Different inhaled allergen challenge models give reproducible results

Lee, Wha-Yong; Southworth, Thomas; Singh, Dave

doi:10.1016/j.pupt.2015.06.005

Cited by 4 publications

(5 citation statements)

References 8 publications

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“…Many studies have also demonstrated the reproducibility of the BAC in mild allergic asthmatics. 87 Importantly, the intraclass correlation coefficient for the allergen dose eliciting the EAR, the LAR, and a significant increase in sputum eosinophilia are .80, .77, and .60, respectively (all values within the good-to-excellent range). [88][89][90] On the other hand, no published study has investigated the reproducibility of the CAC, although a 92% concordance for HDM has been reported in a congress communication.…”

Section: Reproducib Ilit Ymentioning

confidence: 86%

“…Of note, no false positive result was observed. Many studies have also demonstrated the reproducibility of the BAC in mild allergic asthmatics 87 . Importantly, the intraclass correlation coefficient for the allergen dose eliciting the EAR, the LAR, and a significant increase in sputum eosinophilia are .80, .77, and .60, respectively (all values within the good‐to‐excellent range) 88–90 .…”

Section: Reproducibilitymentioning

confidence: 93%

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Organ‐specific allergen challenges in airway allergy: Current utilities and future directions

Fauquert¹,

Alba‐Linero

Gherasim³

et al. 2023

Allergy

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Atopy has been long used as the screening method for airway allergy. Nevertheless, aeroallergens can trigger respiratory symptoms not only in atopic patients (atopic respiratory allergy, ARA), but also in non‐atopic subjects (local respiratory allergy, LRA). Moreover, ARA and LRA can coexist in the same patient, and this clinical scenario has been called dual respiratory allergy (DRA). When the clinical history cannot determine the relevance of sensitizations in ARA patients, nasal, conjunctival or bronchial allergen challenges (NAC, CAC, and BAC, respectively) should be conducted. Moreover, these tests are required to identify patients with LRA and DRA. The clarification of the allergic triggers of airway diseases has a profound impact on the management strategies the patients can be offered. Importantly, allergen immunotherapy (AIT) remains as the only disease‐modifying intervention for ARA. Recent data indicate that AIT might have a similar effect on LRA patients. Nevertheless, AIT success relies largely on the correct phenotyping of allergic individuals, and NAC, CAC, and BAC are very helpful tools in this regard. In this review, we will summarize the main indications and methodology of CAC, NAC, and BAC. Importantly, the clinical implementation of these tests might translate into precision medicine approaches and better health outcomes for patients with airway allergy.

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Section: Reproducib Ilit Ymentioning

confidence: 86%

Section: Reproducibilitymentioning

confidence: 93%

Organ‐specific allergen challenges in airway allergy: Current utilities and future directions

Fauquert¹,

Alba‐Linero

Gherasim³

et al. 2023

Allergy

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“…Baseline induced sputum and bronchoscopy samples were collected. Induced sputum samples were processed to obtain supernatant for protein analysis and differential cell count cytospins [ 20 ]. Bronchoscopy was performed to collect bronchoalveolar lavage (BAL) fluid for protein analysis and bronchial biopsies for immunohistochemical analysis.…”

Section: Methodsmentioning

confidence: 99%

“…Levels of IL-5 and eosinophil cationic protein (ECP) were assessed in sputum supernatants and bronchoalveolar lavage by MesoScaleDiscovery assay at SGS Cephac Europe, Saint Benoît Cedex, France. Sputum differential cell counts were assessed by Rapi-Diff stain [ 20 ].…”

Section: Methodsmentioning

confidence: 99%

PI3K, p38 and JAK/STAT signalling in bronchial tissue from patients with asthma following allergen challenge

et al. 2018

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BackgroundInhaled allergen challenges are often used to evaluate novel asthma treatments in early phase clinical trials. Current novel therapeutic targets in asthma include phosphoinositide 3-kinases (PI3K) delta and gamma, p38 mitogen-activated protein kinase (p38) and Janus kinase/Signal Transducer and Activator of Transcription (JAK/STAT) signalling pathways. The activation of these pathways following allergen exposure in atopic asthma patients it is not known.MethodsWe collected bronchial biopsies from 11 atopic asthma patients at baseline and after allergen challenge to investigate biomarkers of PI3K, p38 MAPK and JAK/STAT activation by immunohistochemistry. Cell counts and levels of eosinophil cationic protein and interleukin-5 were also assessed in sputum and bronchoalvelar lavage.ResultsBiopsies collected post-allergen had an increased percentage of epithelial cells expressing phospho-p38 (17.5 vs 25.6%, p = 0.04), and increased numbers of sub-epithelial cells expressing phospho-STAT5 (122.2 vs 540.6 cells/mm2, p = 0.01) and the PI3K marker phospho-ribosomal protein S6 (180.7 vs 777.3 cells/mm2, p = 0.005). Type 2 inflammation was increased in the airways post allergen, with elevated levels of eosinophils, interleukin-5 and eosinophil cationic protein.ConclusionsFuture clinical trials of novel kinase inhibitors could use the allergen challenge model in proof of concept studies, while employing these biomarkers to investigate pharmacological inhibition in the lungs.

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“…6,56,86 When controlling for all these factors, BAC has a good reproducibility in mild asthmatics. 87 The dose eliciting EAR in a patient subjected to consecutive bronchial challenges with the same allergen remains within a twofold variation, 85 with an excellent (0.80) intraclass correlation coefficient (ICC) demonstrated for the percentage fall in FEV 1 during the 3 h following allergen inhalation. 84 Moreover, a good-to-excellent (0.60-0.77) ICC has been described for LAR, whereas a good (0.60) ICC was reported for sputum eosinophilia 7 h after allergen inhalation.…”

Section: Reproducib Ilit Ymentioning

confidence: 99%

EAACI position paper on the clinical use of the bronchial allergen challenge: Unmet needs and research priorities

Agache

Antolín‐Amérigo

Blay

et al. 2022

Allergy

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Allergic asthma (AA) is a common asthma phenotype, and its diagnosis requires both the demonstration of IgE‐sensitization to aeroallergens and the causative role of this sensitization as a major driver of asthma symptoms. Therefore, a bronchial allergen challenge (BAC) would be occasionally required to identify AA patients among atopic asthmatics. Nevertheless, BAC is usually considered a research tool only, with existing protocols being tailored to mild asthmatics and research needs (eg long washout period for inhaled corticosteroids). Consequently, existing BAC protocols are not designed to be performed in moderate‐to‐severe asthmatics or in clinical practice. The correct diagnosis of AA might help select patients for immunomodulatory therapies. Allergen sublingual immunotherapy is now registered and recommended for controlled or partially controlled patients with house dust mite‐driven AA and with FEV1 ≥ 70%. Allergen avoidance is costly and difficult to implement for the management of AA, so the proper selection of patients is also beneficial. In this position paper, the EAACI Task Force proposes a methodology for clinical BAC that would need to be validated in future studies. The clinical implementation of BAC could ultimately translate into a better phenotyping of asthmatics in real life, and into a more accurate selection of patients for long‐term and costly management pathways.

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Different inhaled allergen challenge models give reproducible results

Cited by 4 publications

References 8 publications

Organ‐specific allergen challenges in airway allergy: Current utilities and future directions

Organ‐specific allergen challenges in airway allergy: Current utilities and future directions

PI3K, p38 and JAK/STAT signalling in bronchial tissue from patients with asthma following allergen challenge

EAACI position paper on the clinical use of the bronchial allergen challenge: Unmet needs and research priorities

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