Laryngeal effects of antigen stimulation challenge with perennial allergen Dermatophagoides pteronyssinus.

Abstract

We conducted a pilot study to assess the effects of antigen stimulation on the appearance and function of the larynx. The prospective, double-blind, randomized study included 9 adult patients with a skin-prick test positive for Dermatophagoides pteronyssinus. Subjects were blindly challenged via nebulizer with either an active antigenic suspension or placebo. Baseline and 30-minute evaluations of the larynx were performed. Assessments included subjective voice and videostroboscopic assessments, acoustic analysis of voice, speech aerodynamic testing, and allergy and voice handicap questionnaires. Although both inflammation and increased mucus were noted, there were no significant differences between the antigen- and placebo-exposed subjects on any of the measures obtained. Our preliminary investigation was not successful in demonstrating a direct causal relationship between antigen exposure and physical or functional changes in the larynx. Future studies will involve modifications to our current methodology, including increasing the concentration of antigen, prolonging the exposure time, and observing for late phase responses.