Immunotherapy with Alternaria alternata: Present and future

The prevalence of fungal allergies is greater than previously believed; consequently, such processes have been underestimated as potential causes of respiratory tract disease. Most patients sensitized to fungi exhibit perennial symptoms, though their intensity increases in the summer and autumn months. Skin reactions to the antigens of Alternaria alternata are associated with a high risk of allergic respiratory conditions in the presence of spores of this fungus - fundamentally in children and young adults - with a special form of presentation as life-threatening asthma. Very few controlled studies have examined the efficacy and safety of fungal extract immunotherapy - the main problem being the lack of standardized extracts for the diagnosis and treatment of such patients. In the year 2005 a tolerance study was made in children in relation to a depot extract containing the predominant antigen of Alternaria, with two different regimens (short and cluster). Tolerance was found to be good, with a 0.95 % incidence of local reactions and a 0.95 % incidence of grade 2 systemic reactions. Few studies involving sublingual immunotherapy have been conducted to date.