杭州浙大迪迅生物基因工程有限公司

原标题：鼻变应原激发和环境暴露舱激发:一项比较对猫过敏原的临床和生物学反应的随机试验
①背景：直接滴鼻过敏原激发（NAC）和环境暴露室（EEC）是进行受控过敏原激发的两种方法。这些方法的临床和生物学可比性尚未得到彻底研究。②目的:比较猫过敏原在NAC和EEC中的临床和免疫反应。③方法：24名参与者被随机分为两组，一组先接受NAC，然后在EEC中接受为期两天的激发；另一组先在EEC接受为期两天的激发，然后再接受NAC，两次激发之间有28天的洗脱间隔。我们测量了鼻症状评分(TNSS)、鼻吸气峰值流量(PNIF)、鼻(0-8小时)和血清细胞因子、血清抗体、外周血抗原特异性T淋巴细胞和鼻刮片中的基因表达。主要结果是在NAC或在EEC过敏原暴露后3小时内TNSS在曲线下的面积。④结果：这两种激发都增加了鼻液和血清中IL-5和IL-13的含量，并导致与粘膜生物学和转录调节相关的基因模块在鼻细胞表达改变。基因模块的变化比细胞因子的测量更显示出与TNSS和PNIF的显著相关性。总的来说，与NAC相比，EEC暴露产生的反应更大，反应终止的更早。虽然这两项激发在症状严重程度或时间上没有相关性，但在细胞因子水平上发现了惊人的相关性。⑤结论：虽然NAC和EEC的临床结果在时间和大小上是不同的，但是免疫反应是相似的。选择特定的过敏原攻击方法应取决于研究目标和成本。
延伸阅读
JACI：                                              
Nasal Allergen Challenge and Environmental Exposure Chamber Challenge: A Randomized Trial Comparing Clinical and Biological Responses to Cat Allergen
https://doi.org/10.1016/j.jaci.2020.02.024
Abstract:
Abstract
Background
The direct-instillation nasal allergen challenge (NAC) and the environmental exposure chamber (EEC) are two methods of conducting controlled allergen provocations. The clinical and biological comparability of these methods has not been thoroughly investigated.
Objective
To compare clinical and immunologic responses to cat allergen in NAC versus EEC.
Methods
Twenty-four participants were randomized to receive either NAC followed by a two-day challenge in an EEC or a two-day challenge in EEC followed by NAC. Challenges were separated by 28-day washout periods. We measured total nasal symptom scores (TNSS), peak nasal inspiratory flow (PNIF), nasal (0-8hours) and serum cytokines, serum antibodies, peripheral blood antigen-specific T-lymphocytes, and gene expression in nasal scrapings. The primary outcome was the TNSS area under the curve for the first 3 hours after allergen exposure in NAC or after initiation of exposure in EEC.
Results
Both challenges increased IL-5 and IL-13 in nasal fluids and serum and resulted in altered nasal cell expression of gene modules related to mucosal biology and transcriptional regulation. Changes in gene modules, more so than cytokine measurements, showed significant associations with TNSS and PNIF. Overall, EEC exposure generated larger responses and more early terminations compared to NAC. Although the two challenges did not correlate in symptom magnitude or temporality, striking correlations were observed in cytokine levels.
Conclusion
Although clinical outcomes of NAC and EEC were temporally different and non-equivalent in magnitude, immunologic responses were similar. Selection of a particular allergen challenge method should depend on considerations of study objectives and cost.
All Author:David Larson PiyushPate Anne MarieSalapatek PeterCouroux Don Whitehouse AdelaPina Jacqueline L.Johnson Michelle L.Sever SrinathSanda JulianPoyser, MS5TheresaAllio Guy W.Scadding TielinQin Mohamed H.Shamji William W.Kwok Eddie A.JamesDeanna French AlinaLelic …Stephen R.Durham
　　创建过敏性疾病的科研、科普知识交流平台，为过敏患者提供专业诊断、治疗、预防的共享平台。