Utility of silver birch and house dust mite extracts derived from licensed sublingual tablets for nasal allergen challenge

IF 4.6 2区医学 Q2 ALLERGY

Clinical and Translational Allergy Pub Date : 2024-05-23 DOI:10.1002/clt2.12360

Bianca Olivieri, Ana Jimenez Gil, Kostadin Stoenchev, Stephen R. Durham, Guy Scadding

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Abstract

Background

Nasal allergen challenge (NAC) is used to investigate the effects of allergen exposure and assess treatment efficacy in allergic rhinitis (AR). This study aims to establish dose-responses to NAC using licensed silver birch (SB) pollen and house dust mite (HDM) sublingual tablets as sources of the allergen extracts in participants with AR.

Methods

Sixteen volunteers with HDM-induced perennial AR and 15 volunteers with SB pollen-induced seasonal rhinitis underwent a graded up-dosing NAC with extracts derived from HDM allergen (Acarizax®) and SB (Itulazax®) tablets, respectively. Total nasal symptom score (TNSS, range 0–12) and peak nasal inspiratory flow (PNIF) were recorded before, at 10 min and at the end of the NAC. The dose of each allergen that provoked a TNSS of at least 7 (“provoking dose 7”) in most allergic participants was identified. NACs using the “provoking dose 7” were performed on 5 non-allergic individuals to test for irritant effects. The “provoking dose 7” of HDM extract was used in a subgroup of two SB allergic, non-HDM allergic, volunteers, and vice versa for SB extract, to test for allergen specificity of the responses.

Results

Most patients experienced a TNSS of at least 7/12 at a median concentration of 1500 AU/mL for both SB pollen and HDM. The average decline in PNIF at this dose was 63.15% for SB and 63.99% for HDM. NACs using the 1500 AU/mL concentrations were performed on 5 non-allergic individuals with no symptomatic or PNIF response. 1500 AU/mL of HDM extract produced no symptoms in SB allergics nor 1500 AU/mL SB extract in HDM allergics.

Conclusion

For both SB and HDM extracts, the optimal allergen dose for NAC to cause a moderate-severity response (“provoking dose 7/12”) was 1500 AU/mL. Licensed sublingual allergen tablets provide a readily available and inexpensive source of SB and HDM extracts for use in future interventional studies in AR.

Abstract Image

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从特许舌下含片中提取的银桦和屋尘螨提取物可用于鼻过敏原挑战。

背景：鼻过敏原挑战（NAC）用于研究过敏原暴露的影响和评估过敏性鼻炎（AR）的治疗效果。本研究旨在使用获得许可的银桦树（SB）花粉和屋尘螨（HDM）舌下含片作为过敏原提取物的来源，确定过敏性鼻炎患者对 NAC 的剂量反应：16名患有HDM诱发的常年性鼻炎的志愿者和15名患有SB花粉诱发的季节性鼻炎的志愿者分别接受了由HDM过敏原（Acarizax®）和SB（Itulazax®）药片提取物制成的分级上量NAC治疗。鼻腔症状总评分（TNSS，范围 0-12）和鼻腔吸气流量峰值（PNIF）分别在 NAC 前、10 分钟和结束时记录。确定引起大多数过敏参与者 TNSS 至少达到 7（"激起剂量 7"）的每种过敏原的剂量。使用 "激起剂量 7 "对 5 名非过敏者进行了 NAC，以测试刺激效应。在两名对 SB 过敏但对 HDM 不过敏的志愿者组成的分组中使用 HDM 提取物的 "激起剂量 7"，反之亦然，以测试反应的过敏原特异性：结果：当 SB 花粉和 HDM 的中位浓度为 1500 AU/mL 时，大多数患者的 TNSS 至少为 7/12。在此剂量下，SB 花粉和 HDM 花粉的 PNIF 平均下降率分别为 63.15%和 63.99%。对 5 名无症状或无 PNIF 反应的非过敏者进行了浓度为 1500 AU/mL 的 NAC 试验。1500 AU/mL的HDM提取物在SB过敏者中未产生任何症状，1500 AU/mL的SB提取物在HDM过敏者中也未产生任何症状：对于 SB 和 HDM 提取物，NAC 引起中度严重反应（"激起剂量 7/12"）的最佳过敏原剂量为 1500 AU/mL。获得许可的舌下含服过敏原片剂提供了现成且廉价的 SB 和 HDM 提取物来源，可用于未来的 AR 干预研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Translational Allergy Immunology and Microbiology-Immunology

CiteScore

7.50

自引率

4.50%

发文量

117

审稿时长

12 weeks

期刊介绍： Clinical and Translational Allergy, one of several journals in the portfolio of the European Academy of Allergy and Clinical Immunology, provides a platform for the dissemination of allergy research and reviews, as well as EAACI position papers, task force reports and guidelines, amongst an international scientific audience. Clinical and Translational Allergy accepts clinical and translational research in the following areas and other related topics: asthma, rhinitis, rhinosinusitis, drug hypersensitivity, allergic conjunctivitis, allergic skin diseases, atopic eczema, urticaria, angioedema, venom hypersensitivity, anaphylaxis, food allergy, immunotherapy, immune modulators and biologics, animal models of allergic disease, immune mechanisms, or any other topic related to allergic disease.