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Emily Schoemmell, Yesha Raval, Donna L Welch, Paul J Gomes, Keith Jeffrey Lane; Incidence and severity of itchy palate following conjunctival allergen challenge. Invest. Ophthalmol. Vis. Sci. 2016;57(12):310.
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© ARVO (1962-2015); The Authors (2016-present)
During an acute episode of allergic conjunctivitis, mast cell-derived allergic and pro-inflammatory mediators released from the conjunctiva can travel down the nasal lacrimal duct and induce symptoms in the oral and nasopharyngeal tissues. This study evaluated the incidence and severity of itchy palate following conjunctival allergen challenge (CAC) with seasonal and perennial allergens in a population of atopic subjects.
423 subjects with a history of allergic conjunctivitis participated in 5 separate IRB-approved trials. Patients were initially titrated with escalating doses of allergen to determine qualifying dosing levels for elicitation of a moderate ocular allergic response (itching 2+ (0-4 scale) and redness 2+ (0-4 scale). In each trial, itchy palate was evaluated using a standardized 0-4 scale at 20 minutes post-CAC. A meta-analysis of incidence and severity of itchy palate was performed to better understand patterns of palate response to ocular challenge.
Eighty-two percent of subjects (348/423) experienced some sensation of itchy palate following allergen challenge. Thirty-eight percent of subjects (163/423) experienced moderate to severe itchy palate (defined as a score ≥ 3 on 0-4 scale) following CAC.
A high percentage of allergic conjunctivitis patients experience some level of itchy palate following CAC (82%). A smaller percentage of patients (38%) reported moderate to severe itchy palate. This subgroup of more severe subjects may have increased sensitivity in the oral and nasopharyngeal tissues, and thus comprises a cohort for further analysis of atopic disease. More work should be performed to investigate the relationship between occurrence of moderate to severe itchy palate following CAC with environmental aeroallergens and gastrointestinal allergic response to various allergens, including food proteins.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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