Symptom dynamics during repeated serial allergen challenge chamber exposures to house dust mite

[...]we suggest that out-of-pollination season challenges with HDM in the ACC might help mitigate the confounding of factors present in the natural setting: variable or low exposure to HDM, lack of association of ssIgE levels with rTSSs, and effects of competing environmental influences in a primed polysensitized subject. An example that highlights the potential for this imbalance is the observation that the effectiveness of anti-IgE therapy for asthma differed by the overall sensitization status of the trial participants.15 Therapies might be more effective in patients with greater responsiveness to allergen exposure, a trait that can be readily identified in an ACC. [...]we surmise that mindfulness of the abovementioned confounders and use of an ACC might together facilitate detection of differences in the effects of placebo versus therapy in clinical trials, especially in exploratory studies with novel therapeutic agents when both the participant numbers and therapy effect sizes might be modest.