Journal ArticleDOI
Bronchial allergen challenges in children – safety and predictors
TLDR
In allergic asthma, the diagnosis of house dust mite allergy is mainly based on the patient's history, allergy testing by the skin prick test (SPT) or the levels of allergen‐specific IgE, so data from 350 bronchial provocations with HDM are retrospectively analysed.Abstract:
Background
In allergic asthma, the diagnosis of house dust mite (HDM) allergy is mainly based on the patient's history, allergy testing by the skin prick test (SPT) or the levels of allergen-specific IgE. We retrospectively analysed data from 350 bronchial provocations with HDM and related it to the following parameters: specific IgE, bronchial hyperresponsiveness (BHR) to methacholine testing (MCT) and exhaled NO (eNO).
Methods
Approximately 350 patients (5–18 yr of age) with allergic asthma and a positive SPT to HDMs were included. To define the sensitivity and specificity for the detection method of an early asthmatic response (EAR), a receiver-operating characteristic (ROC) curve was plotted. The accuracy was measured by the area under the ROC curve (AUC). A logistic regression model was used to predict the individual probability of a positive challenge. The results of the regression model were validated in a prospective group of n = 75 patients.
Results
The following cut-off values showed the best combination of sensitivity and specificity: specific IgE Dermatophagoides farinae 19.6 kU/l (AUC, 0.88), PD20FEV1 0.13 mg methacholine (AUC, 0.73) and eNO 20.1 ppb (AUC, 0.71). The following equation predicted the individual probability of a positive challenge in the retrospective and prospective group: p = 1.[1 + exp[−(−1.78 + 2.46.10log D. far − 1.25.10logPD20 metha)]]−1, (AUC = 0.88).
Conclusions
The value of using the specific IgE and MCT as predictors was confirmed in a large number of patients. We also showed, for the first time, that the eNO predicted the EAR. The logistic regression model is repeatable with a good accuracy.read more
Citations
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Journal ArticleDOI
Risk and safety requirements for diagnostic and therapeutic procedures in allergology: World Allergy Organization Statement
Marek L. Kowalski,Ignacio J. Ansotegui,Werner Aberer,Mona Al-Ahmad,Mübeccel Akdis,Barbara Ballmer-Weber,Kirsten Beyer,Miguel Blanca,Simon G A Brown,Chaweewan Bunnag,Arnaldo Capriles Hulett,Mariana Castells,Hiok Hee Chng,Frédéric de Blay,Motohiro Ebisawa,Stanley M. Fineman,David B.K. Golden,Tari Haahtela,Michael A. Kaliner,Connie Katelaris,Bee Wah Lee,Joanna Makowska,Ulrich Müller,Joaquim Mullol,John Oppenheimer,Hae-Sim Park,James Parkerson,Giovanni Passalacqua,Ruby Pawankar,Harald Renz,Franziska Ruëff,Mario Sánchez-Borges,Joaquín Sastre,Glenis Scadding,Scott H. Sicherer,Pongsakorn Tantilipikorn,James M. Tracy,Vera Van Kempen,Barbara Bohle,G. Walter Canonica,Luis Caraballo,Maximiliano Gómez,Komei Ito,Erika Jensen-Jarolim,Mark Larché,Giovanni Melioli,Lars K. Poulsen,Rudolf Valenta,Torsten Zuberbier +48 more
TL;DR: A group of allergy experts within the World Allergy Organization (WAO), representing various continents and areas of allergy expertise, presents this report on risk associated with diagnostic and therapeutic procedures in allergology and proposes a consensus on safety requirements for performing procedures in allergy offices.
Journal ArticleDOI
Inhaled allergen bronchoprovocation tests
Zuzana Diamant,Gail M. Gauvreau,Donald W. Cockcroft,Louis-Philippe Boulet,Peter J. Sterk,Franciscus H.C. de Jongh,Barbo Dahlen,Paul M. O'Byrne +7 more
TL;DR: Recommendations on challenge methods, response measurements, sample size, safety, and harmonization for future applications are provided, highlighting its important role in early drug development.
Journal ArticleDOI
In vivo diagnosis of allergic diseases--allergen provocation tests.
Ioana Agache,M. B. Bilò,G-J Braunstahl,Luís Delgado,Pascal Demoly,Philippe Eigenmann,Philippe Gevaert,Eva Rebelo Gomes,P W Hellings,Friedrich Horak,Antonella Muraro,Thomas Werfel,Marek Jutel +12 more
TL;DR: Allergen challenge test has been the mainstay of diagnosis of allergic diseases for a long time since it offers a direct proof of the clinical relevance of a particular allergen for the allergic disease symptoms and severity.
Journal ArticleDOI
Bronchial allergen provocation: A useful method to assess the efficacy of specific immunotherapy in children
Martin Rosewich,Sonja Arendt,Samir El Moussaoui,Johannes Schulze,Ralf Schubert,Stefan Zielen +5 more
TL;DR: The primary research question is whether bronchial allergen provocation (BAP) can be used to assess the efficacy of SCIT.
Journal ArticleDOI
Induction of Bronchial Tolerance After 1 Cycle of Monophosphoryl-A-Adjuvanted Specific Immunotherapy in Children With Grass Pollen Allergies
TL;DR: After 1 cycle of MPL-SCIT, specific Bronchial tolerance may be significantly induced, whereas in patients without SCIT, bronchial hyperactivity may remain unchanged.
References
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