Werfel, T.T.WerfelHeratizadeh, A.A.HeratizadehNiebuhr, M.M.NiebuhrKapp, A.A.KappRoesner, L.M.L.M.RoesnerKarch, A.A.KarchErpenbeck, V.J.V.J.ErpenbeckLösche, C.C.LöscheJung, T.T.JungKrug, N.N.KrugBadorrek, P.P.BadorrekHohlfeld, J.M.J.M.Hohlfeld2022-03-052022-03-052015https://publica.fraunhofer.de/handle/publica/24050110.1016/j.jaci.2015.04.0152-s2.0-849302603132-s2.0-84937023045Background: It has frequently been speculated that pruritus and skin lesions develop after topical exposure to aeroallergens in sensitized patients with atopic dermatitis (AD). Objective: We sought to study cutaneous reactions to grass pollen in adult patients with AD with accompanying clear IgE sensitization to grass allergen in an environmental challenge chamber using a monocenter, double-blind, placebo-controlled study design. Methods: Subjects were challenged on 2 consecutive days with either 4000 pollen grains/m3 of Dactylis glomerata pollen or clean air. The severity of AD was assessed at each study visit up to 5 days after challenge by (objective) scoring of AD (SCORAD). Additionally, air-exposed and non-air-exposed skin areas were each scored using local SCORAD scoring and investigator global assessments. Levels of a series of serum cytokines and chemokines were determined by using a Luminex-based immunoassay. The primary end point of the study was the change in objective SCORAD scores between prechallenge and postchallenge values. Results: Exposure to grass pollen induced a significant worsening of AD. Apronounced eczema flare-up of air-exposed rather than covered skin areas occurred. In grass pollen-exposed subjects a significantly higher increase in CCL17, CCL22, and IL-4 serum levels was observed. Conclusions: This study demonstrates that controlled exposure to airborne allergens of patients with a so-called extrinsic IgE-mediated form of AD induced a worsening of cutaneous symptoms.enAtopic dermatitisInhalant allergenGrass pollenEnvironmental challenge chamberexposure616journal article