Evaluation of paediatric tolerance to an extract of Alternaria alternata under two treatment regimes. A multicentre study

Martínez-Cañavate, Ana; Eseverri, JL; Ródenas, R.; Tabar, A. I.; Garde, J.; Torres, Javier; Bone, J. M.; Pedemonte, C.

doi:10.1157/13075696

Cited by 15 publications

(5 citation statements)

References 6 publications

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“…We found 6 studies which evaluated the safety of immunotherapy using mold extracts. 116 , 117 , 118 , 119 , 120 , 121 In 1982, Kaad and Ostergaard treated 38 children with an Alternaria iridis extract mixed with a Cladosporium herbarum extract over a period of 3.5 years. Nineteen percent of the patients had to stop treatment because of severe side reactions associated with the generation of precipitating serum antibodies.…”

Section: Introductionmentioning

confidence: 99%

“…Only a few adverse reactions to an extract of Alternaria tenuis were reported which were associated with only 1 induction schedule. Finally, Martínez-Canavate et al 121 compared the tolerance of a conventional short regime to a cluster regime in a pediatric population. Whereas more local reactions were observed in the conventional regime, no significant differences between the 2 regimes were found regarding systemic reactions.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Mold Allergens in Respiratory Allergy: From Structure to Therapy

Twaroch

Curin

Valenta

et al. 2015

Allergy Asthma Immunol Res

179

128

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Allergic reactions to fungi were described 300 years ago, but the importance of allergy to fungi has been underestimated for a long time. Allergens from fungi mainly cause respiratory and skin symptoms in sensitized patients. In this review, we will focus on fungi and fungal allergens involved in respiratory forms of allergy, such as allergic rhinitis and asthma. Fungi can act as indoor and outdoor respiratory allergen sources, and depending on climate conditions, the rates of sensitization in individuals attending allergy clinics range from 5% to 20%. Due to the poor quality of natural fungal allergen extracts, diagnosis of fungal allergy is hampered, and allergen-specific immunotherapy is rarely given. Several factors are responsible for the poor quality of natural fungal extracts, among which the influence of culture conditions on allergen contents. However, molecular cloning techniques have allowed us to isolate DNAs coding for fungal allergens and to produce a continuously growing panel of recombinant allergens for the diagnosis of fungal allergy. Moreover, technologies are now available for the preparation of recombinant and synthetic fungal allergen derivatives which can be used to develop safe vaccines for the treatment of fungal allergy.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mold Allergens in Respiratory Allergy: From Structure to Therapy

Twaroch

Curin

Valenta

et al. 2015

Allergy Asthma Immunol Res

179

128

View full text Add to dashboard Cite

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“…There are few studies of fungal immunotherapy with A alternata [21][22][23][24][25] and only 1 with the major allergen Alt a 1 purified in its natural form. 13 Alt a 1 is an allergen that is exclusive to the Fungi kingdom and has a prevalence of greater than 90% in patients sensitized to A alternata and species of other genera of the order Pleosporales.…”

Section: Discussionmentioning

confidence: 99%

Double-blind, randomized, placebo-controlled trial of allergen-specific immunotherapy with the major allergen Alt a 1

Tabar

Prieto

Alba

et al. 2019

Journal of Allergy and Clinical Immunology

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Background: There have been few studies conducted on the efficacy and safety of specific immunotherapy with allergen extracts of fungi compared with other allergen extracts, and there are no data on the major allergen Alt a 1 of the fungus Alternaria alternata. Objectives: We sought to evaluate the efficacy and safety of subcutaneous immunotherapy with 2 different doses of Alt a 1 in patients with rhinoconjunctivitis caused by sensitization to A alternata. Method: We performed a multicenter, randomized, doubleblind, placebo-controlled trial with Alt a 1 administered subcutaneously in patients with allergic rhinoconjunctivitis with or without controlled asthma aged 12 to 65 years. Three groups were included: the placebo group and active groups receiving 0.2 or 0.37 mg of Alt a 1 per dose. The main end point was the combined symptom and medication score. Secondary end points were cutaneous reactivity and serum IgE and IgG 4 levels to Alt a 1. Recorded adverse reactions were graded according to World Allergy Organization criteria. Results: There were significant reductions in the combined symptom and medication score for the 0.37-mg dose of Alt a 1 compared with placebo at 12 months of treatment. Reduced cutaneous reactivity and IgE levels, together with increased IgG 4 levels, were demonstrated for the 2 active groups versus the placebo group. A similar safety profile was found for both active groups compared with the placebo group. No serious adverse drug reactions were reported. Conclusion: Immunotherapy with Alt a 1 was efficacious and safe, reducing the symptoms and medication consumption associated with rhinoconjunctivitis after only 1 year of treatment. The clinical benefits were associated with reduced skin reactivity and specific IgE levels and increased IgG 4 levels.

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“…Earlier, an older vaccine (without proper allergen extract standardization) induced many adverse systemic reactions. This greatly limited the possibilities of such treatment [ 106 , 107 , 108 ].…”

Section: Immunotherapy For Alternaria Sensitizationmentioning

confidence: 99%

Alternaria as an Inducer of Allergic Sensitization

Hernández-Ramírez

Barber

Tomé-Amat

et al. 2021

JoF

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Alternaria alternata is a saprophytic mold whose spores are disseminated in warm dry air, the typical weather of the Mediterranean climate region (from 30° to 45°), with a peak during the late summer and early autumn. Alternaria spores are known to be biological contaminants and a potent source of aeroallergens. One consequence of human exposure to Alternaria is an increased risk of developing asthma, with Alt a 1 as its main elicitor and a marker of primary sensitization. Although the action mechanism needs further investigation, a key role of the epithelium in cytokine production, TLR-activated alveolar macrophages and innate lymphoid cells in the adaptive response was demonstrated. Furthermore, sensitization to A. alternata seems to be a trigger for the development of co-sensitization to other allergen sources and may act as an exacerbator of symptoms and an elicitor of food allergies. The prevalence of A. alternata allergy is increasing and has led to expanding research on the role of this fungal species in the induction of IgE-mediated respiratory diseases. Indeed, recent research has allowed new perspectives to be considered in the assessment of exposure and diagnosis of fungi-induced allergies, although more studies are needed for the standardization of immunotherapy formulations.

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Evaluation of paediatric tolerance to an extract of Alternaria alternata under two treatment regimes. A multicentre study

Cited by 15 publications

References 6 publications

Mold Allergens in Respiratory Allergy: From Structure to Therapy

Mold Allergens in Respiratory Allergy: From Structure to Therapy

Double-blind, randomized, placebo-controlled trial of allergen-specific immunotherapy with the major allergen Alt a 1

Alternaria as an Inducer of Allergic Sensitization

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