the total maximum possible score was 6.…”

Section: Methodsmentioning

confidence: 48%

“…CAC was performed according to the modified Abelson method [19] with the allergen latex extracts (100 PNU/ml) (Allergopharma, Joachim Ganzer KG, Reinbek, Germany). Originally, the protein concentration was 1,000 PNU of drug substance per ml in aqueous solution, containing 50% glycerol and 0.2% w/v phenol as preservative.…”

Section: Methodsmentioning

confidence: 49%

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Clinical Value of Conjunctival Allergen Challenge in Diagnosing Allergic Conjunctivitis Related to Latex

Chełmińska

Niedoszytko

Jassem³

2010

Int Arch Allergy Immunol

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Background: The clinical value of conjunctival allergen challenge (CAC) with latex allergen in patients with allergic conjunctivitis remains undefined. The aim of this study was to assess the value of conjunctival allergen challenge with latex extract in a group of patients with latex sensitization and a history of conjunctivitis after contact with latex products. Methods: Fifty patients who had symptoms of conjunctivitis following contact with latex were studied. The control group consisted of 30 subjects without any symptoms of conjunctivitis, negative skin prick test and sIgE <0.35 kU/l for latex. Questionnaires on signs and symptoms, skin prick tests with latex, sIgE and CAC with latex extract were administered. The study was performed at the Department of Allergology of the Medical University of Gdansk in Poland. Results: CAC with latex was positive in 46 patients (92%) and in none of the control group. CAC was the most sensitive diagnostic method (92% sensitivity and 100% specificity). The sensitivity of other methods (skin prick test and sIgE) was lower: 84 and 88%, respectively. Provocation did not induce any serious adverse events. Conclusion: Our study demonstrated the high sensitivity and safety of CAC with the extract of latex allergens in the diagnosis of patients with latex allergy. This method may be considered a diagnostic option in cases with uncertain diagnosis.

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Efficacy of Ketotifen Fumarate 0.025% Ophthalmic Solution Compared With Placebo in the Conjunctival Allergen Challenge Model

Abelson

Chapin²,

Kapik³

et al. 2003

Arch Ophthalmol

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Background: Ketotifen fumarate blocks histamine 1 (H 1 ) receptors, stabilizes mast cells, and acts as an eosinophil inhibitor (decreases chemotaxis and activation of eosinophils).Objective: To assess the efficacy of ketotifen 0.025% ophthalmic solution in the prevention of symptoms of allergic conjunctivitis, using the conjunctival allergen challenge model. Methods:This was a single-center, double-masked, randomized, placebo-controlled, contralateral-eye comparison, allergen challenge trial conducted in the United States. Subjects were randomized to receive ketotifen 0.025% in one eye and placebo in the other. At visits 1 and 2, allergen challenges were performed to determine the allergen concentration eliciting a qualifying reaction for each subject. At the 3 subsequent visits, subjects received 1 drop of ketotifen 0.025% ophthalmic solution in one eye and vehicle solution as placebo in the other eye 15 minutes (visit 3), 6 hours (visit 4), and 8 hours (visit 5) be-fore allergen challenge. The primary efficacy measure was the subject's rating of itching at 3, 7, and 10 minutes after challenge. CLINICAL SCIENCES

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Conjunctival Allergen Challenge

Cited by 259 publications

References 7 publications

Comparison of Conjunctival and Nasal Provocation Test in Allergic Rhinitis to House Dust Mite

Comparison of Conjunctival and Nasal Provocation Test in Allergic Rhinitis to House Dust Mite

Clinical Value of Conjunctival Allergen Challenge in Diagnosing Allergic Conjunctivitis Related to Latex

Efficacy of Ketotifen Fumarate 0.025% Ophthalmic Solution Compared With Placebo in the Conjunctival Allergen Challenge Model

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