Symptom dynamics during repeated serial allergen challenge chamber exposures to house dust mite  Robert L. Jacobs, MD, Charles P. Andrews, MD, Daniel A. Ramirez, MD, Cynthia G. Rather, CCRC, Nathan Harper, MS, Fabio Jimenez, BS, Hernan Martinez, MD, Muthu Manoharan, MS, Andrew Carrillo, BS, Margit Gerardi, RN, PhD, Robert E. Esch, PhD, Weijing He, MD, Sunil K. Ahuja, MD  Journal of Allergy and Clinical Immunology  Volume 135, Issue 4, Pages 1071-1075 (April 2015) DOI: 10.1016/j.jaci.2014.09.047 Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Study design and symptom levels in HDM-sensitive (M+) and nonsensitive (M−) participants in the natural setting versus the ACC. A, The 4 study phases. ‡Number of TSS measurements in each phase. B, Means ± SEMs of TSSs recorded in the study phases. Means (with 95% CIs) of the minimum and maximum TSSs observed in M+ participants are shown as dashed lines with gray bands. The rTSS was recorded twice daily in the natural setting (run-in and observation phases), and the iTSS was recorded at baseline and then at 30-minute intervals after HDM exposure in the ACC. C, Correlation between the maximum iTSS recorded in ACC-I and ACC-II in 21 M+ participants. The trend line, correlation r (rho) value, P value, and slope and intercept are shown. D, Proportion of M+ participants achieving the indicated increase in iTSSs from baseline levels (ΔiTSS) during each exposure. E, Proportion of M+ participants with the indicated baseline (before exposures 1 and 5) and maximum iTSSs recorded during ACC-I and ACC-II. Journal of Allergy and Clinical Immunology 2015 135, 1071-1075DOI: (10.1016/j.jaci.2014.09.047) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Symptom responses in M+ participants stratified by ssIgE levels for D pteronyssinus and SPT responses to pollen. A, Mean ± SEM rTSSs or iTSSs in M+ participants according to detectable versus undetectable ssIgE levels (M+IgE− vs M+IgE+ participants). ‡Number of TSS measurements in each phase. B and C, Box-and-whisker plots for the maximum rTSS or iTSS in M+IgE− and M+IgE+ participants (Fig 2, B) and M+P− and M+P+ participants (Fig 2, C). P values test whether the means are different. D, Mean CD69+HLA-DR+CD8+ T cells for M+P− and M+P+ participants. Data for CD4+ T cells are shown in Fig E5. A linear generalized estimating equations model was used to test whether the mean across all 4 time points in ACC-I or ACC-II differed between M+P− and M+P+ participants. E-G, Box-and-whisker plots for ΔiTSS by ssIgE status and SPT reactivity to pollen (Fig 2, E) and differences in TSSs from scores recorded before exposures 1 and 5 from the TSSs the evening before the run-in and observation (Obs.) phases, respectively, in all (M+), M+P−, and M+P+ participants and daily ΔiTSSs in M+ participants during each exposure (Fig 2, G). ΔiTSS indicates the maximum iTSS minus the baseline iTSS at the corresponding exposure. NS, Not significant. #.05 < P value ≤ .15. *.01 < P value ≤ .05. **P ≤ .01. Journal of Allergy and Clinical Immunology 2015 135, 1071-1075DOI: (10.1016/j.jaci.2014.09.047) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions