What is the role of immunotherapy in the treatment of mold allergy?

Updated: Dec 02, 2020
  • Author: Shih-Wen Huang, MD; Chief Editor: Harumi Jyonouchi, MD  more...
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For patients with allergic rhinitis and/or conjunctivitis, immunotherapy may offer lasting relief of symptoms. In general, results have not been as positive as those for patients with pollen allergy. Likewise, immunotherapy for allergic asthma due to mold allergy is not highly recommended. Immunotherapy has not been useful for patients with AFS, ABPA, or ABPM.

However, in a recent review by Hall and deShazo, after reviewing several studies of immunotherapy on AFS, they found evidence that allergen immunotherapy is effective in the treatment of symptoms of AFS and may decrease the rate of postoperative exacerbation and further operation. There was no evidence that it induces immune complex disease. Thus, they concluded allergen immunotherapy could be a useful adjunctive therapy for AFS. However, they cautioned that if the therapy is administered before the removal of fungal contents, it could worsen sinusitis. More studies are pending on this issue. [28]

There is also a published report that the efficacy of sublingual specific immunotherapy (SLIT) in patients with respiratory allergy to Alternaria alternata is confirmed. Fifty-two subjects with a mean age of 20 +/- 9 years were studied. Clinical improvement was seen in 97% of the SLIT group, in contrast to 27% of the control group. The authors concluded SLIT, based on the blinded, controlled, 3-year study, should be considered for future therapy for respiratory allergy to fungi. [29]   

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