Rhinoconjunctivitis severity induced by cat exposure influences early and late asthmatic responses: Evidence from an environmental exposure chamber

Piotin A, Godet J, Domis N, de Blay F. Clin Exp Allergy. 2024; 00: 1-11. doi:10.1111/cea.14485

Abstract

Background

The impact of allergic rhinoconjunctivitis on the early (EAR) and late asthmatic response (LAR) has yet to be assessed during optimal allergen exposure conditions.

Objective

We aimed to assess predictive factors of the EAR and LAR and to evaluate the relation between rhinitis, conjunctivitis and asthma induced by cat allergen exposure in an environmental exposure chamber (EEC).

Methods

Data from two cohort studies involving asthmatic patients with cat allergy who performed a cat allergen exposure challenge in ALYATEC EEC were analysed. Spirometry, visual analogue scale (VAS) for asthma, VAS for rhinitis, Total Nasal Symptoms Score, Total Ocular Symptoms Score (TOSS), Rhinoconjunctivitis Total Symptoms Score and Abelson score were used to assess asthma, rhinitis and conjunctivitis during and after exposure.

Results

Correlation map between respiratory and rhinoconjunctivitis parameters
in patients with an EAR during cat allergen exposure.

An EAR occurred in 65.1% of patients, 32.1% of whom had a LAR. The diameter of the prick test to cat allergens and non-specific bronchial hypersensitivity level were independent risk factors for EAR (p < .05). No independent risk factors for LAR were identified. Rhinoconjunctivitis severity during exposure correlated with the asthma VAS during EAR and LAR (p < .05). Allergen exposure time needed to trigger an EAR correlated with the Abelson score during exposure (p < .05). The asthma VAS and TOSS during exposure correlated with faster LAR occurrence (p < .05).

Conclusion

Prick test size and non-specific bronchial hypersensitivity level were confirmed as independent predictive factors of EAR during allergen exposure in an EEC. This study demonstrated the relation between the severity of rhinitis, conjunctivitis and asthma induced by allergen exposure for both EAR and LAR.

Graphical Abstract

Prick test diameter and non-specific bronchial hypersensitivity level were independent predictive factors of early asthmatic response (EAR) during allergen exposure in an environmental exposure chamber (EEC). Severity of rhinitis and conjunctivitis were related to asthma symptoms induced by allergen exposure both during EAR and late asthmatic response (LAR).

Key messages

• Prick test and NSBH were independent predictors of early asthmatic response (EAR) in EEC.
• Severity of allergen-induced rhinoconjunctivitis was correlated with severity of early and late asthmatic response (LAR).
• Asthmatic patients with severe allergen-induced rhinoconjunctivitis appear to be ideal candidates for studying anti-asthmatic treatments.

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