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Bronchial allergen challenge: dose versus concentration.

L Frølund1, F Madsen, B Scharling

  • 1Allergy Unit, State University Hospital, Copenhagen, Denmark.

Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology
|February 1, 1992
PubMed
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Bronchial allergen challenge dosage, not concentration, determines asthma response. A 10-breath regimen showed a stronger early and late asthmatic response than a 2-breath regimen, confirming the equivalent dose hypothesis.

Area of Science:

  • Allergy and Immunology
  • Respiratory Medicine
  • Pulmonology

Background:

  • Asthma management relies on understanding allergen-induced responses.
  • Dosing regimens in bronchial allergen challenges may influence asthmatic responses.

Purpose of the Study:

  • To investigate if equivalent allergen doses via different dosing regimens (two vs. 10 breaths) yield similar early and late asthmatic responses.
  • To assess the impact of dosing frequency on the magnitude of asthmatic reactions.

Main Methods:

  • Fifteen patients with extrinsic allergic asthma underwent bronchial allergen challenges.
  • Two dosing regimens (two breaths vs. 10 breaths) were compared using increasing allergen concentrations until a 20% decrease in FEV1 was achieved.
  • Reproducibility was assessed in seven patients using the two-breath regimen.

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Main Results:

  • The two-breath regimen yielded a significantly higher provocative concentration of allergen (PC20FEV1) compared to the 10-breath regimen.
  • The 10-breath regimen resulted in a statistically significant greater magnitude of both early and late asthmatic responses.
  • Bronchial allergen challenge reproducibility was found to be acceptable.

Conclusions:

  • The study confirms the 'equivalent dose hypothesis' in asthma.
  • Allergen dosage, rather than concentration, is the primary determinant of early and late asthmatic responses.
  • Dosing regimen significantly impacts the observed magnitude of asthmatic reactions during bronchial provocation tests.