Fungal allergies in patients with atopic dermatitis and psoriasis

Abstract

Examining a role of fungal allergy in the development of atopic dermatitis (AD) and psoriasis (PS) is of particular interest and determines the relevance of the current study. The purpose of the study is to analyze and carry out a comparative analysis for multiple sensitizations to fungal allergens in patients with AD and PS. Materials and methods. The study involved patients with atopic dermatitis (group 1, n = 53, mean age 33.0±1.3 years) and psoriasis (group 2, n = 53, mean age 40.0±1.8 years) aged from 18 to 66 years old. Sensitization to fungal allergens was assessed by skin prick testing with standardized fungal allergens: Candida albicans, Alternaria alternata, Aspergillus fumigatus, Cladosporium herbarum, Penicillium notatum (Allergopharma, Germany) and nutritional yeast (Microgen, Russia). The concentration of allergen-specific IgE to a mixture of fungal allergens: Penicillium notatum, Cladosporium herbarum, Aspergillus fumigatus, Mucor racemosus, Alternaria alternata (Alkor Bio, Russia) was determined by the method of indirect immunofluorescence analysis on a semiautomatic analyzer Multiskan FC (ThermoFisher Scientific, Finland). The test was considered positive at an IgE level of ≥ 0.35 kE/L. Statistica 8.0 software package was used for statistical analysis. Results and discussion. When studying the features of sensitization to fungal allergens, it was determined that in the group of patients with AD was the highest frequency of sensitization to nutritional yeast, as well as fungi of the genus Alternaria alternata and Cladosporium herbarum. In the group of PS patients, the highest frequency of sensitization to fungi of the genus Cladosporium herbarum, Aspergillus fumigatus and Alternaria alternata was found. When studying intergroup differences, it was determined that the rate of sensitization to fungi was insignificantly higher in the group of patients with PS in comparison with AD. Sensitization to a mixture of fungal allergens based on the concentration of allergen-specific IgE was more often observed in the group of AD patients vs. patients with PS: 15% versus 5,3%. Most likely, reagins of a different class (IgG4) can participate in the development of AD and PS, or other immunopathological mechanisms of allergy triggering (according to the Gell and Coombs classification) can be involved. Thus, fungal allergy may play an important role in the etiopathogenesis of atopic dermatitis and psoriasis. Our research can guide clinicians in terms of personalized approaches to the diagnosis and treatment of these pathologies, including specific allergological examination, not only for patients with AD, but also for those with PS.