The effect of Fel d 1-derived T-cell peptides on upper and lower airway outcome measurements in cat-allergic subjects.
BACKGROUND
We previously showed that overlapping Fel d 1-derived T-cell peptides inhibited surrogate markers of allergy (i.e. early and late-phase skin reactions and T-cell function) in cat allergic subjects. The present pilot study was designed to determine whether this treatment affected clinically relevant outcome measurements such as the allergen-induced nasal and bronchial reactions, and asthma/rhinitis quality of life (QOL).


METHODS
Sixteen cat-allergic asthmatic subjects who gave a dual (early and late) asthmatic response (DAR) to inhaled cat allergen were randomly assigned to receive either Fel d 1 peptides (approximately 300 mug in increasing, divided doses) or placebo (8 active : 8 placebo). Twelve single early responders (SER) were also studied in an open fashion design. Allergen-induced bronchial and nasal measurements as well as the QOL was measured at baseline, 4-8 weeks (follow-up 1 (FU1)) and 3-4 months (FU2).


RESULTS
In the active, but not placebo, group there were significant decreases in the late asthmatic reaction (LAR) to whole cat dander (P = 0.03) at FU2 but with no between group difference. There were also significant improvements in asthma quality of life (QOL) scores [asthma-activity limitation (P = 0.014); rhinitis-sleep (P = 0.024), non-nose/non-eye symptoms (P = 0.031), nasal problems (P = 0.015)]. In the open study Fel d 1 peptide treatment resulted in significant decreases in number of sneezes (P = 0.05), weight of nasal secretions (P = 0.04) and nasal blockage (P = 0.01) following allergen challenge.


CONCLUSIONS
Multiple, short, overlapping Fel d 1 T-cell peptides have potential for inhibiting upper and lower airway outcome measurements in cat allergic patients. Larger, dose-ranging, studies are required before firm conclusions on clinical efficacy of peptide allergen therapy can be made.
Alexander
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C
Department of Allergy and Clinical Immunology, Faculty of Medicine, Imperial College, National Heart & Lung Institute, London, UK.
Tarzi
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M
Larché
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M
Kay
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D000328:Adult; D000818:Animals; D001249:Asthma / Q000628:therapy*; D002415:Cats / Q000276:immunology*; D003888:Desensitization, Immunologic; D005260:Female; D006023:Glycoproteins / Q000737:chemistry / Q000627:therapeutic use*; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology / Q000628:therapy*; D007108:Immune Tolerance; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000138:chemical synthesis / Q000737:chemistry / Q000627:therapeutic use*; D012220:Rhinitis / Q000628:therapy*; D013601:T-Lymphocytes / Q000276:immunology; D016896:Treatment Outcome
D006023:Glycoproteins; D010455:Peptides; C059296:Fel d 1 protein, Felis domesticus