Inhaled allergen bronchoprovocation tests - 30/10/13
Abstract |
The allergen bronchoprovocation test is a long-standing exacerbation model of allergic asthma that can induce several clinical and pathophysiologic features of asthma in sensitized subjects. Standardized allergen challenge is primarily a research tool, and when properly conducted by qualified and experienced investigators, it is safe and highly reproducible. In combination with validated airway sampling and sensitive detection techniques, allergen challenge allows the study of several features of the physiology of mainly TH2 cell–driven asthma in relation to the kinetics of the underlying airway pathology occurring during the allergen-induced late response. Furthermore, given the small within-subject variability in allergen-induced airway responses, allergen challenge offers an adequate disease model for the evaluation of new (targeted) controller therapies for asthma in a limited number of subjects. In proof-of-efficacy studies thus far, allergen challenge showed a fair positive predicted value and an excellent negative predictive value for the actual clinical efficacy of new antiasthma therapies, underscoring its important role in early drug development. In this review we provide recommendations on challenge methods, response measurements, sample size, safety, and harmonization for future applications.
El texto completo de este artículo está disponible en PDF.Key words : Allergen challenge, methodology, asthma, drug development
Abbreviations used : AHR, APC20, AUC, EAR, eNO, LAR, SOP
Esquema
Disclosure of potential conflict of interest: Z. Diamant works part time at a CRO (QPS Netherlands, Groningen, NL) and has received one or more grants from or has one or more grants pending with MSD, Biomedical Systems, and Benecke BV. G. M. Gauvreau has been supported by one or more grants from Genentech and CSL and has received one or more consulting fees or honoraria from ONO and AIM Therapeutics. D. W. Cockcroft has received one or more grants from or has one or more grants pending with ONO, Novartis, Amgen, and Genentech and has received royalties for allergen and methacholine challenge standard operating procedures. B. Dahlén has consultancy arrangements with Actelion, has received one or more payments for lecturing from or is on the speakers' bureau for Meda and Novartis, and has received royalties from Studentlitteratur. P. M. O'Byrne has been supported by one or more grants from AIM, AstraZeneca, Amgen, GlaxoSmithKline, ONO, Genentech, and Novartis; has received one or more consulting fees or honoraria from AstraZeneca, GlaxoSmithKline, Merck, and Novartis; and has received one or more fees for participation from the Joint Oversight Board for LABA safety study. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 132 - N° 5
P. 1045 - novembre 2013 Regresar al númeroBienvenido a EM-consulte, la referencia de los profesionales de la salud.
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