Cockroach sensitization mitigates allergic rhinoconjunctivitis symptom severity in patients allergic to house dust mites and pollen - 04/09/15
Abstract |
Background |
Modifiers of symptom severity in patients with allergic rhinoconjunctivitis (AR) are imprecisely characterized. The hygiene hypothesis implicates childhood microbial exposure as a protective factor. Cockroach sensitization (C+) might be a proxy for microbial exposure.
Objective |
We sought to determine whether C+ assayed by means of skin prick tests influenced AR symptom severity in controlled and natural settings.
Methods |
Total symptom scores (TSSs) were recorded by 21 participants with house dust mite allergy (M+) in the natural setting and during repeated exposures of 3 hours per day to house dust mite allergen in an allergen challenge chamber (ACC). In M+ participants the peripheral blood and nasal cells were assayed for T-cell activation and transcriptomic profiles (by using RNA sequencing), respectively. Participants allergic to mountain cedar (n = 21), oak (n = 34), and ragweed (n = 23) recorded TSSs during separate out-of-season exposures to these pollens (any pollen sensitization [P+]) in the ACC; a subset recorded TSSs in the pollination seasons.
Results |
The hierarchy of TSSs (highest to lowest) among M+ participants tracked the following skin prick test sensitization statuses: M+P+C− > M+P+C+ > M+P−C− > M+P−C+. In nasal cells and peripheral blood the immune/inflammatory responses were rapidly resolved in M+P+C+ compared with M+P+C− participants. Among those allergic to pollen, C+ was associated with a lower TSS during pollen challenges and the pollination season. After aggregated analysis of all 4 ACC studies, C+ status was associated with a 2.8-fold greater likelihood of a lower TSS compared with C− status (odds ratio, 2.78; 95% CI, 1.18-6.67; P = .02).
Conclusions |
C+ status is associated with mitigation of AR symptom severity in adults with AR.
Le texte complet de cet article est disponible en PDF.Key words : Cockroach sensitization, allergen challenge chamber, allergic rhinoconjunctivitis, T-cell activation, aeroallergens, house dust mite, skin prick test, pollen
Abbreviations used : ACC, AR, C+, GEE, HDM, ILC, M+, P+, SPT, ssIgE, TLR, TSS, VLO
Plan
| S.K.A. received support from the following grants: the Doris Duke Distinguished Clinical Scientist Award, the Burroughs Wellcome Clinical Scientist in Transitional Research Award, the Max and Minnie Tomerlin Voelcker Award, and the Center for Personalized Medicine (CX00875-01AI) at the South Texas Veterans Health Care System. R.L.J., C.P.A., and D.A.R., are co-owners of Biogenics Research Chamber and have not received financial support. C.G.R. is the Executive Director of Chamber Operations. |
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| Disclosure of potential conflict of interest: C. G. Rather is employed by Biogenics Research Chamber. C. P. Andrews has received consultancy fees from Merck and Boehringer Ingelheim, is employed by Diagnostics Research Group and ICON Clinical Research, and is a shareholder and investigator with Biogenics Research Chamber. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 136 - N° 3
P. 658-666 - septembre 2015 Retour au numéro
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