@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 We are grateful to the CoNAC study participants and their families who gave of themselves to be our investigational partners, as well as to the entirety of the Inner-City Asthma Consortium (ICAC), who are dedicated to our inner-city asthma mission and clinical research excellence. In particular, we would like to thank the following ICAC institutions and investigators (principal investigators are indicated by asterisks): Cincinnati Children's Hospital?G. Hershey*, C. Kercsmar*, J. Brewington, S. Zak, S. Austin, A. Blust, K. Connolly, Z. Ehsan, L. Henkes, A. Jagpal, G. McPhail, M. Rechtin, J. Torres-Garcia, A. Witt, K. Curtsinger, P. Groh; UT Southwestern Medical Center?M. Gill*, R. Gruchalla*, D. Gonzales, B. Lewis, D. Santoyo, B. Shao, H. Zhao, K. DeBacco, C. Ordinario; Children's Hospital Colorado?A. Liu*, A. Anderson, W. Anderson, C. Dutmer, K. Freeman, M. Gleason, H. Hainey, H. Hoch, V. Lopez, N. Miyazawa, P. Pinedo-Estrada, A. Schiltz, D. Searing, B. Tippin, C. Campos, M. Christie, D. Liptzin; Columbia University Medical Center?M. Kattan*, Y. Fernandez-Pau, C. Lamm, S. Lovinsky-Desir, E. Arteaga-Solis, S. Tsang, N. Whitney, M. Pierce, P. Yaniv; Children's National Hospital?S. Teach*, E. Cowin, A. Mathis, D. Pillai, D. Quint, D. Hall, M. Savitz, M. Sullivan, E. Gorin, A. Sullivan. 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",
month = jul,
doi = "10.1111/pai.13480",
language = "English (US)",
volume = "32",
pages = "971--979",
journal = "Pediatric Allergy and Immunology",
issn = "0905-6157",
publisher = "Blackwell Munksgaard",
number = "5",
}