背景:变态反应专家在猫过敏管理中的工具箱是有限的。临床研究表明,全β-乳球蛋白(holoBLG)可以恢复特应性免疫细胞的微量营养缺陷,并以完全非过敏原特异性的方式缓解过敏症状。通过这项研究,我们旨在提供猫过敏的证明原理。
方法:开发了一种在标准化ECARF过敏原暴露室(AEC)中针对猫过敏的新型攻击方案。在一项开放的试点研究(NCT05455749)中,在3个月的干预阶段(holoBLG锭剂2次,每日2次)之前和之后,临床相关的猫过敏患者在AEC中接受猫过敏原刺激120分钟.鼻腔,结膜,支气管,每10分钟对瘙痒症状进行评分-构成总症状评分(TSS)。每30分钟测量峰值鼻吸气流量(PNIF)。此外,在干预前后进行了滴定法鼻激发试验(NPT).主要终点是与基线相比,最终暴露结束时TSS的变化。次要终点包括PNIF的变化,NPT,并在暴露后24小时内出现晚期反应。
结果:35名患者(平均年龄:40岁)完成了研究。与基线相比,holoBLG补充导致中位TSS显著改善50%(p<0.001),以及鼻中流量为20L/min(p=0.0035)。20%的患者在基线暴露后报告了晚期反应,但最终曝光后为0%。
结论:猫过敏患者可以从holoBLG锭剂的靶向微量营养中获益。正如以前在其他过敏症中看到的那样,holoBLG补充也诱导了猫过敏的免疫弹性,导致症状明显改善。
BACKGROUND: The allergists´ tool box in cat allergy management is limited. Clinical studies have shown that holo beta-lactoglobulin (holoBLG) can restore micronutritional deficits in atopic immune cells and alleviate allergic symptoms in a completely allergen-nonspecific manner. With this study, we aimed to provide proof of principle in cat allergy.
METHODS: A novel challenge protocol for cat allergy in a standardized ECARF allergen exposure chamber (AEC) was developed. In an open pilot study (NCT05455749), patients with clinically relevant cat allergy were provoked with cat allergen for 120 min in the AEC before and after a 3-month intervention phase (holoBLG lozenge 2x daily). Nasal, conjunctival, bronchial, and pruritus symptoms were scored every 10 min- constituting the total symptom score (TSS). Peak nasal inspiratory flow (PNIF) was measured every 30 min. In addition, a titrated nasal provocation test (NPT) was performed before and after the intervention. Primary endpoint was change in TSS at the end of final exposure compared to baseline. Secondary endpoints included changes in PNIF, NPT, and occurrence of late reactions up to 24 h after exposure.
RESULTS: 35 patients (mean age: 40 years) completed the study. Compared to baseline, holoBLG supplementation resulted in significant improvement in median TSS of 50% (p < 0.001), as well as in median nasal flow by 20 L/min (p = 0.0035). 20% of patients reported late reactions after baseline exposure, but 0% after the final exposure.
CONCLUSIONS: Cat allergic patients profited from targeted micronutrition with the holoBLG lozenge. As previously seen in other allergies, holoBLG supplementation also induced immune resilience in cat allergies, resulting in significant symptom amelioration.