Immunotherapy with Alternaria alternata: present and future

Area of Science:

• Allergy and Immunology
• Respiratory Medicine
• Mycology

Background:

• Fungal allergies are more prevalent than previously thought and are underestimated causes of respiratory diseases.
• Patients with fungal sensitization often experience perennial symptoms, worsening in summer and autumn.
• Alternaria alternata sensitization is linked to a high risk of allergic respiratory conditions, including severe asthma, especially in children and young adults.

Purpose of the Study:

• To evaluate the efficacy and safety of fungal extract immunotherapy.
• To address the lack of standardized fungal extracts for diagnosis and treatment.
• To assess the tolerance of a depot extract of Alternaria in children.

Main Methods:

• A tolerance study of a depot extract containing Alternaria antigen was conducted in children.
• Two different administration regimens (short and cluster) were used.
• Incidence of local and systemic reactions was recorded.

Main Results:

• The Alternaria depot extract demonstrated good tolerance in children.
• The incidence of local reactions was 0.95%.
• The incidence of grade 2 systemic reactions was 0.95%.

Conclusions:

• Fungal immunotherapy, specifically with standardized Alternaria extracts, is a potential treatment for allergic respiratory diseases.
• Further controlled studies are needed to establish the efficacy of fungal immunotherapy, including sublingual immunotherapy.
• The findings support the safety of Alternaria depot extract immunotherapy in pediatric populations.