Validation of an Environmental Exposure Chamber for Inhalation Studies With House Dust Mite Allergen in Patients With Allergic Rhinitis

This clinical validation study is aimed at testing the efficacy of a new environmental challenge chamber (ECC) to induce symptoms of allergic rhinitis in patients allergic to house dust mite. The symptoms will be recorded on a validated symptom score as Total Nasal Symptom Score (TNSS), allowing for determine whether the challenge is dose dependent and reproducible.

Study Overview

• Status: Completed
• Conditions: Allergy to House Dust Mite
• Intervention / Treatment: Procedure: Exposure to house dust mite

Detailed Description

At Fraunhofer ITEM, a novel technique to create an atmosphere loaded with allergenic particles was recently developed. In brief, particles are produced in a combined process of nebulization and drying of a solution containing soluble allergenic extracts and lactose. The particle size distribution is regulated by the droplet size distribution and the lactose concentration in the solution, while the allergen content can be chosen independently. Thus, the Fraunhofer scientists have created a universal tool which provides them with the possibility to create atmospheres containing allergenic particles of arbitrary sizes containing a variety of different allergens. By choosing particle sizes preferentially depositing in the nose (above 10 µm) or the lungs (5 to 10 µm), and selecting allergen concentrations commonly found in the environment, it is possible to build up challenge atmospheres for a large variety of indications.

The first clinical application of this new method will be to create an atmosphere simulating the natural exposure to house dust mite allergens. The challenge aerosol will be composed of lactose as carrier material and the two major allergens Der p1 and Der p2 of house dust mites originating from a licenced allergen extract for inhaled challenge.

• Study Type: Interventional
• Enrollment (Anticipated): 18
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Germany
  • Hannover, Germany, 30625
    • Fraunhofer-Institute for Toxicology and Experimental Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 55 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Male and female subjects aged 18-55 years.
• Non smokers or ex-smokers with a history of less than 10 pack years, having been nonsmokers for at least the last 12 months.
• History of allergic rhinitis to house dust mite. Subjects with mild intermittent asthma that is controlled with occasional use of as-needed short-acting beta-agonists may be included.
• Normal lung function (FEV1 ≥ 80 % pred)
• Positive skin prick test for dermatophagoides pteronyssinus.
• Able and willing to give written informed consent to take part in the study.
• Available to complete all study measurements.

• Women will be considered for inclusion if they are:

  • Not pregnant, as confirmed by pregnancy test (see flow chart) and not nursing.
  • Of non-child bearing potential (i.e. physiologically incapable of becoming pregnant, including any female who is pre-menarchial or post-menopausal, with documented proof of hysterectomy or tubal ligation, or meet clinical criteria for menopause and has been amenorrhoeic for more than 1 year prior to the screening visit).
  • Of childbearing potential and using a highly effective method of contraception during the entire study (vasectomised partner, sexual abstinence - the lifestyle of the female should be such that there is complete abstinence from intercourse from two weeks prior to the first dose of study medication until at least 72 hours after treatment -, implants, injectables, combined oral contraceptives, hormonal IUDs or double-barrier methods, i.e. any double combination of IUD, condom with spermicidal gel, diaphragm, sponge, and cervical cap).

Exclusion Criteria:

• History of a respiratory tract infection and/or exacerbation of asthma within 4 weeks before the screening.
• Any history of life-threatening asthma, defined as an asthma episode that required intubation and/or was associated with hypercapnea, respiratory arrest or hypoxic seizures.
• Administration of oral, injectable or dermal corticosteroids within 8 weeks or intranasal and/or inhaled corticosteroids 4 weeks prior to enrollment.
• Past or present disease, which as judged by the investigator, may affect the outcome of this study. These diseases include, but are not limited to, cardiovascular disease, malignancy, hepatic disease, renal disease, hematological disease, neurological disease, endocrine disease or pulmonary disease (including but not confined to chronic bronchitis, emphysema, tuberculosis, bronchiectasis or cystic fibrosis).
• Any structural nasal abnormalities or nasal polyps on examination, history of frequent nose bleeding or recent nasal surgery.
• Conditions or factors, which would make the subject unlikely to be able to stay in the Fraunhofer ECC for four to six hours.
• Specific Immunotherapy (SIT) within the last two years prior to screening.
• Risk of non-compliance with study procedures.
• Participation in another clinical trial 30 days prior to enrolment.
• Any contraindication for adrenalin use (e.g. use of local and systemic beta-blockers)
• Intolerance to any excipients especially lactose and/or milk products
• History of drug or alcohol abuse

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: Non-Randomized
• Interventional Model: Crossover Assignment
• Masking: Single

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Total nasal symptom score (TNSS)	To assess the effect of a 4 hour-environmental allergen challenge with house dust mite extract in an ECC on the total nasal symptom score (TNSS), defined as the sum of obstruction, rhinorrhea, itch, and sneeze, each of which has been scored on a scale from 0 to 3.	During 4 hours of challenge

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Rhinomanometry	To assess the effect of a 4-hour-environmental allergen challenge with house dust mite extract.	During 4 hours of challenge
visual analogue scale (VAS) for total nasal symptoms	To assess the effect of a 4-hour-environmental allergen challenge with house dust mite extract	During 4 hours of challenge
Nasal secretion	To assess the effect of a 4-hour-environmental allergen challenge with house dust mite extract.	during 4 hours of challenge
Exhaled Nitric Oxide (NO)	To assess the effect of a 4-hour-environmental allergen challenge with house dust mite extract.	during and up to 24 hours after challenge
FEV1	To assess the effect of a 4-hour-environmental allergen challenge with house dust mite extract.	during and up to 24 hours after challenge

Collaborators and Investigators

• Sponsor: Fraunhofer-Institute of Toxicology and Experimental Medicine

Publications and helpful links

Helpful Links

• Sponsor's homepage

Study record dates

Study Major Dates

• Study Start: January 1, 2011
• Primary Completion (Actual): May 1, 2011
• Study Completion (Actual): May 1, 2011

Study Registration Dates

• First Submitted: January 10, 2011
• First Submitted That Met QC Criteria: January 11, 2011
• First Posted (Estimate): January 12, 2011

Study Record Updates

• Last Update Posted (Estimate): July 6, 2011
• Last Update Submitted That Met QC Criteria: July 4, 2011
• Last Verified: July 1, 2011

More Information

Terms related to this study

• Keywords: immunotherapy; house dust mite; allergen provocation; environmental challenge; allergen chamber
• Additional Relevant MeSH Terms: Infections; Respiratory Tract Infections; Respiratory Tract Diseases; Immune System Diseases; Hypersensitivity, Immediate; Otorhinolaryngologic Diseases; Respiratory Hypersensitivity; Hypersensitivity; Nose Diseases; Rhinitis; Rhinitis, Allergic
• Other Study ID Numbers: 09/01 Valex1