The effect of Fel d 1‐derived T‐cell peptides on upper and lower airway outcome measurements in cat‐allergic subjects
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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 μg 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.
