Double-blind, placebo-controlled rush immunotherapy with a standardized Alternaria extract

Area of Science:

• Allergen immunotherapy
• Clinical immunology
• Respiratory medicine

Background:

• Unstandardized mold extracts yield ineffective specific immunotherapy.
• Standardization of allergen extracts is crucial for efficacy.
• Alternaria mold is a common allergen implicated in allergic respiratory diseases.

Purpose of the Study:

• To evaluate the efficacy of specific immunotherapy with a standardized Alternaria extract in patients allergic solely to Alternaria.
• To assess the impact of immunotherapy on clinical symptoms, immunological markers, and nasal challenge responses.

Main Methods:

• A double-blind, placebo-controlled study involving 24 patients allergic to Alternaria.
• Standardization of the Alternaria extract using multiple techniques (isoelectric focusing, immunoelectrophoresis, RAST inhibition, skin tests).
• Administration of immunotherapy over 1 year with a rush protocol followed by maintenance injections, compared to placebo.

Main Results:

• Actively treated patients showed significantly lower symptom-medication scores and improved self-evaluation of treatment efficacy.
• Nasal challenges demonstrated a significantly increased mean provocative dose in the actively treated group.
• Skin test reactivity was significantly reduced, and specific IgG levels increased significantly in the actively treated group.

Conclusions:

• Specific immunotherapy with a standardized Alternaria extract is effective in patients solely sensitized to Alternaria.
• Standardized extracts are essential for successful mold immunotherapy.
• This treatment approach can significantly alleviate allergic rhinitis and asthma symptoms associated with Alternaria allergy.