RT Journal Article
SR Electronic
T1 Evaluation of asthma responses in ALYATEC EEC in birch allergic rhinitis (AR) with and without asthma
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 2375
DO 10.1183/13993003.congress-2022.2375
VO 60
IS suppl 66
A1 A Gherasim
A1 F Dietsch
A1 M Beck
A1 T Riff
A1 N Domis
A1 F De Blay
YR 2022
UL http://erj.ersjournals.com/content/60/suppl_66/2375.abstract
AB Background: Birch pollen mainly induces allergic rhino conjunctivitis. There is a considerable discordance between patient reported asthma and responses during bronchial allergen challenge.Objective: To analyze asthma responses to birch allergen in ALYATEC Environmental Exposure Chamber (EEC) in patients with and without asthma.Methods: 30 patients with AR without asthma and 24 with GINA 1 birch-related asthma, were exposed to 60 ng/m3 of Bet v 1 in EEC. Patients must have positive skin prick tests (SPT) and birch specific IgE at selection. Exposures lasted 4 hours to assess rhinitis responses in patients with AR and 1 hour for asthma only. Nasal response was defined as Total Nasal Symptom Score (TNSS) ≥ 5, Early Asthma Response (EAR) as 20% drop in FEV1 and Late Asthma Response as 15% drop in FEV1, 3 to 24 hours after EAR.Results: Among patients with AR without asthma, 53.3% had EAR and 16.6% LAR. The mean time to obtain EAR was 77 min [range 30-240]. Dual asthmatic responses occurred more frequently in patients with early nasal responses (mean Δ TNSS=5.76±1.1). EAR occurred in all asthmatics within 34 min [15-60], followed by 62.5% of LAR. The severity of asthma response was assessed by the maximum drop in FEV1, with 25.0 (±4.66) for EAR and 19.9 (±3.18) for LAR. Sensitization to birch was similar in both populations; SPT mean wheal diameter of 8.68 mm for AR without asthma and 7.81 mm in asthmatics.Conclusion: Birch-related asthma seems underestimated in patients with AR. Birch allergen induced dual bronchial responses in more than 50% of asthmatics. These results are comparable to those obtained in mite asthmatics, suggesting that birch is as asthmogenic as mite allergen.FootnotesCite this article as Eur Respir J 2022; 60: Suppl. 66, 2375.This article was presented at the 2022 ERS International Congress, in session “-”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).