Early and late phase asthmatic response in lower airways of cat-allergic asthmatic patients - a comparison between experimental and environmental allergen challenge

• Published in: Allergy 2007-05, Vol.62 (5), p.488-494
• Main Authors: Arvidsson, M.B, Löwhagen, O, Rak, S
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Air Pollutants - adverse effects; Air Pollutants - immunology; Allergens - administration & dosage; Allergens - immunology; Allergic diseases; Animals; Asthma - diagnosis; Asthma - immunology; Biological and medical sciences; Bronchial Hyperreactivity - diagnosis; Bronchial Hyperreactivity - immunology; Bronchial Provocation Tests; cat allergy; Cats - immunology; environmental allergen challenge; experimental allergen challenge; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Immunopathology; late asthmatic response; Male; Medical sciences; Middle Aged; Time Factors
• ISSN: 0105-4538; 1398-9995; 0108-1675
• DOI: 10.1111/j.1398-9995.2007.01278.x

Standardized experimental allergen challenges are usually adopted to investigate the effect of allergen exposure on the lower airways. Environmental (natural) allergen challenges are used less often, mainly because of difficulties in standardizing the method, safety reasons and costs. The aim of this study was to investigate the relationship between an experimental and an environmental bronchial challenge. For this reason a natural challenge model was developed. Sixty-two patients with a history of cat allergen-induced symptoms involving the lower airways, positive skin prick test, positive in vitro specific IgE to cat allergen and bronchial hyper-responsiveness were included. All 62 patients underwent an experimental challenge in the laboratory followed by an environmental allergen challenge. All 62 patients developed an early asthmatic response [>=20% fall in forced expiratory volume in 1 s (FEV₁)] in the experimental challenge and 60% (37/62) during the environmental challenge. A late asthmatic response (>=15% fall in FEV₁ within 3-24 h) was seen in 56% (35/62) of the patients after the experimental challenge. Following the environmental challenge 47% (29/62) of the patients developed a late response. Thirty-four per cent (21/62) of the patients developed a late response in both challenge models and 31% (19/62) did not develop a late response in any model. Thus, there was consistency in 65% (40/62) of the patients in both challenge models. We found consistency in the pattern of response to inhaled allergen between the two challenge models and we believe that experimental bronchial challenge is likely to reflect the development of relevant inflammation in the lower airways after low-dose allergen exposure in the environment.