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Exacerbation of atopic dermatitis upon grass pollen exposure in an environmental challenge chamber

Werfel, Thomas, Heratizadeh, Annice, Niebuhr, Margarete, Kapp, Alexander, Karch, Annika, Erpenbeck, Veit, Loesche, Christian, Jung, Thomas, Krug, Norbert, Badorrek, Philipp and Hohlfeld, Jens M (2015) Exacerbation of atopic dermatitis upon grass pollen exposure in an environmental challenge chamber. J Allergy Clin Immunol.


Background: It has frequently been speculated that pruritus and skin lesions develop after topical exposure to aeroallergens in sensitized patients with atopic dermatitis (AD).
Objective: To study the cutaneous reactions to grass pollen in adult patients suffering from AD with accompanying clear IgE-sensitization to grass allergen in an environmental challenge chamber using a monocenter, double-blind, placebo-controlled study design.
Methods: Subjects were challenged on two consecutive days with either 4000 pollen grains/m3 of Dactylis glomerata pollen or clean air. The severity of AD was assessed at each study visit up to five days post challenge by (objective) scoring atopic dermatitis (SCORAD) and Investigator Global Assessment (IGA). Additionally, air-exposed and non-air exposed skin areas were each scored by modified SCORAD and IGA assessments. Serum CCL17 (TARC) levels were determined by ELISA. The primary endpoint of the study was the change in objective SCORAD between pre-challenge and post-challenge.
Results: Exposure to grass pollen induced a significant worsening of AD. A pronounced flare-up of air-exposed eczema rather than of covered skin areas occurred. With exposure to grass pollen a trend of increased CCL17 could be observed.
Conclusions: This study demonstrates that controlled exposure to airborne allergens of patients with so-called “extrinsic” IgE-mediated form of AD induced a worsening of dermal symptoms.
This trial was registered with (NCT01475994).

Item Type: Article
Date Deposited: 05 Dec 2015 00:45
Last Modified: 05 Dec 2015 00:45


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