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Related Experiment Video

Updated: May 20, 2026

Murine Model of Allergen Induced Asthma
08:05

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Published on: May 14, 2012

Bronchial allergen challenges: doubling or quadrupling dose steps?

S Mousalli1, V van Kampen, R Merget

  • 1Institute of the Ruhr-University, Bürkle-de-la-Camp-Platz 1, Bochum, Germany.

Advances in Experimental Medicine and Biology
|July 25, 2012
PubMed
Summary
This summary is machine-generated.

Quadrupling allergen dose steps in inhalation challenges may be a safe alternative to doubling, potentially shortening test duration for diagnosing occupational asthma. This method showed similar maximal responses and dose-response slopes without increasing severe reactions.

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Area of Science:

  • Allergy and Immunology
  • Respiratory Medicine
  • Occupational Health

Background:

  • Inhalation challenges are the gold standard for diagnosing occupational asthma, but standardized methods are lacking.
  • The optimal dose escalation strategy in stepwise allergen challenges remains an open question.
  • Recent recommendations suggest limiting dose increases to doubling for safety.

Purpose of the Study:

  • To retrospectively analyze the safety and efficacy of quadrupling dose steps in allergen inhalation challenges.
  • To compare quadrupling dose steps with doubling dose steps regarding safety and response.
  • To evaluate the feasibility of quadrupling dose steps as an alternative diagnostic method.

Main Methods:

  • Retrospective analysis of dosimeter allergen challenges conducted over 10 years.
  • Allergens were inhaled using an APSpro dosimeter and DeVilbiss 646 nebulizer.
  • Test termination criteria included a ≥20% fall in forced expiratory volume in 1 second (FEV1).

Main Results:

  • Seventeen positive tests in 13 subjects were identified.
  • Mean FEV1 decrease after the last allergen dose was 26.7% at 10 minutes and 26.2% at 20-30 minutes.
  • No significant differences were observed in terminal dose-response slopes or maximal responses between doubling and quadrupling dose steps.

Conclusions:

  • Quadrupling dose steps in allergen inhalation challenges appear to be a safe alternative to doubling dose steps.
  • This approach may shorten test duration without increasing the risk of severe asthmatic reactions.
  • Physicians may consider lower starting doses, enhancing the overall safety of allergen inhalation challenges.