DOUBLE-BLIND, PLACEBO-CONTROLLED RUSH IMMUNOTHERAPY WITH A STANDARDIZED ALTERNARIA EXTRACT

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.