Responses to ragweed pollen in a pollen challenge chamber versus seasonal exposure identify allergic rhinoconjunctivitis endotypes Robert L. Jacobs,

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Presentation transcript:

Responses to ragweed pollen in a pollen challenge chamber versus seasonal exposure identify allergic rhinoconjunctivitis endotypes Robert L. Jacobs, MD, Nathan Harper, BS, Weijing He, MD, Charles P. Andrews, MD, Cynthia G. Rather, CCRC, Daniel A. Ramirez, MD, Sunil K. Ahuja, MD Journal of Allergy and Clinical Immunology Volume 130, Issue 1, Pages 122-127.e8 (July 2012) DOI: 10.1016/j.jaci.2012.03.031 Copyright © 2012 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Study design and participants. Study visits and timings of symptoms were recorded by participants in the natural season and in the PCC. The number of participants in each phase of the study is shown. Journal of Allergy and Clinical Immunology 2012 130, 122-127.e8DOI: (10.1016/j.jaci.2012.03.031) Copyright © 2012 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Average TSSs and trend lines in the PCC. Means ± SDs of the TSSs for all exposure visits recorded in all participants, regardless of the number of PCC visits (A); those who completed all visits (slow/low responders; B), and those not completing all visits (rapid/high responders; C). Baseline is the average TSS from 4 days before and the morning of the first PCC visit. P values for data in Fig 2, C, versus Fig 2, B are as follows: a, .197; b-g, <.001. D-F, Changes in TSSs over time during the PCC visits were estimated by using linear generalized estimating equation modeling. Δ, Difference. Journal of Allergy and Clinical Immunology 2012 130, 122-127.e8DOI: (10.1016/j.jaci.2012.03.031) Copyright © 2012 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Correlation of seasonal TSSmax and PCC TSSmax and cluster analysis. A, Correlation of natural season TSSmax and PCC TSSmax. Brown and purple regression lines represent subjects with concordant versus discordant (ie, PCC TSSmax < natural season TSSmax) symptoms between the natural season and the PCC, respectively. The shaded band represents ± 2 SDs from the ideal line (Y = X). B, Cluster analysis based on both seasonal TSSmax and PCC TSSmax. Participants were letter and color coded. Black letters indicate participants with less than 4 PCC visits. Endotypes are noted by Roman numerals I, II, and III. Journal of Allergy and Clinical Immunology 2012 130, 122-127.e8DOI: (10.1016/j.jaci.2012.03.031) Copyright © 2012 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E1 Inclusion/exclusion criteria for the natural season and the PCC. Journal of Allergy and Clinical Immunology 2012 130, 122-127.e8DOI: (10.1016/j.jaci.2012.03.031) Copyright © 2012 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E2 Average symptom scores and pollen counts during the natural season. Shown is the mean TSS (triangles), TNSS (squares), and TOSS (diamonds), as well as pollen counts (blue shading), in the 31 participants who recorded symptoms for 15 days during the peak of the natural season. Symptoms were recorded twice a day (morning [AM] and evening [PM]). Journal of Allergy and Clinical Immunology 2012 130, 122-127.e8DOI: (10.1016/j.jaci.2012.03.031) Copyright © 2012 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E3 Correlation among symptom scores between natural season versus PCC visits. A, Relative contributions of TOSSs and TNSSs to the TSS. B, Proportion of significant responders by TOSS (score ≥5) or TNSS (score ≥7). Journal of Allergy and Clinical Immunology 2012 130, 122-127.e8DOI: (10.1016/j.jaci.2012.03.031) Copyright © 2012 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E4 Cumulative frequency of symptom scores for the first 4 days of the peak of the natural season (A-C) and during chamber runs (D-F). Symptom scores are color coded. We chose the TSSs from the first 4 days in the peak natural season for comparisons. In Fig E4, F, the blue and red lines are superimposed. Journal of Allergy and Clinical Immunology 2012 130, 122-127.e8DOI: (10.1016/j.jaci.2012.03.031) Copyright © 2012 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E5 Correlation between the maximum TSS in the chamber (A) and natural season (B) with the ragweed skin test. Pearson correlation r values and trend lines were shown. Journal of Allergy and Clinical Immunology 2012 130, 122-127.e8DOI: (10.1016/j.jaci.2012.03.031) Copyright © 2012 American Academy of Allergy, Asthma & Immunology Terms and Conditions