Background: Respiratory allergy to conifers pollens is a growing phenomenon all over the world (Mediterranean area, USA, Japan). In France and Italy Cupressus sempervirens is the commonest offender.
Objective: To check the efficacy of specific immunotherapy by the sublingual route using a monomeric allergoid of Cupressus Arizonica pollen.
Material and methods: 20 patients and 10 controls were randomly selected. The diagnosis was assessed on a clinical hivernal symptomatology of allergic rhinitis, and/or asthma, positive skin test and RAST, and nasal provocation test to Cupressus arizonica. The extract was a monomeric allergoid titrated in allergenic units (AU). The treatment was coseasonal from the beginning of december to the end of march. It was not conducted double blind.
Results: The evaluation of the allergenic potency of native and modified Cupressus arizonica extracts have shown that the modified extract has a decreased skin test IgE binding capacity. According to symptom, drug consumption scores and nasal provocation test, there was a statistical improvement in the active group (compared to the control group) without any side effect.
Discussion: The use of a modified Cupressus arizonica extract, which is easier to prepare than Cupressus sempervirens and which is a monomeric allergoid, has shown that by the sublingual route, this therapeutic approach is safe and that the first results were satisfactory without any side effect. This good tolerance was anticipated by the fact that, checked on 16 volunteers by skin test, the allergoid gave a less important local reaction on skin testing than the native extract.
Conclusion: This study has shown that: The KCNO modified Cupressus arizonica extract has a reduced IgE binding capacity; This monomeric allergoid is safe and effective administrated by the oromucosal route in clinical respiratory allergy to Cupressaceae and devoid of any side effect.