Importance of mold allergy in asthma

Abstract

Fungal exposure is hypothesized (controversially) to contribute to asthma development and to trigger symptoms in patients with asthma. The ubiquity of environmental fungal exposure makes a careful review of evidence essential. Evidence that exposure to high concentrations of fungal spores, antigens, or metabolites is associated with asthma development is limited. However, because mechanisms of asthma genesis are poorly understood, so too are the mechanisms of this potential association. This association is not proof of causality. Stronger evidence supports the hypothesis that fungal exposure triggers symptoms in asthmatic individuals. Proposed mechanisms have been tested and correlations between exposure and symptoms demonstrated. Though some correlations remain speculative, controlled studies could test such hypotheses. Because asthma is common and fungal exposure is ubiquitous, it is surprising that asthmatics don't have more symptoms when exposed to fungi. Fortunately, symptoms are dose dependent, creating an opportunity to develop clinically effective interventions. Given the right guidance, even patients with severe asthma can create healthy indoor environments.

Endophytic mycobiota of leaves and roots of the grass Holcus lanatus

“…Therefore, some of the most successful species from the point of view of their isolate richness are multi-host and multi-organ endophytes. Further evidence of the ubiquitousness and biological success of some of these dominant endophytic species is that their spores are common components of indoor and outdoor air, and endophytes such as Alternaria, Aureobasidium, Cladosporium, and Penicillium, are known to cause respiratory allergies and asthma in humans (Fang et al 2005;Portnoy et al 2008). The endophytic stage may be an important part of the life cycle ensuring dispersal of these ubiquitous airborne species.…”

Culturable mold in indoor air and its association with moisture-related problems and asthma and allergy among Swedish children

“…The exposure levels found in the office building seldom exceeded 10 4 CFU/m 3 , even in problem buildings, and mean levels ranged from 20 to 1000 CFU/m 3 (the median for the total spore concentration in the current study was 91 CFU/m 3 ). Portnoy et al, 2008 concludes in a review article that there is limited evidence supporting the hypothesis that exposure to high concentrations of fungal spores, fungal antigens, and possible fungal metabolites is associated with an increase risk of developing asthma. On the other hand, the hypothesis that high exposure to fungi can trigger symptoms of asthma in sensitized individuals is supported by stronger evidence (Portnoy et al, 2008), a conclusion also supported by the review by Institute of Medicine (2004).…”

New-onset adult asthma in relation to damp and moldy workplaces

“…Much research has focused on fungal spores as the main oVending agent, as several mold species have been reported to speciWcally trigger allergic asthma (Portnoy et al 2008;Sahakian et al 2008). Exposure to molds is not restricted to the workplace as molds are ubiquitous in our environment, outdoors as well as indoors, and therefore a reliable quantitative assessment of the exposure is diYcult.…”