title: Efficacy and safety of immunotherapy for allergies to Alternaria alternata in children.
abstract: BACKGROUND
  The safety and efficacy of specific immunotherapy for mold allergy are not known in children and adolescents.
  
  
  OBJECTIVE
  We evaluated the efficacy and safety of specific immunotherapy with a standardized allergen extract in a randomized, double-blind, placebo-controlled, 3-year prospective study of patients who were allergic to only Alternaria alternata.
  
  
  METHODS
  Fifty children and adolescents (25 girls; 5-18 years of age) with A alternata-induced seasonal allergic rhinoconjunctivitis and/or bronchial asthma were randomly assigned to groups given treatment (Novo-Helisen Depot, A alternata 100%) or placebo. The primary end point was the combined symptom medication score. Secondary end points included safety, quality of life, and sensitivity to allergen-specific nasal challenge.
  
  
  RESULTS
  Forty-five children completed the 3-year study. Although there was no significant change in year 1, the combined symptom medication score decreased in years 2 and 3 of the study (by 38.7% and 63.5%, respectively; P < .001 for each). The reduction in symptoms was associated with a significant improvement in quality of life (P < .05) and decrease in sensitivity after allergen-specific nasal challenge. Side effects were observed in 7 patients; the most common (edema at the site of injection) occurred after 11 injections.
  
  
  CONCLUSIONS
  Allergen-specific immunotherapy with standardized A alternata extract reduces symptoms of asthma and rhinoconjunctivitis in children and adolescents without serious side effects.
authors.affiliation: Department of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Kuna
authors.forename: Jadwiga
authors.initials: J
authors.lastname: Kaczmarek
authors.forename: Maciej
authors.initials: M
authors.lastname: Kupczyk
mesh_terms: D000293:Adolescent; D000528:Alternaria / Q000276:immunology*; D001249:Asthma / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003233:Conjunctivitis, Allergic / Q000628:therapy; D003888:Desensitization, Immunologic / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000276:immunology / Q000523:psychology / Q000628:therapy*; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D012220:Rhinitis / Q000628:therapy