The use of nasal allergen vs allergen exposure chambers to evaluate allergen immunotherapy

Introduction Allergen-specific immunotherapy (AIT) is the only disease-modifying treatment option for allergic rhinitis (AR) patients with persistent moderate-severe AR for whom traditional pharmacotherapies are ineffective. The nasal allergen challenge (NAC) and allergen exposure chamber (AEC) are two translational models of AR that can be used to investigate the properties, safety, and efficacy of AIT. Areas Covered Peer-reviewed, human-centered articles utilizing AEC or NAC models to investigate AIT between 2010 and 2020 were curated from PubMed, EMBASE, and OVID Medline databases. AECs have been used to evaluate traditional subcutaneous and sublingual administrations of AIT, including cross-protective effects and different dosing regimens. More recently, the effectiveness of novel AIT formulations has been evaluated. NACs are another model used to study AIT, including using novel intralymphatic routes of administration. It is an especially powerful and versatile tool to determine if basic science and animal model findings are clinically translatable. Expert opinion The AEC and NAC models both produce clinically relevant and reproducible results. AECs are more effective for studying many participants but are limited because they require a specialized facility. As more AIT therapies and new formulations are developed over time, the versatility of the NAC will be especially useful.

Automated summary

Allergen-specific immunotherapy (AIT) is the main disease-modifying treatment option for allergic rhinitis (AR) patients with persistent moderate-severe AR, when traditional pharmacotherapies are not effective. Nasal allergen challenge (NAC) and allergen exposure chamber (AEC) are translational models used to study the properties, safety, and efficacy of AIT. AECs are more effective for studying multiple participants but require specialized facilities, while NAC is a powerful tool to determine the clinical translation of basic science and animal model findings, especially as new AIT therapies and formulations are developed.