Clinical standardization of two controlled allergen challenge facilities: The Environmental Exposure Unit and the Biogenics Research Chamber

Ann Allergy Asthma Immunol. 2019 Jun;122(6):639-646.e2. doi: 10.1016/j.anai.2019.03.007. Epub 2019 Mar 13.

Abstract

Background: Controlled allergen challenge facilities (CACF), in disparate geographic regions with dissimilar engineering and base populations, have historically functioned as single, independent sites in clinical allergy trials. We aimed to demonstrate "between-unit reproducibility" to allow controlled challenge trials of participants using 2 CACFs.

Objective: To compare and standardize 2 CACFs located in Kingston, Ontario, Canada, and San Antonio, Texas, by examining participant-reported symptom severity during qualifying and treatment visits and evaluating response to treatment, while using the same allergen.

Methods: At 2 different CACFs, participants were enrolled in a double-blind, placebo-controlled, crossover intervention trial with cetirizine 10 mg. Different distribution devices delivered common short ragweed pollen via laminar air flow and maintained an airborne concentration of 3500 ± 700 grains/m3 in both facilities. A 1-hour "sham" run with no pollen release preceded a priming exposure of 3 hours and was followed 3 days later by a qualifying/treatment 5-hour exposure. At least 14 days later, another priming exposure was followed by the crossover exposure and treatment.

Results: Forty-eight and 43 subjects completed the study at Kingston and San Antonio, respectively. Demographics were similar. Fewer than 10% exhibited symptoms with sham exposure. No significant differences were found between the 2 facilities in maximal total rhinoconjunctivitis symptom score, total nasal symptom score, and total ocular symptom score, nor in areas under the curve. In both facilities, no significant effects of cetirizine 10 mg over placebo were detected.

Conclusion: The results were equivalent, demonstrating that the 2 CACFs can be used together in dual-center clinical trials and show the possibility of multicenter trials involving multiple CACFs.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Allergens / immunology
  • Ambrosia / immunology
  • Antigens, Plant / immunology
  • Atmosphere Exposure Chambers / standards
  • Atmosphere Exposure Chambers / statistics & numerical data*
  • Canada / epidemiology
  • Conjunctivitis, Allergic / epidemiology*
  • Conjunctivitis, Allergic / immunology
  • Environment, Controlled
  • Environmental Exposure / standards*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Observer Variation
  • Pollen / immunology
  • Reproducibility of Results
  • Rhinitis / epidemiology*
  • Rhinitis / immunology
  • United States / epidemiology

Substances

  • Allergens
  • Antigens, Plant