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

被引:197
作者
HORST, M [1 ]
HEJJAOUI, A [1 ]
HORST, V [1 ]
MICHEL, FB [1 ]
BOUSQUET, J [1 ]
机构
[1] HOP AIGUELONGUE,MALAD RESP CLIN,AVE MAJOR FLANDRE,F-34059 MONTPELLIER,FRANCE
关键词
D O I
10.1016/0091-6749(90)90156-X
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Specific immunotherapy is ineffective with unstandardized mold extracts. A double-blind, placebo-controlled study was performed in 24 patients (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 and contained allergen Alternaria major allergen a I and antigen B. Thirteen patients received the active treatment, and 11 received the placebo. Immunotherapy was started by a 2-day rush protocol; maintenance injections were administered for 1 year. The patient's self-evaluation of the treatment was significantly (p < 0.001) lower in the placebo-treated group. Global symptom-medication scores, including asthma and rhinoconjunctivitis, were significantly (p < 0.005) lower in the actively treated group. Nasal challenges with Alternaria extract were performed before immunotherapy and after 1 year of treatment. There was no difference in the placebo-treated group and a significantly (p < 0.01) increased mean provocative dose in the actively treated group. Skin tests were significantly reduced in the actively treated group. Specific IgG increased significantly in the actively treated group and were stable in the placebo-treated group. There was a significant correlation between nasal challenges and nasal symptom-medication scores (p < 0.03) or the patient's self-evaluation of efficacy (p < 0.05). This study demonstrated that patients only sensitized to Alternaria benefit from specific immunotherapy with a standardized Alternaria extract. © 1990.
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页码:460 / 472
页数:13
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