M. Horst et al., DOUBLE-BLIND, PLACEBO-CONTROLLED RUSH IMMUNOTHERAPY WITH A STANDARDIZED ALTERNARIA EXTRACT, Revue francaise d'allergologie et d'immunologie clinique, 34(4), 1994, pp. 331-343
Specific immunotherapy is ineffective with unstandardized mold extract
s. A double-blind, placebo-controlled study was performed in 24 patien
ts (5 to 56 years of age) only allergic to Alternaria. The extract was
standardized by isoelectric focusing, crossed immunoelectrophoresis,
crossed radioimmunoelectrophoresis, RAST inhibition, and skin tests an
d contained allergen Alternaria major allergen a I and antigen B. Thir
teen patients received the active treatment, and 11 received the place
bo. Immunotherapy was started by a 2-day rush protocol; maintenance in
jections were administered for 1 year. The patient's self-evaluation o
f the treatment was significantly (p < 0.001) lower in the placebo-tre
ated group. Global symptom-medication scores, including asthma and rhi
noconjunctivitis, were significantly (p < 0.005) lower in the actively
treated group. Nasal challenges with Alternaria extract were performe
d before immunotherapy and after 1 year of treatment. There was no dif
ference in the placebo-treated group and a significantly (p < 0.01) in
creased mean provocative dose in the actively treated group. Skin test
s were significantly reduced in the actively treated group. Specific I
gG increased significantly in the actively treated group and were stab
le in the placebo-treated group. There was a significant correlation b
etween nasal challenges and nasal symptom-medication scores (p < 0.03)
or the patient's self-evaluation of efficacy (p < 0.05). This study d
emonstrated that patients only sensitized to Alternaria benefit from s
pecific immunotherapy with a standardized Alternaria extract.