Allergy, Pulmonary and Critical Care Division, Department of Medicine, University of Wisconsin, Madison, WI, USA.
PLoS One. 2013;8(1):e51963. doi: 10.1371/journal.pone.0051963. Epub 2013 Jan 16.
Despite its incorporation into research studies, the safety aspects of segmental allergen bronchoprovocation and differences in cellular response among different allergens have received limited consideration.
We performed 87 segmental challenges in 77 allergic asthma subjects. Allergen dose was based on each subject's response to whole lung allergen challenge. Bronchoalveolar lavage was performed at 0 and 48 hours. Safety indicators included spirometry, oxygen saturation, heart rate, and symptoms.
Among subjects challenged with ragweed, cat dander, or house dust mite, there were no differences in safety indicators. Subjects demonstrated a modest oxygen desaturation and tachycardia during the procedure that returned to normal prior to discharge. We observed a modest reduction in forced vital capacity and forced expiratory volume in one second following bronchoscopy. The most common symptoms following the procedure were cough, sore throat and fatigue. Total bronchoalveolar lavage fluid cell numbers increased from 13±4 to 106±108×10(4) per milliliter and eosinophils increased from 1±2 to 44±20 percent, with no significant differences among the three allergens.
In mild allergic asthma, segmental allergen bronchoprovocation, using individualized doses of aeroallergens, was safe and yielded similar cellular responses.
尽管分段过敏原支气管激发已被纳入研究，但对其安全性方面以及不同过敏原之间细胞反应的差异关注有限。
我们对 77 名过敏性哮喘患者进行了 87 次分段挑战。过敏原剂量基于每个患者对全肺过敏原激发的反应。支气管肺泡灌洗在 0 小时和 48 小时进行。安全性指标包括肺活量、血氧饱和度、心率和症状。
在接受豚草、猫皮屑或屋尘螨挑战的患者中，安全性指标无差异。患者在该过程中表现出适度的氧饱和度下降和心动过速，但在出院前恢复正常。我们观察到支气管镜检查后用力肺活量和一秒用力呼气量略有下降。该过程后最常见的症状是咳嗽、喉咙痛和疲劳。总支气管肺泡灌洗液细胞数从 13±4 增加到 106±108×10(4)个/毫升，嗜酸性粒细胞从 1±2 增加到 44±20%，三种过敏原之间无显著差异。
在轻度过敏性哮喘中，使用个体化的气传过敏原剂量进行分段过敏原支气管激发是安全的，且产生相似的细胞反应。
