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Reproducibility of the Cytokine Response Following Nasal Allergen ChallengeCT Pantin, J Burrough, P Cadden, D SinghUniversity of Manchester, Medicines Evaluation Unit, University Hospital of South Manchester Foundation Trust, Southmoor Road, ManchesterRationale: Nasally inhaled allergen provokes increased nasal secretion, cytokine production, and nasal symptoms. This induces a biphasic allergic response comprising of an early (0-2hours) and a late component (4-8 hours). The aim of this study is to investigate the reproducibility of late response cytokine levels in secretions post nasal allergen challenge.Methods: 17 subjects with allergic rhinitis underwent nasal allegen challenge. Skin prick testing was performed to determine the choice of allergen (which comprised cat, house dust mite and 6 species of grass) utilized to challenge study subjects. Nasal secretions (collected by Ivalon® Post-op Sinus Pack K9), nasal secretion weight and total nasal symptom score were measured from baseline up to 8 hours post allergen inhalation. A repeat nasal allergen challenge was performed 7 to 14 days later. Concentrations of IL-5 and IL-8 in the post allergen challenge nasal secretions were determined using ELISA and corrected for nasal secretion weight to give the absolute cytokine concentration per subject. The 8 hour time point was analysed for reproducibility.Results: IL-5 concentrations were elevated from 4 hours through to 8 hours post allergen challenge at both visits in 7 subjects’ nasal secretions. No IL-5 was detected at any time point in 10 subjects. There was no significant difference in the 8 hour IL-5 concentration between visits (p=0.38). IL-8 concentrations increased from 4 hours through to 8 hours post allergen at both visits in all subjects. There was no significant difference in IL-8 concentration between visits (p=0.86). The intra class correlation coefficient (ri) for both cytokines was > 0.6 suggesting good agreement between the two challenges. The ri value for IL-8 is > 0.75 indicating very good agreement.Cytokine (pg) First Nasal Allergen ChallengeMean (SD) Second Nasal Allergen ChallengeMean (SD) Mean Difference(95% CI) Intra Class Correlation CoefficientIL-5 62.2 (82.8) 185.5 (224.9) 123.3 (-40.8, 287.4) 0.62 IL-8 262.0 (300.2) 322.3 (394.5) 60.3 (-175.5, 296.1) 0.76 Table Reproducibility of Cytokine Response at 8 Hours Following Nasal Allergen ChallengeConclusions: Nasal allergen challenges using Ivalon® Post-op Sinus Pack K9 sponges are able to reproducibly detect the nasal late allergen cytokine response. |
