Journal
ALLERGY
Volume 71, Issue 12, Pages 1693-1700Publisher
WILEY
DOI: 10.1111/all.12947
Keywords
aerosol generation; allergen challenge; allergic rhinitis; clinical trial; immunotherapy
Categories
Funding
- ALLERGOPHARMA GmbH & Co. KG, Reinbek, Germany
- Fraunhofer-Society, Germany
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BackgroundEfficacy testing of immunotherapy in field studies is often hampered by variation of airborne allergens. Standardized allergen exposure in challenge chamber settings might be an alternative. Therefore, we developed a universal technique to create an atmosphere loaded with allergen particles of adjustable size from aqueous solutions of licensed allergen extracts. ObjectiveThe aim of this study was to apply this technique and test the safety and efficacy of challenges with house dust mite (HDM) allergen in the Fraunhofer allergen challenge chamber. MethodsAerosol particles carrying HDM allergen were produced by spray-drying of an aqueous solution containing HDM allergen and lactose. In a monocenter, placebo-controlled, single-blind, dose-escalation pilot study, 18 subjects with perennial allergic rhinitis and sensitization to HDM were exposed to HDM allergen for 4 h at either 250, 500, 1000 SQE/m(3) or lactose alone (0 SQE/m(3)) 7 days apart. The dose of 500 SQE/m(3) was repeated to investigate reproducibility. Total nasal symptom score (TNSS) was the primary endpoint. ResultsExposure to HDM increased TNSS (mean SD) to 3.4 +/- 1.8, 3.3 +/- 2.1, and 3.6 +/- 2.0 at 250, 500 and 1000 SQE/m(3), respectively, while lactose alone did not change TNSS (0.7 +/- 0.6). The results were reproducible at 500 SQE/m(3). Pulmonary function and adverse event frequency did not change with escalation of allergen dose. ConclusionThis HDM allergen particle generation is safe, specific and reproducible and can therefore be used for efficacy testing of immunotherapy and for basic clinical research.
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