RT Journal Article
SR Electronic
T1 Specific nasal challenge in the diagnosis of alternaria-induced asthma
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p4072
VO 38
IS Suppl 55
A1 Dimitrios Latsios
A1 Despoina Papakosta
A1 Konstantinos Porpodis
A1 Theodoros Kontakiotis
A1 Chloe Asaridou
A1 Katerina Manika
A1 Dimitrios Gioulekas
A1 Konstantinos Zarogoulidis
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p4072.abstract
AB Background: Allergic sensitization to Alternaria has been identified as a risk factor for the development and persistence of asthma and is associated with severe and life-threatening episodes. The interaction between upper and lower airways has not been investigated for Alternaria.Aims and objectives: To investigate whether specific nasal challenge with Alternaria allergen can be used as a diagnostic tool for Alternaria-induced asthma.Patients and methods: The study included 15 adults patients with mild, allergic asthma sensitive to Alternaria and two control groups: 1) 8 patients with mild, allergic asthma non-attributed to Alternaria and 2) 7 healthy controls. Diagnosis of asthma was already established by positive both reversibility and methacholine test. Two nasal provocation tests were performed, one with normal saline (placebo) and another with Alternaria antigen (specific nasal challenge, SNC) performed at two different days. FEV1 was measured during a 12-hour period, at 18 time points (10, 20, 30, 40, 50, 60, 90, 120, 180, 240, 300, 360, 420, 480, 540, 600, 660, 720 minutes) after nasal provocation.Results: A significant FEV1 decline >20% from baseline (26.02±2.38%) was recorded after SNC (p<0.001 compared to placebo) in 10 out of the 15 patients (66.7%) (p<0.001 compared to both control groups). All asthmatic responses were initiated with a mean 8-hour latency, were recorded at more than three consecutive time points and were sustained until the end of the 12-hour time period.Conclusions: Specific nasal challenge could be a reliable and specific tool for the diagnosis of Alternaria-induced asthma, alternatively to bronchial challenge, in case confirmation of mould implication is necessary.