Abstract

Introduction: Treatment effects in allergen immunotherapy (AIT) studies are based on symptomatic improvement, and evaluations of naturally exposed patients do often show weak efficacy. Allergen challenge tests, such as conjunctival (CAC), nasal (NAC), or bronchial (BAC) challenge tests, or challenges in allergen exposure chambers (AEC) are accepted by regulators for AIT phase II studies only. Materials and methods: This review aims to describe different allergen challenge test methods, summarizes safety and limitations for each, and discusses their potential for use in AIT trials. Results: Organ-specific allergen challenges provide information about individual reactivity, reaction threshold, and organspecific efficacy of AIT. AECs, targeting all affected organs simultaneously, were developed to investigate disease mechanisms and treatment effects under controlled and reproducible conditions. Conclusion: A high level of standardization is existing for NAC only; in CAC and BAC, the toolbox is limited to subjective symptom scoring with no validated objective parameters identified yet. AECs are complex and heterogenous; correlation of systems and comparability of study data is claimed. All challenge methods are safe when conducted by experienced staff.

Author Details

Authors

• Petra Zieglmayer¹,²
• René Zieglmayer²
• Patrick Lemell²

Departments

• ¹ Karl Landsteiner University, Krems, and
• ² Vienna Challenge Chamber, Vienna, Austria

Address

PD Dr. Petra Zieglmayer, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Department für Allgemeine Gesundheitsberufe, Kompetenzzentrum für Allergologie und Immunologie, Dr.-Karl-Dorrek-Straße 30, 3500 Krems, Austria
Email: [email protected]

Citation