Clinical evolution of patients with respiratory allergic disease due to sensitisation to Alternaria alternata being treated with subcutaneous immunotherapy

Zapatero, L.; Martínez-Cañavate, Ana; Lucas, José Manuel Bejarano; Guallar, I.; Torres, Javier; Guardia, P.; Torre, Fernando De la; Pedemonte, C.

doi:10.1016/j.aller.2010.03.011

Cited by 13 publications

(7 citation statements)

References 17 publications

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“…In a randomized trial of SCIT for grass pollen in children with seasonal allergic asthma, the use of SCIT resulted in a reduction in asthma symptommedication score compared with placebo, and there were also significant reductions in cutaneous, conjunctival, and bronchial symptoms [143]. In patients with bronchial asthma monosensitized to Alternaria, SCIT reduced symptoms of asthma and rhinoconjunctivitis, improved quality of life, and decreased concomitant drug use in children and adolescents, with a low frequency of serious side effects [144,145]. A clear change in airway responsiveness and serum sIgE level was also reported [146].…”

Section: Pediatric Populationsmentioning

confidence: 99%

Specific allergen immunotherapy for the treatment of allergic asthma: a review of current evidence

Domínguez‐Ortega

Delgado

Blanco

et al. 2017

J Investig Allergol Clin Immunol

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Asthma is frequently associated with atopy, characterized by the production of specific immunoglobulin E in response to environmental allergens. Currently, two types of allergen immunotherapy (AIT) are used in clinical practice: subcutaneous and sublingual immunotherapy, both accepted as key components of the therapeutic repertoire for allergic rhinitis and conjunctivitis. However, their role in asthma remains controversial. The present document is aimed at providing the clinicians with a review of the evidence on the use of AIT in asthma, focusing on the most relevant aspects of its mechanism of action, its efficacy, and existing data on safety, tolerability, and cost-effectivity, both in pediatric and adult populations. A systematic search of MEDLINE, Cochrane, and Clinical Trials databases from 2000 to April of 2016 was carried out by a panel of experts from the Spanish Allergy and Clinical Immunology Scientific Society. Relevant studies prior to the year 2000 included in ulterior systematic reviews were also considered. More than 4000 articles were identified during the search and 241 were selected to retrieve available evidence on AIT, which was graded according to the Oxford classification. All the group members reviewed the resulting text until the final version reached the consensual agreement. A summary of recommendations on the more relevant topics are proposed. The role of AIT as a valuable therapeutic strategy for prevention of exacerbation and progressive decline in lung function is highlighted. Future research should include specific tools for asthma evaluation when assessing AIT effectiveness in asthmatic patients. ResumenEl asma se asocia frecuentemente con alergia, entendida ésta como la producción de IgE específica frente a alérgenos ambientales. Actualmente, existen dos tipos de inmunoterapia específica con alérgenos (ITE) para la práctica clínica habitual: subcutánea y sublingual, ambas indicadas en el tratamiento de la rinitis y la conjuntivitis alérgicas. Sin embargo, su papel en el asma resulta todavía controvertido. Dominguez-Ortega J, et al.

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Section: Pediatric Populationsmentioning

confidence: 99%

Specific allergen immunotherapy for the treatment of allergic asthma: a review of current evidence

Domínguez‐Ortega

Delgado

Blanco

et al. 2017

J Investig Allergol Clin Immunol

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“…As a consequence of the clinical implications induced by A. alternata , the allergen immunotherapy (AIT) to this allergenic source has been considered an appropriate alternative for treating allergy‐suffering patients . Until now, the efficacy of Alternaria treatments have been demonstrated with native extracts but safety issues are still pending.…”

Section: Introductionmentioning

confidence: 99%

Preclinical safety and immunological efficacy of Alternaria alternata polymerized extracts

Morales¹,

Gallego²,

Iraola³

et al. 2017

Immunity Inflam & Disease

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Introduction Alternaria alternata is a widespread fungi whose allergy is a risk factor for asthma development. The use of a polymerized allergen extract (allergoid) may be safer than native extract based treatments while maintaining efficacy. The objective of this study was to characterize biochemically and immunochemically a new Alternaria alternata allergoid.MethodsCharacterization of native and allergoid extracts was performed by determination of protein content, protein and allergenic profile, biological potency, identification of Alternaria allergens, and Alt a 1 quantification. Safety was evaluated in toxicological assays (Ames test, limit test, and fish embryo acute toxicity test in zebrafish, and maximum tolerated dose and Dose‐range finding study in rats). Efficacy was evaluated as the capacity to induce IgG antibodies that block IgE‐binding to the allergen and cytokine induction (IFN‐γ, IL‐4, IL‐6, IL‐10, and TNF‐α) in PBMC from atopic donors.ResultsProtein and antigenic profiles showed significant modification of the depigmented allergoid with respect to the native extract, inducing a lower IgE binding capacity. Alt a 1, Alt a 3, Alt a 6, and Alt a 8 allergen sequences were identified in the polymer. No toxicological nor genotoxicity effects were observed. The polymer induced IgG antibodies that blocked human IgE binding epitopes, and it induced higher IL‐10 levels and similar levels of the other cytokines than native extract in PBMC.ConclusionsThis new A. alternata allergoid could be an effective immunotherapy treatment leading to cytokine stimulation and inducing synthesis of IgG antibodies able to block IgE binding to the allergen. In addition, no toxicological effect was observed, and it may be safer than native extract due to its lower IgE binding capacity and cytokine induction that suggest tolerance induction via T cell shift to Treg (IL‐10).

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“…We excluded the Zapatero study and the Meltzer study, because they did not include a control population, and the Bernardis study, as it compared SCIT to SLIT (Figure ). Finally, we identified another RCT, started in 2011, whose results are still unpublished (EUCTR2010‐024440‐15‐ES)…”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of allergen immunotherapy in patients with allergy to molds: A systematic review

Bona

Frisenda

Albanesi

et al. 2018

Clin Experimental Allergy

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Clinical evolution of patients with respiratory allergic disease due to sensitisation to Alternaria alternata being treated with subcutaneous immunotherapy

Abstract: respiratory allergic disease due to Alternaria alternata is a disease which is hard to control, and in our daily practice, the use of specific subcutaneous immunotherapy can be of significant benefit in our paediatric patients.

Cited by 13 publications

References 17 publications

Specific allergen immunotherapy for the treatment of allergic asthma: a review of current evidence

Specific allergen immunotherapy for the treatment of allergic asthma: a review of current evidence

Preclinical safety and immunological efficacy of Alternaria alternata polymerized extracts

Efficacy and safety of allergen immunotherapy in patients with allergy to molds: A systematic review

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