Allergic Non-Asthmatic Adults Have Regional Pulmonary Responses to Segmental Allergen Challenge

Vanessa J Kelly; Tilo Winkler; Jose G Venegas; Mamary Kone; Daniel L Hamilos; Roshi Afshar; Josalyn L Cho; Andrew D Luster; Benjamin D Medoff; R Scott Harris

doi:10.1371/journal.pone.0143976

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Allergic Non-Asthmatic Adults Have Regional Pulmonary Responses to Segmental Allergen Challenge

Journal article

Open access

Peer reviewed

Allergic Non-Asthmatic Adults Have Regional Pulmonary Responses to Segmental Allergen Challenge

Vanessa J Kelly, Tilo Winkler, Jose G Venegas, Mamary Kone, Daniel L Hamilos, Roshi Afshar, Josalyn L Cho, Andrew D Luster, Benjamin D Medoff and R Scott Harris

PloS one, Vol.10(12), pp.e0143976-e0143976

2015

DOI: 10.1371/journal.pone.0143976

PMCID: PMC4671597

PMID: 26640951

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Abstract

Allergic non-asthmatic (ANA) adults experience upper airway symptoms of allergic disease such as rhinorrhea, congestion and sneezing without symptoms of asthma. The aim of this study was to utilize PET-CT functional imaging to determine whether allergen challenge elicits a pulmonary response in ANA subjects or whether their allergic disease is truly isolated to the upper airways. In 6 ANA subjects, bronchoalveolar lavages (BAL) were performed at baseline and 24h after instillation of an allergen and a diluent in separate lung lobes. After instillation (10h), functional imaging was performed to quantify and compare regional perfusion, ventilation, fractional gas content (Fgas), and glucose uptake rate (Ki) between the baseline, diluent and allergen lobes. BAL cell counts were also compared. In ANA subjects, compared to the baseline and diluent lobes, perfusion and ventilation were significantly lower in the allergen lobe (median [inter-quartile range], baseline vs. diluent vs. allergen: Mean-normalized perfusion; 0.87 [0.85-0.97] vs. 0.90 [0.86-0.98] vs. 0.59 [0.55-0.67]; p<0.05. Mean-normalized ventilation 0.89 [0.88-0.98] vs. 0.95 [0.89-1.02] vs. 0.63 [0.52-0.67], p<0.05). In contrast, no significant differences were found in Fgas between baseline, diluent and allergen lobes or in Ki. Total cell counts, eosinophil and neutrophil cell counts (cells/ml BAL) were significantly greater in the allergen lobe compared to the baseline lobe (all P<0.05). Despite having no clinical symptoms of a lower airway allergic response (cough and wheeze) allergic non-asthmatic subjects have a pulmonary response to allergen exposure which manifests as reduced ventilation and perfusion.

Young Adult

Allergens - administration & dosage

Multimodal Imaging

Humans

Middle Aged

Hypersensitivity - immunology

Adult

Female

Male

Tomography, X-Ray Computed

Positron-Emission Tomography

Lung - immunology

Details

Title: Subtitle: Allergic Non-Asthmatic Adults Have Regional Pulmonary Responses to Segmental Allergen Challenge
Creators: Vanessa J Kelly - Divisions of Pulmonary and Critical Care and Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
Tilo Winkler - Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
Jose G Venegas - Department of Anaesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
Mamary Kone - Divisions of Pulmonary and Critical Care and Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
Daniel L Hamilos - Divisions of Pulmonary and Critical Care and Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
Roshi Afshar - Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
Josalyn L Cho - Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
Andrew D Luster - Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
Benjamin D Medoff - Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
R Scott Harris - Divisions of Pulmonary and Critical Care and Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
Resource Type: Journal article
Publication Details: PloS one, Vol.10(12), pp.e0143976-e0143976
DOI: 10.1371/journal.pone.0143976
PMID: 26640951
PMCID: PMC4671597
NLM abbreviation: PLoS One
ISSN: 1932-6203
eISSN: 1932-6203
Publisher: Public Library of Science
Grant note: R01 HL088297 / NHLBI NIH HHS HL086717 / NHLBI NIH HHS R01 AI040618 / NIAID NIH HHS HL088297 / NHLBI NIH HHS AI095261 / NIAID NIH HHS U19 AI095261 / NIAID NIH HHS AI040618 / NIAID NIH HHS R01 HL086717 / NHLBI NIH HHS R37 AI040618 / NIAID NIH HHS 12POST11820025 / PHS HHS
Language: English
Date published: 2015
Academic Unit: Pulmonary, Critical Care, and Occupational Medicine; Anesthesia; Internal Medicine
Record Identifier: 9984094504602771

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