@article{c41a40d47cde423a90320da5076dca6c,
title = "Development of nasal allergen challenge with cockroach in children with asthma",
abstract = "Background: Nasal allergen challenge (NAC) could be a means to assess indication and/or an outcome of allergen-specific therapies, particularly for perennial allergens. NACs are not commonly conducted in children with asthma, and cockroach NACs are not well established. This study's objective was to identify a range of German cockroach extract doses that induce nasal symptoms and to assess the safety of cockroach NAC in children with asthma. Methods: Ten adults (18-37 years) followed by 25 children (8-14 years) with well-controlled, persistent asthma and cockroach sensitization underwent NAC with diluent followed by up to 8 escalating doses of cockroach extract (0.00381-11.9 µg/mL Bla g 1). NAC outcome was determined by Total Nasal Symptom Score (TNSS) and/or sneeze score. Cockroach allergen–induced T-cell activation and IL-5 production were measured in peripheral blood mononuclear cells. Results: 67% (6/9) of adults and 68% (17/25) of children had a positive NAC at a median response dose of 0.120 µg/mL [IQR 0.0380-0.379 µg/mL] of Bla g 1. Additionally, three children responded to diluent alone and did not receive any cockroach extract. Overall, 32% (11/34) were positive with sneezes alone, 15% (5/34) with TNSS alone, and 21% (7/34) with both criteria. At baseline, NAC responders had higher cockroach-specific IgE (P =.03), lower cockroach-specific IgG/IgE ratios (children, P =.002), and increased cockroach-specific IL-5–producing T lymphocytes (P =.045). The NAC was well tolerated. Conclusion: We report the methodology of NAC development for children with persistent asthma and cockroach sensitization. This NAC could be considered a tool to confirm clinically relevant sensitization and to assess responses in therapeutic studies.",
keywords = "allergic rhinitis, asthma, children, cockroach allergy, inner city, nasal allergen challenge",
author = "{the National Institute of Allergy and Infectious Diseases Inner City Asthma Consortium} and {Rudman Spergel}, {Amanda K.} and Sever, {Michelle L.} and Jacqueline Johnson and Gill, {Michelle A.} and Veronique Schulten and April Frazier and Kercsmar, {Carolyn M.} and Stephanie Lovinsky-Desir and Searing, {Dan A.} and Alessandro Sette and Baomei Shao and Teach, {Stephen J.} and Gern, {James E.} and Busse, {William W.} and Alkis Togias and Wood, {Robert A.} and Liu, {Andrew H.}",
note = "Funding Information: This project has been funded in whole or in part with federal funds from the National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services, under contract numbers HHSN272200900052C and HHSN272201000052I, and cooperative agreement numbers 1UM1AI114271‐01 and UM2AI117870. Additional support was provided by the National Center for Research Resources, and National Center for Advancing Translational Sciences, National Institutes of Health, under grants NCRR/NIH UL1TR000451, UL1RR025780, and UL1TR000075 and NCATS/NIH UL1TR000154, UL1TR001082, UL1TR000077‐04, UL1TR000040, UL1TR000150, and UL1TR001105 Funding Information: All authors, with the exception of A. Togias and AK Rudman Spergel, report grants from NIH/NIAID during the conduct of study. S. Lovinsky‐Desir, V. Schulten, A. Frazier, A. Sette, B. Shao, AK Rudman Spergel, J. Johnson, D. Searing, and A. Togias have nothing to disclose outside the submitted work. MA Gill reports an honorarium for and support for travel to the 2017 AAAAI meeting during the conduct of study. M. Gill also reports monetary compensation from the American Academy of Pediatrics for her work teaching the biannual Pediatrics board review course, PREP The Course, outside the submitted work. C. Kercsmar reports personal fees from GlaxoSmithKline and royalties from Up to Date outside the submitted work. SJ Teach reports royalties from Up to Date, as well as grants from NIH/NHLBI, PCORI, and EJF Philanthropies outside the submitted work. J. Gern reports personal fees from PREP Biopharm Inc, Regeneron, and MedImmune, as well as stock options from Meissa Vaccines Inc outside the submitted work. W. Busse reports personal fees from Boston Scientific, ICON, Novartis, GlaxoSmithKline, Genentech, Boehringer Ingelheim, Sanofi Genzyme, AstraZeneca, Teva, 3 M, PrEP Biopharm, Circassia, Regeneron, Peptinnovate, and Elsevier outside the submitted work. RA Wood reports employment at Johns Hopkins University, royalties from Up to Date, and institutional grants from NIH, DBV, Aimmune, Astellas, and HAL‐Allergy outside the submitted work. AH Liu reports personal fees from Merck Sharp & Dohme as speaker honoraria and from Phadia Thermo Fisher as consulting honoraria. AH Liu also reports other support from GlaxoSmithKline for serving as a data monitoring committee member for an asthma study. Drs. Rudman Spergel's and Togias{\textquoteright} co‐authorship of this publication does not necessarily constitute endorsement by the National Institute of Allergy and Infectious Diseases, the National Institutes of Health, or any other agency of the US government. Publisher Copyright: {\textcopyright} 2021 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd. This article has been contributed to by US Government employees and their work is in the public domain in the USA.",
year = "2021",
doi = "10.1111/pai.13480",
language = "English (US)",
journal = "Pediatric Allergy and Immunology",
issn = "0905-6157",
publisher = "Blackwell Munksgaard",
}