Allergen Administration in Bronchial Provocation Tests

  • B. J. O. Wong
  • F. E. Hargreave


Allergen inhalation tests measure the respiratory response to inhaled allergen. The response can be localised to the airways, to the peripheral respiratory tissues or both. In this chapter we will deal only with airway (asthmatic) responses. The materials and methods described in this chapter are those used in our laboratory, however, the principles are generally applicable. Alternative methods are considered in the Discussion.


Airway Responsiveness Allergen Extract Peak Flow Rate Allergen Inhalation Disodium Cromoglycate 
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  1. 1.
    Altounyan REC (1970) Changes in histamine and atropine responsiveness as a guide to diagnosis and evaluation of therapy in obstructive airways disease. In: Pepys J, Frandland AW (eds) Disodium cromoglycate in allergic airways disease. Butterworth, London, pp 47–53Google Scholar
  2. 2.
    Bryant DH, Burns MW (1976) Bronchial histamine reactivity: its relationship to reactivity of the bronchi to allergens. Clin Allergy 6: 523–532.PubMedCrossRefGoogle Scholar
  3. 3.
    Cartier A, Thomson NC, Frith PA, Roberts R, Hargreave FE (1982) Allergen-induced increase in bronchial responsiveness to histamine: relationship to the late 180 B. J. O. Wong and F. E. Hargreave asthmatic response and change in airway caliber. J Allergy Clin Immunol 70: 170–177Google Scholar
  4. 4.
    Chai H, Farr RS, Froehlich LA, Mathison DA, McLean JA, Rosenthal RR, Sheffer AL, Spector SI, Townley RG (1975) Standardization of bronchial inhalation challenge procedures. J Allergy Clin Immunol 56: 323–327PubMedCrossRefGoogle Scholar
  5. 5.
    Cockcroft DW, Killian DN, Mellon JJA, Hargreave FE (1977) Bronchial reactivity to inhaled histamine: a method and clinical survey. Clin Allergy 7: 235–243PubMedCrossRefGoogle Scholar
  6. 6.
    Cockcroft DW, Ruffin RE, Dolovich J, Hargreave FE (1977) Allergen-induced increase in non-allergic bronchial reactivity. Clin Allergy 7: 503–513PubMedCrossRefGoogle Scholar
  7. 7.
    Cockcroft DW, Murdock KY (1987) Changes in bronchial responsiveness to histamine at intervals after allergen challenge. Thorax 42: 302–308PubMedCrossRefGoogle Scholar
  8. 8.
    Cockcroft DW, Murdock KY, Kirby J, Hargreave F (1987) Prediction of airway responsiveness to allergen from skin sensitivity to allergen and airway responsiveness to histamine. Am Rev Respir Dis 135: 264–267PubMedGoogle Scholar
  9. 9.
    Crimi E, Brusasco V, Losurdo E, Crimi P (1986) Predictive accuracy of late asthmatic reaction to dermatophagoides pteronyssinus. J Allergy Clin Immunol 78: 908–913PubMedCrossRefGoogle Scholar
  10. 10.
    Durham SR, Craddock CF, Cookson WO, Benson MK (1988) Increases in airway responsiveness to histamine precede allergen-induced late asthmatic responses. J Allergy Clin Immunol 82: 764–770PubMedCrossRefGoogle Scholar
  11. 11.
    Frith PA, Ruffin RE, Juniper EF, Dolovich J, Hargreave FE (1981) Inhibition of allergen-induced asthma by three forms of sodium cromoglycate. Clin Allergy 11: 67–77PubMedCrossRefGoogle Scholar
  12. 12.
    Gibson PG, Manning PJ, O’Byrne PM, Girgis-Gabardo A, Dolovich J, Denburg JA, Hargreave FE (1991) Allergen induced asthmatic responses: relationship between increases in airway responsiveness and increases in circulating eosinophils, basophils and their progenitors. Am Rev Respir Dis 1991; 143: 331–335Google Scholar
  13. 13.
    Hargreave FE (1987) Inhalation provocation tests. In: Lessof MH, Lee TH, Kemeny DM (eds) Allergy: an international textbook. Wiley, Chichester, pp 289–303Google Scholar
  14. 14.
    Hargreave FE, Dolovich J, Robertson DG, Kerigan AT (1974) II. The late asthmatic responses. Can Med Assoc J 110: 415–424Google Scholar
  15. 15.
    Hargreave FE, Fink JN, Cockcroft DW, Fish JE, Holgate ST, Ramsdale EH, Roberts RS, Shapiro GG, Sheppard D (1986) Workshop 4: the role of bronchoprovocation. J Allergy Clin Immunol 78: 517–524CrossRefGoogle Scholar
  16. 16.
    Hargreave FE, Marone G, Platts-Mills T (1989) Diagnostic procedures. In: Hol-gate ST (ed) The role of inflammatory processes in airway hyperresponsiveness. Blackwell, Oxford, pp 80–107Google Scholar
  17. 17.
    Herxheimer H (1952) The late bronchial reaction in induced asthma. Int Arch Allergy 3: 323–328PubMedCrossRefGoogle Scholar
  18. 18.
    Hoeppner VH, Murdock KY, Kooner S, Cockcroft DW (1985) Severe acute occupational asthma: caused by accidental allergen exposure in an allergen challenge laboratory. Ann Allergy 55 (1): 36–37PubMedGoogle Scholar
  19. 19.
    Juniper EF, Frith PA, Hargreave FE (1981) Airway responsiveness to histamine and methacholine: relationship to minimum treatment to control symptoms of asthma. Thorax 36: 575–579PubMedCrossRefGoogle Scholar
  20. 20.
    Juniper EF, Kline PA, Vanzieleghem MA, Ramsdale EH, O’Byrne PM, Hargreave FE (1990) Effect of long-term treatment with an inhaled corticosteroid (budesonide) on airway hyperresponsiveness and clinical asthma in nonsteroiddependent asthmatics. Am Rev Respir Dis 142: 832–836PubMedGoogle Scholar
  21. 21.
    Juniper EF, Cockcroft DW, Hargreave FE (1991) Histamine and methacholine inhalation tests: a laboratory tidal breathing protocol. AB DRACO (subsidiary of ABASTRA) Lund, Sweden 1991Google Scholar
  22. 22.
    Lai CKW, Twentyman OP, Holgate ST (1989) The effect of an increase in inhaled allergen dose after rimiterol hydrobromide on the occurrence and magnitude of the late asthmatic response and associated change in nonspecific bronchial responsiveness. Am Rev Respir Dis 140: 917–923PubMedGoogle Scholar
  23. 23.
    Lowenstein H (1983) Report on behalf of the International Union Standardization Subcommittee. Arb Paul Ehrlich Inst 78: 41–48PubMedGoogle Scholar
  24. 24.
    Lowenstein H, Ipsen H, Lind P, Matthiesen F (1987) The physicochemical and biological characteristics of allergens. In: Lessof MH, Lee TH, Kemeny DM (eds) Allergy: an international textbook. Wiley, Chichester, pp 87–104Google Scholar
  25. 25.
    Machado L, Stalenheim G (1990) Factors influencing the occurrence of late bronchial reactions after allergen challenge. Allergy 45 (4): 268–274PubMedCrossRefGoogle Scholar
  26. 26.
    Melillo G (1986) Bronchial Challenge with a micronized, freeze-dried allergen extract administered as a powder by a special turboinhaler. In: Melillo G, Cocco G, Centanni G (eds) XIIIth congress on of the European academy of allergology and clinical immunology — workshop on “The use of allergen in powder form for provocation tests and for immunotherapy in allergic asthma”, pp 3–14Google Scholar
  27. 27.
    O’Byrne PM, Dolovich J, Hargreave FE (1987) Late asthmatic responses. Am Rev Respir Dis 136: 740–751PubMedCrossRefGoogle Scholar
  28. 28.
    Pepys J, Hargreave FE, Chan M, McCarthy DS (1968) Inhibitory effects of dis-odium cromoglycate ( Intal) on allergen inhalation tests. Lancet ii: 134Google Scholar
  29. 29.
    Ruffin RE, Cockcroft DW, Hargreave FE (1978) A comparison of the protective effect of fenoterol and Sch1000 on allergen-induced asthma. J Allergy Clin Immunol 61:42— 47Google Scholar
  30. 30.
    Ryan G, Latimer KM, Dolovich J, Hargreave FE (1982) Bronchial responsiveness to histamine: relationship to diurnal variation of peak flow rate, improvement after bronchodilator and airway calibre. Thorax 37: 423–429PubMedCrossRefGoogle Scholar
  31. 31.
    Woolcock AJ, Yan K, Salome CM (1988) Effect of therapy on bronchial hyper-responsiveness in the long-term management of asthma. Clin Allergy 18: 165–176PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1993

Authors and Affiliations

  • B. J. O. Wong
    • 1
  • F. E. Hargreave
    • 1
  1. 1.Firestone Regional Chest and Allergy UnitSt. Joseph’s HospitalHamiltonCanada

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