A Double‐Blind, Multicenter Immunotherapy Trial in Children, Using a Purified and Standardized Cladosporium herbarum Preparation II. In Vitro Results

Abstract

This double‐blind immunotherapy trial in children, using a purified and standardized Cladosporium herbarum allergen preparation, has shown that children with mould asthma and/or rhinoconjunctivitis, responded to immunotherapy with a decrease in specific IgE and a significant increase in specific IgG. There was a marked increase in tile ratio specific IgG/specific IgE, as a result of active treatment. IgE‐CRIE radiostaining patterns showed no pronounced changes after 10 months' active treatment and no “new sensitivities” could be detected in the studied patients, IgG‐CRIE radiostaining, primarily directed towards the important allergens, was significantly increased in the active group and particularly towards Ag‐12 (partially identical to a previously described major allergen in Cladosporium herbarum. Ag‐54). Children treated with histamine placebo showed no change antibody patterns during 10 months of treatment.

Allergen immunotherapy: A practice parameter second update

“…Several studies with Alternaria and Cladosporium species suggest that allergen immunotherapy with fungi might be effective. [133][134][135][136][137][138] The allergen content of most mold extracts is highly variable. 238, 239 However, there is evidence that proteolytic enzymes present in some mold extracts could digest other antigens, such as pollens, when combined in a mixture.…”

The diagnosis and management of rhinitis: An updated practice parameter

“…Allergen immunotherapy is effective in both adults and children. 471,479,[482][483][484][485] Its efficacy is confirmed for the treatment of inhalant allergy caused by pollen, 466,[486][487][488][489][490][491][492] fungi, [493][494][495][496][497] animal allergens, [498][499][500][501][502][503][504][505] dust mite, [506][507][508][509][510][511][512][513][514][515][516][517] and cockroach. 518 Allergen immunotherapy should be considered for patients who have symptoms of allergic rhinitis or rhinoconjunctivitis after natural exposure to allergens and who demonstrate specific IgE antibodies to relevant allergens.…”

Allergen immunotherapy: A practice parameter third update

“…Therefore immunotherapy should be considered along with pharmacotherapy and allergen avoidance in the management of children with allergic rhinitis/rhinoconjunctivitis, allergic asthma, and stinging insect hypersensitivity. B Immunotherapy for children has been shown to be effective and well tolerated, 106,186,187 although at least 1 study did not show efficacy. 188 However, this study did not include an important allergen, cockroach, which has been shown to correlate with asthma severity in other studies of inner-city asthmatic children.…”

“…Several studies with Alternaria and Cladosporium species suggest that allergen immunotherapy with fungi might be effective. [102][103][104][105][106][107] However, the allergen content of most commercially available mold extracts is variable but generally low. 325,326 Extracts for some potentially clinically important fungi are not available.…”