Allergy Asthma Immunol Res.  2016 Sep;8(5):404-411. 10.4168/aair.2016.8.5.404.

Does Spore Count Matter in Fungal Allergy?: The Role of Allergenic Fungal Species

• Lin WR
• Chen YH
• Lee MF
• Hsu LY
• Tien CJ
• Shih FM
• Hsiao SC
• Wang PH

• KMID: 2295149
• DOI: http://doi.org/10.4168/aair.2016.8.5.404

Abstract

PURPOSE
Fungi have been known to be important aeroallergens for hundreds of years. Most studies have focused on total fungal concentration; however, the concentration of specific allergenic fungi may be more important on an individual basis.
METHODS
Ten fungal allergic patients and 2 non-fungal allergic patients were enrolled. The patients with a decrease in physician or patient global assessment by more than 50% of their personal best were considered to have an exacerbation of allergic symptoms and to be in the active stage. Those who maintained their physician and patient global assessment scores at their personal best for more than 3 months were considered to be in the inactive stage. The concentrations of dominant fungi in the patients' houses and outdoors were measured by direct and viable counts at active and inactive stages.
RESULTS
The exacerbation of allergic symptoms was not correlated with total fungal spore concentration or the indoor/outdoor ratio (I/O). Specific fungi, such as Cladosporium oxysporum (C. oxyspurum), C. cladosporioides, and Aspergillus niger (A. niger), were found to be significantly higher concentrations in the active stage than in the inactive stage. Presumed allergenic spore concentration threshold levels were 100 CFU/m3 for C. oxysporum, and 10 CFU/m3 for A. niger, Penicillium brevicompactum and Penicillium oxalicum.
CONCLUSIONS
The major factor causing exacerbation of allergic symptoms in established fungal allergic patients may be the spore concentration of specific allergenic fungi rather than the total fungal concentration. These results may be useful in making recommendations as regards environmental control for fungal allergic patients.

Keyword

Fungal allergy; spore count; threshold level; airborne fungal spore; I/O ratio; household

MeSH Terms

Aspergillus niger
Cladosporium
Colony Count, Microbial*
Family Characteristics
Fungi
Humans
Hypersensitivity*
Niger
Penicillium
Spores*
Spores, Fungal

Figure

• 

  Fig. 1 (A) Direct spore count in the subjects' houses during the active and inactive stages of allergy, (B) Viable count in the subjects' houses during the active and inactive stages of allergy. r-1 and r-2 denote mean spore counts in room 1 and room 2 for each patient. 0 denotes means of outdoor spore counts for each patient.

• 

  Fig. 2 The Box-and-Whisker plot of fungal spore concentration (CFU/m3) in the active and inactive stages among patients with positive ImmunoCAP test results for specific IgE to the designated fungal allergens. (A) Cladosporium oxysporum, (B) Cladosporium cladosporioides, (C) Cladosporium spp, (D) Aspergillus niger, (E) Penicillium brevicompactum, and (F) Penicillium oxalicum.

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