Repeated aerosol exposure to small doses of allergen. A model for chronic allergic asthma

Am J Respir Crit Care Med. 1998 Jun;157(6 Pt 1):1900-6. doi: 10.1164/ajrccm.157.6.9603034.

Abstract

To improve our understanding of the pathophysiology of chronic allergic asthma, we mimicked natural allergen exposure by giving tiny doses of dust-mite extract (equivalent to estimated daily exposure in a typical bedroom) in three weekly sessions for 4 wk. Nine mild asthmatic adults who were highly sensitive to dust-mite allergen participated in the study. Serial assessments of bronchial reactivity by methacholine challenge, pulmonary function, symptoms, and bronchodilator requirements were obtained. Seven of nine subjects had a twofold or more (median: 6, range: 2.7 to 25) reduction (p = 0.008) in PC20, after which saline inhalations were substituted for dust-mite extract. Bronchial reactivity returned to normal within 2 to 3 wk after cessation of dust-mite inhalations in all but one subject. Predosing FEV1 dropped 10% over 4 wk of provocation (p = 0.001) and 7 of 9 returned to prestudy level within 2 wk after dosing was stopped. Late-phase responses were seen in 6 of 9 subjects. We conclude that repeated aerosol exposure to dust-mite allergen in doses comparable to natural bedroom exposure is sufficient to adversely affect pulmonary function and bronchial hyperractivity in sensitized individuals. These changes are rapidly reversible. This low-dose provocational strategy provides an attractive model for the experimental study of allergic asthma. Arshad SH, Hamilton RG, Adkinson NF, Jr. Repeated aerosol exposure to small doses of allergen: a model for chronic allergic asthma.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aerosols
  • Allergens / administration & dosage*
  • Animals
  • Antigens, Dermatophagoides
  • Asthma / immunology
  • Asthma / physiopathology*
  • Bronchial Hyperreactivity / physiopathology
  • Bronchial Provocation Tests
  • Chronic Disease
  • Environmental Exposure
  • Female
  • Forced Expiratory Volume
  • Glycoproteins / administration & dosage*
  • Humans
  • Male
  • Methacholine Chloride
  • Middle Aged
  • Mites

Substances

  • Aerosols
  • Allergens
  • Antigens, Dermatophagoides
  • Glycoproteins
  • Methacholine Chloride