Immunotherapy with an Aluminum Hydroxide-Adsorbed <i>Juniperus ashei</i> Foreign Pollen Extract in Seasonal Indigenous Cypress Pollen Rhinoconjunctivitis

Abstract

Background:The efficacy of standardized Juniperus ashei extract was assessed in patients with allergic rhinoconjunctivitis due to European cypress pollens. Methods:Forty adults with European cypress-allergic rhinoconjunctivitis were randomized to receive immunotherapy or a matched placebo. Specific immunotherapy was performed with a standardized, aluminum hydroxide-adsorbed J. ashei extract with a potency of 100 IR (arbitrary index of reactivity) containing 54 µg of Jun a 1/ml (Alustal, Stallergenes, France). Subcutaneous injections started in October 2000. The maintenance dose was 0.30 ml of the 100-IR concentration per month. Rhinitis and conjunctivitis symptoms were rated according to a 4-point score. Results: Seventeen patients from the treated group and 15 patients from the placebo group completed year 2001; 14 in each group completed year 2002. A statistically significant improvement (41%, p < 0.02) in the conjunctivitis symptom score was observed in actively treated patients compared to the placebo group at the peak of the 2001 pollen season. Improvement in rhinitis (17%) was not significant. This significant improvement was greater at the peak of the 2002 pollen season (63%, p < 0.01). Conclusions: This study therefore indirectly validates the concept of treatment by major allergen because J. ashei is absent from the region in which this study was conducted.

Subcutaneous immunotherapy for allergic rhinitis: an evidence based review of the recent literature with recommendations

“…Charpin et al . (2007) found mean Juniperus‐specific IgG4 levels in the treatment group to be increased from baseline (251.5 g/L) in the first (5771.7 g/L, p = 0.00001) and second pollen seasons (11,108.4 g/L, p = 0.0001).…”

“…Charpin et al . (2007) published a study of 40 patients comparing SCIT using an aluminum adsorbed Juniperus ashei extract in patients with allergic rhinoconjunctivitis due to European cypress pollens with placebo to investigate the concept of SCIT treatment with major allergen challenge.…”

A Molecular Diagnostic Algorithm to Guide Pollen Immunotherapy in Southern Europe: Towards Component-Resolved Management of Allergic Diseases

“…Due to the structural homology of their major allergens, genuine sensitization to either Cupressus arizonica and/or C. sempervirens , both prevalent in the Mediterranean basin, may be confirmed by this single assay [39]. In this case, the high level of cross-antigenicity between members of the Cupressaceae family may justify therapeutic administration of a single representative pollen extract, even if it is not the same as the originally sensitizing species [40]. …”

Selection of Patients for Sublingual Versus Subcutaneous Immunotherapy

“…Ocular symptoms are rarely reported separately. Charpin et al conducted a double blind placebo control (DBPC) trial in ARC patients and reported a 41% reduction in AC symptoms (p = 0.02) [51]. One of the very few randomized trials of SCIT in AC concluded with statistical significance that SCIT (62% pollen, 19% HDM) was more effective than local pharmacotherapy in reducing the AC symptoms [52].…”