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Related Experiment Videos

Side effects during immunotherapy with purified grass pollen extracts

O Osterballe

    Allergy
    |November 1, 1982
    PubMed
    Summary

    This study compared two timothy grass pollen extracts for allergy hyposensitization. While minor side effects were more common with a 2-component extract, major systemic side effects were similar, often occurring at higher doses and predicted by nasal sensitivity.

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    Area of Science:

    • Allergy and Immunology
    • Immunotherapy
    • Pharmacology

    Background:

    • Grass pollen allergy affects millions globally, necessitating effective treatments like hyposensitization.
    • Current hyposensitization therapies utilize standardized allergen extracts to induce immune tolerance.
    • Optimizing allergen extract composition and administration is crucial for treatment efficacy and safety.

    Purpose of the Study:

    • To compare the safety and efficacy of a 2-component timothy grass pollen extract versus a 20-component extract for perennial hyposensitization.
    • To investigate the incidence, timing, and predictors of systemic side effects (SSE) and local reactions.
    • To assess the impact of extract composition and dosage on treatment outcomes.

    Main Methods:

    • A 3-year prospective, double-blind study involving grass pollen allergic patients.
    • Patients received either a 2-component (major allergens 19 and 25) or a 20-component timothy extract, adsorbed to aluminum hydroxide.
    • Systemic side effects, local skin reactions, and subcutaneous nodules were monitored and analyzed in relation to extract type, dosage, and patient sensitivity.

    Main Results:

    • The 2-component extract showed a higher incidence of minor SSE, while major SSE (urticaria, angioedema, asthma) were equally distributed.
    • Major SSE predominantly occurred before the first pollen season and at high doses (≥1,000 BU), with high nasal sensitivity predicting occurrence in 62% of patients.
    • Delayed local skin reactions were common (70%), and subcutaneous nodules appeared more frequently with perennial dosing (38%) compared to preseasonal therapy (5%).

    Conclusions:

    • Both 2-component and 20-component timothy extracts can be used for hyposensitization, with similar rates of major systemic side effects.
    • Early treatment phase and high allergen dosage are associated with increased risk of major SSE, which can often be managed by dose adjustment.
    • Delayed local reactions and subcutaneous nodules are common, dose-dependent, and related to the aluminum hydroxide content of the extracts.

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