https://phaidra.vetmeduni.ac.at/o:3000 The holo beta-lactoglobulin lozenge reduces symptoms in cat allergy-Evaluation in an allergen exposure chamber and by titrated nasal allergen challenge Bergmann, Karl-Christian Karl-Christian Bergmann 0000-0002-0306-9922 Jensen-Jarolim, Erika Erika Jensen-Jarolim 0000-0003-4019-5765 University of Veterinary Medicine Vienna / Medical University Vienna Kramer, Matthias F. Matthias F. Kramer 0000-0002-3740-4733 Bencard Allergie GmbH / Allergy Therapeutics PLC Roth-Walter, Franziska Franziska Roth-Walter 0000-0001-5005-9228 University of Veterinary Medicine Vienna / Medical University Vienna Zuberbier, Torsten Torsten Zuberbier 0000-0002-1466-8875 Charité-Universitätsmedizin Berlin / Fraunhofer Institute for Translational Medicine and Pharmacology Kugler, Sebastian Sebastian Kugler European Centre for Allergy Research Foundation Becker, Sylvia Sylvia Becker European Centre for Allergy Research Foundation Zwingers, Thomas Thomas Zwingers Allergy Therapeutics PLC Raab, Jennifer Jennifer Raab 0000-0002-5411-5511 Bencard Allergie GmbH Graessel, Anke Anke Graessel 0000-0001-9670-3269 Bencard Allergie GmbH / Allergy Therapeutics PLC Wiley text eng The allergists´ tool box in cat allergy management is limited. Clinical studies have shown that holo beta-lactoglobulin (holoBLG) can restore micronutritional deficits in atopic immune cells and alleviate allergic symptoms in a completely allergen-nonspecific manner. With this study, we aimed to provide proof of principle in cat allergy.A novel challenge protocol for cat allergy in a standardized ECARF allergen exposure chamber (AEC) was developed. In an open pilot study (NCT05455749), patients with clinically relevant cat allergy were provoked with cat allergen for 120 min in the AEC before and after a 3-month intervention phase (holoBLG lozenge 2x daily). Nasal, conjunctival, bronchial, and pruritus symptoms were scored every 10 min- constituting the total symptom score (TSS). Peak nasal inspiratory flow (PNIF) was measured every 30 min. In addition, a titrated nasal provocation test (NPT) was performed before and after the intervention. Primary endpoint was change in TSS at the end of final exposure compared to baseline. Secondary endpoints included changes in PNIF, NPT, and occurrence of late reactions up to 24 h after exposure.35 patients (mean age: 40 years) completed the study. Compared to baseline, holoBLG supplementation resulted in significant improvement in median TSS of 50% (p < 0.001), as well as in median nasal flow by 20 L/min (p = 0.0035). 20% of patients reported late reactions after baseline exposure, but 0% after the final exposure.Cat allergic patients profited from targeted micronutrition with the holoBLG lozenge. As previously seen in other allergies, holoBLG supplementation also induced immune resilience in cat allergies, resulting in significant symptom amelioration. Asthma http://creativecommons.org/licenses/by/4.0/ https://phaidra.vetmeduni.ac.at/api/object/o:3000/download 10.1002/clt2.12274 https://phaidra.vetmeduni.ac.at/o:605 application/pdf Clinical and Translational Allergy 13(7) (2023) Clinical and Translational Allergy 13 7 719.06 kB 2023