Abstract
RationaleDespite its incorporation into research studies, the safety aspects of segmental allergen bronchoprovocation and differences in cellular response among different allergens have received limited consideration.MethodsWe 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.ResultsAmong 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±108×104 per milliliter and eosinophils increased from 1±2 to 44±20 percent, with no significant differences among the three allergens.ConclusionsIn mild allergic asthma, segmental allergen bronchoprovocation, using individualized doses of aeroallergens, was safe and yielded similar cellular responses.
Highlights
Since the first guidelines addressing the use of bronchoscopy and bronchoalveolar lavage in asthma were published in 1985 [1], segmental bronchoprovocation with allergen (SBP-AG) has been used to investigate mechanisms of allergic airway inflammation [2]
They noted a modest decline in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) immediately following the bronchoscopy compared to prebronchoscopy baseline
The spirometry returned toward baseline 24 hours later and only minimal reduction in spirometry was seen after the second bronchoscopy
Summary
Since the first guidelines addressing the use of bronchoscopy and bronchoalveolar lavage in asthma were published in 1985 [1], segmental bronchoprovocation with allergen (SBP-AG) has been used to investigate mechanisms of allergic airway inflammation [2]. The safety aspects of SBP-AG in subjects with atopic asthma were investigated by Krug and colleagues in 1996, using a dust mite or grass allergen dose titration method based on results from skin testing [6]. They reported a 29% incidence of diffuse wheezing among their 49 subjects, 7 of whom required premature termination of the procedure due to respiratory distress. In 2001, Moore and colleagues compared the response to SBP-AG between subjects with mild (n = 8) and moderate (n = 10) asthma with a fixed dose of ragweed extract [7] They noted a modest decline in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) immediately following the bronchoscopy compared to prebronchoscopy baseline. No increase in adverse events was noted with repeated procedures
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
