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Minhas AP, Das S. ABPA and AFRS: addressing prevalence, early diagnosis, allergens, and occupational concerns. J Asthma 2024; 61:767-779. [PMID: 38214461 DOI: 10.1080/02770903.2024.2303766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 01/07/2024] [Indexed: 01/13/2024]
Abstract
OBJECTIVE This study aimed to comprehensively investigate the prevalence of ABPA and AFRS, scrutinize existing diagnostic criteria and immunoassays, pinpoint their limitations, highlight ABPA as an occupational health implication, and identify suggestive measures to improve ABPA diagnosis in the context of Occupational Health Nursing and primary healthcare. DATA SOURCES The data sources such as PubMed, Health and Safety Science Abstracts, OSH Update, Medline, and Google Scholar were searched. STUDY SELECTIONS All published studies in the English language from 1990 till Oct, 2023 using Mesh terms keywords "Allergic bronchopulmonary aspergillosis," "Allergic fungal rhinosinusitis," "Signs and Symptoms," "Rapid Diagnostic Tests," "Diagnosis," "Occupational Health," "Occupational Health Nursing," "Prevalence," "Allergens" following "Boolean operators" search strategy were selected. RESULTS This review succinctly covered signs, symptoms, and prevalence data concerning ABPA and AFRS. It briefly discussed existing diagnostic criteria and immunoassays, highlighted factors influencing the assay's variability, and underscored the role and scope of specific allergens toward improved, simple, and early ABPA diagnosis. ABPA as a neglected occupational health concern was emphasized, and the importance of RDTs in the context of healthcare professionals and OHNs was stated. Finally, this study suggested analyzing the impact of compromised post-pandemic immune status and the use of immunosuppressive drugs on ABPA prevalence among vulnerable communities and occupations. CONCLUSION To conclude, global and Indian ABPA and AFRS prevalence data, factors influencing existing assay variability, and the scope of improvement in RDTs for ABPA diagnosis in the background of primary healthcare professionals and OHNs were addressed.
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Affiliation(s)
- Anu Priya Minhas
- ICMR-National Institute of Occupational Health (ICMR-NIOH), Ahmedabad, India
| | - Santasabuj Das
- ICMR-National Institute of Occupational Health (ICMR-NIOH), Ahmedabad, India
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2
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Strader MB, Saha AL, Fernandes C, Sharma K, Hadiwinarta C, Calheiros D, Conde-de-Oliveira G, Gonçalves T, Slater JE. Distinct proteomes and allergen profiles appear across the life-cycle stages of Alternaria alternata. J Allergy Clin Immunol 2024; 154:424-434. [PMID: 38663817 DOI: 10.1016/j.jaci.2024.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 03/01/2024] [Accepted: 03/20/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Alternaria alternata is associated with allergic respiratory diseases, which can be managed with allergen extract-based diagnostics and immunotherapy. It is not known how spores and hyphae contribute to allergen content. Commercial allergen extracts are manufactured by extracting proteins without separating the different forms of the fungus. OBJECTIVE We sought to determine differences between spore and hyphae proteomes and how allergens are distributed in Aalternata. METHODS Data-independent acquisition mass spectrometry was used to quantitatively compare the proteomes of asexual spores (nongerminating and germinating) with vegetative hyphae. RESULTS We identified 4515 proteins in nongerminating spores, germinating spores, and hyphae; most known allergens are more abundant in nongerminating spores. On comparing significant protein fold-change differences between nongerminating spores and hyphae, we found that 174 proteins were upregulated in nongerminating spores and 80 proteins in hyphae. Among the spore proteins are ones functionally involved in cell wall synthesis, responding to cellular stress, and maintaining redox balance and homeostasis. On comparing nongerminating and germinating spores, 25 proteins were found to be upregulated in nongerminating spores and 54 in germinating spores. Among the proteins specific to germinating spores were proteases known to be virulence factors. One of the most abundant proteins in the spore proteome is sialidase, which has not been identified as an allergen but may be important in the pathogenicity of this fungus. Major allergen Alt a 1 is present at low levels in spores and hyphae and appears to be largely secreted into growth media. CONCLUSIONS Spores and hyphae express overlapping but distinct proteomes. Most known allergens are found more abundantly in nongerminating spores.
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Affiliation(s)
- Michael Brad Strader
- Laboratory of Immunobiochemistry, Division of Bacterial, Parasitic and Allergenic Products, Office of Vaccines Research and Review, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, Md.
| | - Aishwarya L Saha
- Laboratory of Immunobiochemistry, Division of Bacterial, Parasitic and Allergenic Products, Office of Vaccines Research and Review, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, Md
| | - Chantal Fernandes
- University of Coimbra, CNC-UC - Center for Neuroscience and Cell Biology, FMUC - Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
| | - Kavita Sharma
- Laboratory of Immunobiochemistry, Division of Bacterial, Parasitic and Allergenic Products, Office of Vaccines Research and Review, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, Md
| | - Christian Hadiwinarta
- Laboratory of Immunobiochemistry, Division of Bacterial, Parasitic and Allergenic Products, Office of Vaccines Research and Review, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, Md
| | - Daniela Calheiros
- University of Coimbra, CNC-UC - Center for Neuroscience and Cell Biology, FMUC - Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
| | - Gonçalo Conde-de-Oliveira
- University of Coimbra, CNC-UC - Center for Neuroscience and Cell Biology, FMUC - Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
| | - Teresa Gonçalves
- University of Coimbra, CNC-UC - Center for Neuroscience and Cell Biology, FMUC - Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
| | - Jay E Slater
- Laboratory of Immunobiochemistry, Division of Bacterial, Parasitic and Allergenic Products, Office of Vaccines Research and Review, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, Md
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3
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Chen H, Zhu R. Alternaria Allergy and Immunotherapy. Int Arch Allergy Immunol 2024:1-11. [PMID: 38865977 DOI: 10.1159/000539237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 05/03/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND Allergen immunotherapy (AIT) is the only known causative treatment for Alternaria allergy, but the difficulty in standardizing Alternaria extracts hampers its effectiveness and safety. SUMMARY Alternaria, a potent airborne allergen, has a high sensitization rate and is known to trigger the onset and exacerbation of respiratory allergies, even inducing fungal food allergy syndrome in some cases. It can trigger a type 2 inflammatory response, leading to an increase in the secretion of type 2 inflammatory cytokines and eosinophils, which are the culprits behind allergic symptoms. Diagnosing Alternaria allergy is a multistep process, involving a careful examination of clinical symptoms, medical history, skin prick tests, serum-specific IgE detection, or provocation tests. Alt a1, the major component of Alternaria, is a vital player in diagnosing Alternaria allergy through component-resolved diagnosis. Interestingly, Alternaria can reduce the protein activity of other allergens like pollen and cat dander when mixed with them. In order to solve the problems of standardization, efficacy and safety of traditional Alternaria AIT, novel AIT methods targeting Alt a1 and innovative vaccines such as epitope, DNA, and mRNA vaccines seem promising in bypassing the standardization issue of Alternaria extracts. But these studies are in early stages, and most researches are still focused on animal models, calling for more evidence to validate their use in humans. KEY MESSAGES This review delves into the various aspects of Alternaria allergy, including characteristics, epidemiology, immune mechanisms, diagnosis, clinical manifestations, and the application and limitations of Alternaria AIT, aiming to provide a foundation for the management of patients with Alternaria allergy.
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Affiliation(s)
- Hao Chen
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,
| | - Rongfei Zhu
- Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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4
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Hurraß J, Heinzow B, Walser-Reichenbach S, Aurbach U, Becker S, Bellmann R, Bergmann KC, Cornely OA, Engelhart S, Fischer G, Gabrio T, Herr CE, Joest M, Karagiannidis C, Klimek L, Köberle M, Kolk A, Lichtnecker H, Lob-Corzilius T, Mülleneisen N, Nowak D, Rabe U, Raulf M, Steinmann J, Steiß JO, Stemler J, Umpfenbach U, Valtanen K, Werchan B, Willinger B, Wiesmüller GA. AWMF mold guideline "Medical clinical diagnostics for indoor mold exposure" - Update 2023 AWMF Register No. 161/001. Allergol Select 2024; 8:90-198. [PMID: 38756207 PMCID: PMC11097193 DOI: 10.5414/alx02444e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 03/04/2024] [Indexed: 05/18/2024] Open
Affiliation(s)
- Julia Hurraß
- Section for Hygiene in Healthcare Facilities, Division of Infection Control and Environmental Hygiene, Cologne Health Department, Cologne
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Birger Heinzow
- Formerly: State Agency for Social Services (LAsD) Schleswig-Holstein, Kiel
- Co-author
| | - Sandra Walser-Reichenbach
- Formerly: State Agency for Social Services (LAsD) Schleswig-Holstein, Kiel
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Ute Aurbach
- Laboratory Dr. Wisplinghoff
- ZfMK – Center for Environment, Hygiene and Mycology Cologne, Cologne
- Co-author
| | - Sven Becker
- Department for Otorhinolaryngology, Head and Neck Surgery, University Medical Center Tübingen, Tübingen, Germany
- Co-author
| | - Romuald Bellmann
- Department of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria
- Co-author
| | - Karl-Christian Bergmann
- Institute of Allergology Charité, Charité – University Medicine Berlin, Berlin
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Oliver A. Cornely
- Institute for Translational Research, CECAD Cluster of Excellence, University of Cologne, Cologne, Germany and Department I for Internal Medicine, Cologne University Hospital, Cologne
- Co-author
| | - Steffen Engelhart
- Institute for Hygiene and Public Health, University Hospital Bonn, Bonn
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Guido Fischer
- Baden-Württemberg State Health Office in the Stuttgart Regional Council, Stuttgart
- Co-author
| | - Thomas Gabrio
- Formerly: Baden-Württemberg State Health Office in the Stuttgart Regional Council, Stuttgart
- Co-author
| | - Caroline E.W. Herr
- Bavarian Health and Food Safety Authority, Munich
- Environmental Health and Prevention, Institute and Polyclinic for Occupational, Social and Environmental Medicine, University of Munich Hospital Ludwig-Maximilians-University, Munich
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Marcus Joest
- Allergological-Immunological Laboratory, Helios Lung and Allergy Center Bonn, Bonn
- Co-author
| | - Christian Karagiannidis
- Faculty of Health, Professorship for Extracorporeal Lung Replacement Procedures, University of Witten/Herdecke, Witten/Herdecke
- Lung Clinic Cologne Merheim, Clinics of the City of Cologne, Cologne
- Co-author
| | - Ludger Klimek
- Center for Rhinology and Allergology, Wiesbaden
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Martin Köberle
- Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University of Munich, Munich
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Annette Kolk
- Institute for Occupational Safety and Health (IFA) of the German Social Accident Insurance (DGUV), Unit Biological Agents, Sankt Augustin
- Co-author
| | - Herbert Lichtnecker
- Medical Institute for Environmental and Occupational Medicine MIU GmbH Erkrath, Erkrath
- Co-author
| | - Thomas Lob-Corzilius
- Scientific working group of environmental medicine of the German Society of Pediatric Allergology (GPAU)
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Norbert Mülleneisen
- Asthma and Allergy Center Leverkusen, Leverkusen
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Dennis Nowak
- Institute and Polyclinic for Occupational, Social and Environmental Medicine, member of the German Center for Lung Research, Hospital of the University of Munich, Munich
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Uta Rabe
- Center for Allergology and Asthma, Johanniter Hospital Treuenbrietzen, Treuenbrietzen
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Monika Raulf
- Institute for Prevention and Occupational Medicine of the German Statutory Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Jörg Steinmann
- Center for Pediatrics and Adolescent Medicine, University Hospital Giessen and Marburg GmbH, Giessen
- Co-author
| | - Jens-Oliver Steiß
- Specialized Practice in Allergology and Pediatric Pulmonology in Fulda, Fulda
- Institute for Clinical Hygiene, Medical Microbiology and Clinical Infectiology, Paracelsus Private Medical University Nuremberg Clinic, Nuremberg
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Jannik Stemler
- Institute for Translational Research, CECAD Cluster of Excellence, University of Cologne, Cologne, Germany and Department I for Internal Medicine, Cologne University Hospital, Cologne
- Co-author
| | - Ulli Umpfenbach
- Doctor for Pediatrics and Adolescent Medicine, Pediatric Pulmonology, Environmental Medicine, Classical Homeopathy, Asthma Trainer, Neurodermatitis Trainer, Viersen
- Co-author
| | - Kerttu Valtanen
- FG II 1.4 Microbiological Risks, German Environment Agency, Berlin
- Co-author
| | - Barbora Werchan
- German Pollen Information Service Foundation (PID), Berlin, Germany
- Co-author
| | - Birgit Willinger
- Department of Laboratory Medicine, Division of Clinical Microbiology – Medical University of Vienna, Vienna, Austria, and
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
| | - Gerhard A. Wiesmüller
- Laboratory Dr. Wisplinghoff
- ZfMK – Center for Environment, Hygiene and Mycology Cologne, Cologne
- Institute for Occupational, Social and Environmental Medicine, Uniclinic RWTH Aachen, Aachen, Germany
- Co-author
- Member of a scientific medical society, a society or a medical association with voting rights
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5
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Dramburg S, Hilger C, Santos AF, de Las Vecillas L, Aalberse RC, Acevedo N, Aglas L, Altmann F, Arruda KL, Asero R, Ballmer-Weber B, Barber D, Beyer K, Biedermann T, Bilo MB, Blank S, Bosshard PP, Breiteneder H, Brough HA, Bublin M, Campbell D, Caraballo L, Caubet JC, Celi G, Chapman MD, Chruszcz M, Custovic A, Czolk R, Davies J, Douladiris N, Eberlein B, Ebisawa M, Ehlers A, Eigenmann P, Gadermaier G, Giovannini M, Gomez F, Grohman R, Guillet C, Hafner C, Hamilton RG, Hauser M, Hawranek T, Hoffmann HJ, Holzhauser T, Iizuka T, Jacquet A, Jakob T, Janssen-Weets B, Jappe U, Jutel M, Kalic T, Kamath S, Kespohl S, Kleine-Tebbe J, Knol E, Knulst A, Konradsen JR, Korošec P, Kuehn A, Lack G, Le TM, Lopata A, Luengo O, Mäkelä M, Marra AM, Mills C, Morisset M, Muraro A, Nowak-Wegrzyn A, Nugraha R, Ollert M, Palosuo K, Pastorello EA, Patil SU, Platts-Mills T, Pomés A, Poncet P, Potapova E, Poulsen LK, Radauer C, Radulovic S, Raulf M, Rougé P, Sastre J, Sato S, Scala E, Schmid JM, Schmid-Grendelmeier P, Schrama D, Sénéchal H, Traidl-Hoffmann C, Valverde-Monge M, van Hage M, van Ree R, Verhoeckx K, Vieths S, Wickman M, Zakzuk J, Matricardi PM, Hoffmann-Sommergruber K. EAACI Molecular Allergology User's Guide 2.0. Pediatr Allergy Immunol 2023; 34 Suppl 28:e13854. [PMID: 37186333 DOI: 10.1111/pai.13854] [Citation(s) in RCA: 57] [Impact Index Per Article: 57.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 09/05/2022] [Indexed: 05/17/2023]
Abstract
Since the discovery of immunoglobulin E (IgE) as a mediator of allergic diseases in 1967, our knowledge about the immunological mechanisms of IgE-mediated allergies has remarkably increased. In addition to understanding the immune response and clinical symptoms, allergy diagnosis and management depend strongly on the precise identification of the elicitors of the IgE-mediated allergic reaction. In the past four decades, innovations in bioscience and technology have facilitated the identification and production of well-defined, highly pure molecules for component-resolved diagnosis (CRD), allowing a personalized diagnosis and management of the allergic disease for individual patients. The first edition of the "EAACI Molecular Allergology User's Guide" (MAUG) in 2016 rapidly became a key reference for clinicians, scientists, and interested readers with a background in allergology, immunology, biology, and medicine. Nevertheless, the field of molecular allergology is moving fast, and after 6 years, a new EAACI Taskforce was established to provide an updated document. The Molecular Allergology User's Guide 2.0 summarizes state-of-the-art information on allergen molecules, their clinical relevance, and their application in diagnostic algorithms for clinical practice. It is designed for both, clinicians and scientists, guiding health care professionals through the overwhelming list of different allergen molecules available for testing. Further, it provides diagnostic algorithms on the clinical relevance of allergenic molecules and gives an overview of their biology, the basic mechanisms of test formats, and the application of tests to measure allergen exposure.
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Affiliation(s)
- Stephanie Dramburg
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Christiane Hilger
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Alexandra F Santos
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, United Kingdom
- Children's Allergy Service, Evelina London, Guy's and St Thomas' Hospital, London, United Kingdom
| | | | - Rob C Aalberse
- Sanquin Research, Dept Immunopathology, University of Amsterdam, Amsterdam, The Netherlands
- Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Nathalie Acevedo
- Institute for Immunological Research, University of Cartagena, Cartagena de Indias, Colombia, Colombia
| | - Lorenz Aglas
- Department of Biosciences and Medical Biology, Paris Lodron University Salzburg, Salzburg, Austria
| | - Friedrich Altmann
- Department of Chemistry, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Karla L Arruda
- Department of Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Sao Paulo, Brasil, Brazil
| | - Riccardo Asero
- Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy
| | - Barbara Ballmer-Weber
- Klinik für Dermatologie und Allergologie, Kantonsspital St. Gallen, St. Gallen, Switzerland
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Domingo Barber
- Institute of Applied Molecular Medicine Nemesio Diez (IMMAND), Department of Basic Medical Sciences, Facultad de Medicina, Universidad San Pablo CEU, CEU Universities, Madrid, Spain
- RETIC ARADyAL and RICORS Enfermedades Inflamatorias (REI), Madrid, Spain
| | - Kirsten Beyer
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University Munich, Munich, Germany
| | - Maria Beatrice Bilo
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
- Allergy Unit Department of Internal Medicine, University Hospital Ospedali Riuniti di Ancona, Torrette, Italy
| | - Simon Blank
- Center of Allergy and Environment (ZAUM), Technical University of Munich, School of Medicine and Helmholtz Center Munich, German Research Center for Environmental Health, Munich, Germany
| | - Philipp P Bosshard
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Heimo Breiteneder
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Helen A Brough
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
- Children's Allergy Service, Evelina London, Guy's and St Thomas' Hospital, London, United Kingdom
| | - Merima Bublin
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Dianne Campbell
- Department of Allergy and Immunology, Children's Hospital at Westmead, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
- Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Luis Caraballo
- Institute for Immunological Research, University of Cartagena, Cartagena de Indias, Colombia, Colombia
| | - Jean Christoph Caubet
- Pediatric Allergy Unit, Department of Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland
| | - Giorgio Celi
- Centro DH Allergologia e Immunologia Clinica ASST- MANTOVA (MN), Mantova, Italy
| | | | - Maksymilian Chruszcz
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, South Carolina, USA
| | - Adnan Custovic
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Rebecca Czolk
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
- Faculty of Science, Technology and Medicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Janet Davies
- Queensland University of Technology, Centre for Immunology and Infection Control, School of Biomedical Sciences, Herston, Queensland, Australia
- Metro North Hospital and Health Service, Emergency Operations Centre, Herston, Queensland, Australia
| | - Nikolaos Douladiris
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Bernadette Eberlein
- Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University Munich, Munich, Germany
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Kanagawa, Japan
| | - Anna Ehlers
- Chemical Biology and Drug Discovery, Utrecht University, Utrecht, The Netherlands
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Immunology and Dermatology/ Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Philippe Eigenmann
- Pediatric Allergy Unit, Department of Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland
| | - Gabriele Gadermaier
- Department of Biosciences and Medical Biology, Paris Lodron University Salzburg, Salzburg, Austria
| | - Mattia Giovannini
- Allergy Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Francisca Gomez
- Allergy Unit IBIMA-Hospital Regional Universitario de Malaga, Malaga, Spain
- Spanish Network for Allergy research RETIC ARADyAL, Malaga, Spain
| | - Rebecca Grohman
- NYU Langone Health, Department of Internal Medicine, New York, New York, USA
| | - Carole Guillet
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Christine Hafner
- Department of Dermatology, University Hospital St. Poelten, Karl Landsteiner University of Health Sciences, St. Poelten, Austria
| | - Robert G Hamilton
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael Hauser
- Department of Biosciences and Medical Biology, Paris Lodron University Salzburg, Salzburg, Austria
| | - Thomas Hawranek
- Department of Dermatology and Allergology, Paracelsus Private Medical University, Salzburg, Austria
| | - Hans Jürgen Hoffmann
- Institute for Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
| | | | - Tomona Iizuka
- Laboratory of Protein Science, Graduate School of Life Science, Hokkaido University, Sapporo, Japan
| | - Alain Jacquet
- Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Thilo Jakob
- Department of Dermatology and Allergology, University Medical Center, Justus Liebig University Gießen, Gießen, Germany
| | - Bente Janssen-Weets
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
- Odense Research Center for Anaphylaxis, University of Southern Denmark, Odense, Denmark
| | - Uta Jappe
- Division of Clinical and Molecular Allergology, Priority Research Area Asthma and Allergy, Research Center Borstel, Borstel, Germany
- Leibniz Lung Center, Airway Research Center North (ARCN), Member of the German Center for Lung Research, Germany
- Interdisciplinary Allergy Outpatient Clinic, Dept. of Pneumology, University of Lübeck, Lübeck, Germany
| | - Marek Jutel
- Department of Clinical Immunology, Wroclaw Medical University, Wroclaw, Poland
| | - Tanja Kalic
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
- Department of Dermatology, University Hospital St. Poelten, Karl Landsteiner University of Health Sciences, St. Poelten, Austria
| | - Sandip Kamath
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Sabine Kespohl
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr- Universität Bochum, Bochum, Germany
| | - Jörg Kleine-Tebbe
- Allergy & Asthma Center Westend, Outpatient Clinic and Clinical Research Center, Berlin, Germany
| | - Edward Knol
- Department of Immunology and Dermatology/ Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - André Knulst
- Department of Immunology and Dermatology/ Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Jon R Konradsen
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Peter Korošec
- University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia
- Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
| | - Annette Kuehn
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Gideon Lack
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, United Kingdom
- Children's Allergy Service, Evelina London, Guy's and St Thomas' Hospital, London, United Kingdom
| | - Thuy-My Le
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Immunology and Dermatology/ Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Andreas Lopata
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Olga Luengo
- RETIC ARADyAL and RICORS Enfermedades Inflamatorias (REI), Madrid, Spain
- Allergy Section, Internal Medicine Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mika Mäkelä
- Division of Allergy, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Pediatric Department, Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | | | - Clare Mills
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Manchester Institute of Biotechnology, The University of Manchester, Manchester, UK
| | | | - Antonella Muraro
- Food Allergy Referral Centre, Department of Woman and Child Health, Padua University Hospital, Padua, Italy
| | - Anna Nowak-Wegrzyn
- Division of Pediatric Allergy and Immunology, NYU Grossman School of Medicine, Hassenfeld Children's Hospital, New York, New York, USA
- Department of Pediatrics, Gastroenterology and Nutrition, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Roni Nugraha
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
- Department of Aquatic Product Technology, Faculty of Fisheries and Marine Science, IPB University, Bogor, Indonesia
| | - Markus Ollert
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
- Odense Research Center for Anaphylaxis, University of Southern Denmark, Odense, Denmark
| | - Kati Palosuo
- Department of Allergology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | - Sarita Ulhas Patil
- Division of Rheumatology, Allergy and Immunology, Departments of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Division of Allergy and Immunology, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Thomas Platts-Mills
- Division of Allergy and Clinical Immunology, University of Virginia, Charlottesville, Virginia, USA
| | | | - Pascal Poncet
- Institut Pasteur, Immunology Department, Paris, France
- Allergy & Environment Research Team Armand Trousseau Children Hospital, APHP, Paris, France
| | - Ekaterina Potapova
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Lars K Poulsen
- Allergy Clinic, Department of Dermatology and Allergy, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark
| | - Christian Radauer
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Suzana Radulovic
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
- Children's Allergy Service, Evelina London, Guy's and St Thomas' Hospital, London, United Kingdom
| | - Monika Raulf
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr- Universität Bochum, Bochum, Germany
| | - Pierre Rougé
- UMR 152 PharmaDev, IRD, Université Paul Sabatier, Faculté de Pharmacie, Toulouse, France
| | - Joaquin Sastre
- Allergy Service, Fundación Jiménez Díaz; CIBER de Enfermedades Respiratorias (CIBERES); Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
| | - Sakura Sato
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Enrico Scala
- Clinical and Laboratory Molecular Allergy Unit - IDI- IRCCS, Fondazione L M Monti Rome, Rome, Italy
| | - Johannes M Schmid
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
| | - Peter Schmid-Grendelmeier
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
- Christine Kühne Center for Allergy Research and Education CK-CARE, Davos, Switzerland
| | - Denise Schrama
- Centre of Marine Sciences (CCMAR), Universidade do Algarve, Faro, Portugal
| | - Hélène Sénéchal
- Allergy & Environment Research Team Armand Trousseau Children Hospital, APHP, Paris, France
| | - Claudia Traidl-Hoffmann
- Christine Kühne Center for Allergy Research and Education CK-CARE, Davos, Switzerland
- Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Marcela Valverde-Monge
- Allergy Service, Fundación Jiménez Díaz; CIBER de Enfermedades Respiratorias (CIBERES); Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
| | - Marianne van Hage
- Department of Medicine Solna, Division of Immunology and Allergy, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Ronald van Ree
- Department of Experimental Immunology and Department of Otorhinolaryngology, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Kitty Verhoeckx
- Department of Immunology and Dermatology/ Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Stefan Vieths
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - Magnus Wickman
- Department of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Josefina Zakzuk
- Institute for Immunological Research, University of Cartagena, Cartagena de Indias, Colombia, Colombia
| | - Paolo M Matricardi
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
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Fungal Allergen and Mold Allergy Diagnosis: Role and Relevance of Alternaria alternata Alt a 1 Protein Family. J Fungi (Basel) 2022; 8:jof8030277. [PMID: 35330279 PMCID: PMC8954643 DOI: 10.3390/jof8030277] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/03/2022] [Accepted: 03/07/2022] [Indexed: 02/04/2023] Open
Abstract
Alternaria is a genus of worldwide fungi found in different habitats such as soil, the atmosphere, plants or indoor environments. Alternaria species are saprobic—largely involved in the decomposition of organic material—but they can also act as animal pathogens, causing disease in humans and animals, developing infections, toxicosis and allergic diseases. A. alternata is considered one of the most important sources of fungal allergens worldwide and it is associated with severe asthma and respiratory status. Among the A. alternata allergens, Alt a 1 is the main sensitizing allergen and its usefulness in diagnosis and immunotherapy has been demonstrated. Alt a 1 seems to define a protein family that can be used to identify related pathogenic fungi in plants and fruits, and to establish taxonomic relationships between the different fungal divisions.
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Namvar S, Labram B, Rowley J, Herrick S. Aspergillus fumigatus-Host Interactions Mediating Airway Wall Remodelling in Asthma. J Fungi (Basel) 2022; 8:jof8020159. [PMID: 35205913 PMCID: PMC8879933 DOI: 10.3390/jof8020159] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/29/2022] [Accepted: 02/01/2022] [Indexed: 12/03/2022] Open
Abstract
Asthma is a chronic heterogeneous respiratory condition that is mainly associated with sensitivity to airborne agents such as pollen, dust mite products and fungi. Key pathological features include increased airway inflammation and airway wall remodelling. In particular, goblet cell hyperplasia, combined with excess mucus secretion, impairs clearance of the inhaled foreign material. Furthermore, structural changes such as subepithelial fibrosis and increased smooth muscle hypertrophy collectively contribute to deteriorating airway function and possibility of exacerbations. Current pharmacological therapies focused on airway wall remodelling are limited, and as such, are an area of unmet clinical need. Sensitisation to the fungus, Aspergillus fumigatus, is associated with enhanced asthma severity, bronchiectasis, and hospitalisation. How Aspergillus fumigatus may drive airway structural changes is unclear, although recent evidence points to a central role of the airway epithelium. This review provides an overview of the airway pathology in patients with asthma and fungal sensitisation, summarises proposed airway epithelial cell-fungal interactions and discusses the initiation of a tissue remodelling response. Related findings from in vivo animal models are included given the limited analysis of airway pathology in patients. Lastly, an important role for Aspergillus fumigatus-derived proteases in triggering a cascade of damage-repair events through upregulation of airway epithelial-derived factors is proposed.
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Affiliation(s)
- Sara Namvar
- School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester and Manchester Academic Health Science Centre, Manchester M13 9PT, UK; (B.L.); (J.R.)
- School of Science, Engineering and Environment, University of Salford, Salford M5 4WT, UK
- Correspondence: (S.N.); (S.H.)
| | - Briony Labram
- School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester and Manchester Academic Health Science Centre, Manchester M13 9PT, UK; (B.L.); (J.R.)
| | - Jessica Rowley
- School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester and Manchester Academic Health Science Centre, Manchester M13 9PT, UK; (B.L.); (J.R.)
| | - Sarah Herrick
- School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester and Manchester Academic Health Science Centre, Manchester M13 9PT, UK; (B.L.); (J.R.)
- Correspondence: (S.N.); (S.H.)
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8
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Misalignment between Clinical Mold Antigen Extracts and Airborne Molds Found in Water-Damaged Homes. Ann Am Thorac Soc 2021; 19:746-755. [PMID: 34788190 DOI: 10.1513/annalsats.202101-096oc] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
RATIONALE Epidemiologic studies have demonstrated that exposure to molds and other fungi can play a role in a variety of allergic and pulmonary diseases in susceptible individuals. Species-specific mold antigen extracts are used in the clinical evaluation of suspected mold-related conditions, however alignment between these extracts and the species of molds identified in the indoor environment of water-damaged homes has not been rigorously evaluated. OBJECTIVES To identify the predominant genera and species of mold in the air of homes with water damage, mold growth, and/or occupants with respiratory complaints (complaint homes), and to assess their alignment with the mold antigen extracts used in clinical practice. METHODS The genera and species of molds identified in culture-type outdoor and indoor air samples collected from complaint homes throughout the U.S. and Canada from 2002-2017 were examined. Mold antigen extracts available and utilized for skin and serum testing in clinical practice were assessed and alignment between these data were evaluated. RESULTS Culture data from 24,455 indoor air samples from 7,547 complaint homes and 29,493 outdoor samples was evaluated. Mean exposure values (CFU/m3) were calculated for each genus and species, and indoor vs outdoor values compared. Penicillium was the predominant genus identified in water-damaged homes, with a mean exposure (233.3 CFU/m3) 2.9 times higher than that of the Aspergillus genus (81.4 CFU/m3). Five Penicillium (P. aurantiogriseum, P. brevicompactum, P. citrinum, P. crustosum, and P. variabile) and three Aspergillus (A. versicolor, A. sydowii, and A. niger) species were identified as the predominant indoor water-damage related fungi. However, none of these Penicillium species and only one of the Aspergillus species is currently available as an antigen extract for use in skin testing or serum testing panels. CONCLUSIONS Significant misalignment exists between the currently available mold antigen extracts and the predominant species of molds found in water-damaged homes. Improving alignment has the potential to enhance diagnosis of mold-related diseases including allergic asthma and hypersensitivity pneumonitis and to improve patient outcomes via interventions including antigen avoidance through building remediation and occupant relocation, consistent with the findings of a recent ATS Workshop Report.
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Incorvaia C, Al‐Ahmad M, Ansotegui IJ, Arasi S, Bachert C, Bos C, Bousquet J, Bozek A, Caimmi D, Calderón MA, Casale T, Custovic A, De Blay F, Demoly P, Devillier P, Didier A, Fiocchi A, Fox AT, Gevaert P, Gomez M, Heffler E, Ilina N, Irani C, Jutel M, Karagiannis E, Klimek L, Kuna P, O'Hehir R, Kurbacheva O, Matricardi PM, Morais‐Almeida M, Mosges R, Novak N, Okamoto Y, Panzner P, Papadopoulos NG, Park H, Passalacqua G, Pawankar R, Pfaar O, Schmid‐Grendelmeier P, Scurati S, Tortajada‐Girbés M, Vidal C, Virchow JC, Wahn U, Worm M, Zieglmayer P, Canonica GW. Personalized medicine for allergy treatment: Allergen immunotherapy still a unique and unmatched model. Allergy 2021; 76:1041-1052. [PMID: 32869882 DOI: 10.1111/all.14575] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/18/2020] [Accepted: 08/20/2020] [Indexed: 12/17/2022]
Abstract
The introduction of personalized medicine (PM) has been a milestone in the history of medical therapy, because it has revolutionized the previous approach of treating the disease with that of treating the patient. It is known today that diseases can occur in different genetic variants, making specific treatments of proven efficacy necessary for a given endotype. Allergic diseases are particularly suitable for PM, because they meet the therapeutic success requirements, including a known molecular mechanism of the disease, a diagnostic tool for such disease, and a treatment blocking the mechanism. The stakes of PM in allergic patients are molecular diagnostics, to detect specific IgE to single-allergen molecules and to distinguish the causative molecules from those merely cross-reactive, pursuit of patient's treatable traits addressing genetic, phenotypic, and psychosocial features, and omics, such as proteomics, epi-genomics, metabolomics, and breathomics, to forecast patient's responsiveness to therapies, to detect biomarker and mediators, and to verify the disease control. This new approach has already improved the precision of allergy diagnosis and is likely to significantly increase, through the higher performance achieved with the personalized treatment, the effectiveness of allergen immunotherapy by enhancing its already known and unique characteristics of treatment that acts on the causes.
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Affiliation(s)
| | - Mona Al‐Ahmad
- Microbiology Department Faculty of Medicine Kuwait University Kuwait
- Drug Allergy Unit Department of Allergy Al‐Rashed Allergy Center Kuwait
| | | | - Stefania Arasi
- Department of Allergy Bambino Gesu' Childrens' Hospital IRCCS Rome Italy
| | - Claus Bachert
- Upper Airways Research Laboratory ENT Dept Ghent University Hospital Ghent Belgium
- Karolinska Institutet Stockholm Sweden
- Department of ENT Diseases Karolinska University Hospital Stockholm Sweden
| | - Catherine Bos
- Stallergenes Greer Medical Affairs Department Antony France
| | - Jean Bousquet
- University Hospital Montpellier France – MACVIA‐France Montpellier France
| | - Andrzéj Bozek
- Clinical Department of Internal Disease, Dermatology and Allergology Medical University of Silesia Katowice Poland
| | - Davide Caimmi
- Department of Pulmonology and Addictology Arnaud de Villeneuve Hospital Montpellier University Montpellier France
| | - Moises A. Calderón
- Imperial College London – National Heart and Lung Institute Royal Brompton Hospital NHS London UK
| | - Thomas Casale
- Division of Allergy/Immunology University of South Florida Tampa FL USA
| | - Adnan Custovic
- Centre for Respiratory Medicine and Allergy Institute of Inflammation and Repair University of Manchester and University Hospital of South Manchester Manchester UK
| | - Frédéric De Blay
- Allergy Division Chest Diseases Department Strasbourg University Hospital Strasbourg France
| | - Pascal Demoly
- Department of Pulmonology and Addictology Arnaud de Villeneuve Hospital Montpellier University Montpellier France
- Sorbonne Université UMR‐S 1136 INSERM IPLESP EPAR Team Paris France
| | - Philippe Devillier
- Laboratoire de Recherche en Pharmacologie Respiratoire Pôle des Maladies des Voies Respiratoires Hôpital Foch Université Paris‐Saclay Suresnes France
| | - Alain Didier
- Respiratory Disease Dept Larrey Hospital University Hospital of Toulouse Paul Sabatier University Toulouse France
| | - Alessandro Fiocchi
- Department of Allergy Bambino Gesu' Childrens' Hospital IRCCS Rome Italy
| | - Adam T. Fox
- Department of Paediatric Allergy Guy's & St Thomas' Hospitals NHS Foundation Trust London UK
| | - Philippe Gevaert
- Upper Airways Research Laboratory ENT Dept Ghent University Hospital Ghent Belgium
| | | | - Enrico Heffler
- Personalized Medicine, Asthma & Allergy – Humanitas Clinical and Research Center IRCCS Rozzano Italy
- Department of Biomedical Science Humanitas University Pieve Emanuele Italy
| | - Natalia Ilina
- Federal Institute of Immunology of Russia Moscow Russia
| | - Carla Irani
- Department of Internal Medicine and Clinical Immunology Faculty of Medicine Hotel Dieu de France Hospital Saint Joseph University Beirut Lebanon
| | - Marek Jutel
- Department of Clinical Immunology Wrocław Medical University Wrocław Poland
| | | | - Ludger Klimek
- Center for Rhinology and Allergology Wiesbaden Germany
| | - Piotr Kuna
- Division of Internal Medicine, Asthma and Allergy Barlicki University Hospital Medical University of Lodz Lodz Poland
| | - Robin O'Hehir
- Alfred Hospital and Monash University Melbourne Australia
| | - Oxana Kurbacheva
- National Research Center – Institute of Immunology Federal Medical‐Biological Agency of Russia Moscow Russia
| | - Paolo M. Matricardi
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine Charité – University Medicine Berlin Berlin Germany
| | - Mario Morais‐Almeida
- Immunoallergy Department of CUF‐Descobertas Hospital Lisbon Portugal
- CUF‐Infante Santo Hospital Lisbon Portugal
| | - Ralph Mosges
- Faculty of Medicine Institute of Medical Statistics and Computational Biology University of Cologne Cologne Germany
- CRI – Clinical Research International Ltd. Cologne Germany
| | - Natalija Novak
- Department of Dermatology and Allergy University Hospital Bonn Bonn Germany
| | - Yoshitaka Okamoto
- Department of Otorhinolaryngology Chiba University Hospital Chiba Japan
| | - Petr Panzner
- Department of Immunology and Allergology Faculty of Medicine in Pilsen Charles University in Prague Pilsen Czech Republic
| | - Nikolaos G. Papadopoulos
- Division of Infection, Immunity & Respiratory Medicine Royal Manchester Children's Hospital University of Manchester Manchester UK
- Allergy Department 2nd Pediatric Clinic Athens General Children's Hospital "P&A Kyriakou" University of Athens Athens Greece
| | - Hae‐Sim Park
- Department of Allergy and Clinical Immunology Ajou University School of Medicine Suwon South Korea
| | - Giovanni Passalacqua
- Allergy and Respiratory Diseases Ospedale Policlino San Martino – University of Genoa Genoa Italy
| | - Ruby Pawankar
- Department of Pediatrics Nippon Medical School Tokyo Japan
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery Section of Rhinology and Allergy University Hospital Marburg Philipps‐Universität Marburg Marburg Germany
| | | | - Silvia Scurati
- Stallergenes Greer Medical Affairs Department Antony France
| | - Miguel Tortajada‐Girbés
- Pediatric Pulmonology and Allergy Unit Department of Pediatrics Dr. Peset University Hospital Valencia Spain
- Department of Pediatrics, Obstetrics and Gynecology University of Valencia Valencia Spain
- IVI Foundation Valencia Spain
| | - Carmen Vidal
- Allergy Service Complejo Hospitalario Universitario de Santiago Santiago de Compostela Spain
| | - J. Christian Virchow
- Department of Pneumology/Intensive Care Medicine University of Rostock Rostock Germany
| | - Ulrich Wahn
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine Charité – University Medicine Berlin Berlin Germany
| | - Margitta Worm
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine Charité – University Medicine Berlin Berlin Germany
| | | | - Giorgio W. Canonica
- Personalized Medicine, Asthma & Allergy – Humanitas Clinical and Research Center IRCCS Rozzano Italy
- Department of Biomedical Science Humanitas University Pieve Emanuele Italy
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10
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Raulf M. Immediate-Type Hypersensitivity by Occupational Materials. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Luo W, Hu H, Wu Z, Wei N, Huang H, Zheng P, Liu Y, Sun B. Molecular allergen sensitization of Aspergillus fumigatus between allergic bronchopulmonary aspergillosis and A fumigatus-sensitized asthma in Guangzhou, Southern China. J Clin Lab Anal 2020; 34:e23448. [PMID: 32614101 PMCID: PMC7595924 DOI: 10.1002/jcla.23448] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 06/10/2020] [Indexed: 12/11/2022] Open
Abstract
Background Few studies have assessed the sensitization of mycotic allergens and Aspergillus fumigatus molecular allergens. This study aimed to investigate the relationships of A fumigatus components and mycotic allergens in allergic bronchopulmonary aspergillosis (ABPA) patients and A fumigatus (Af)‐sensitized asthma patients. Methods Serum sIgE levels of Penicillium chrysogenum, Cladosporium herbarum, Mucor racemosus, Candida albicans, Alternaria alternata, Helminthosporium halodes, and A fumigatus allergen components (Asp f 1, Asp f 2, Asp f 3, Asp f 4, and Asp f 6) were measured via the ImmunoCAP assay in 18 ABPA and 54 Af‐sensitized asthma patients in Guangzhou city, China. Results 94.44% of ABPA patients and 87.04% of Af‐sensitized asthma patients were co‐sensitized to at least one other fungal allergen. The positive rates of Asp f 1 (88.89% vs 59.26%, P < .05), Asp f 2 (66.67% vs 33.33%, P < .05), Asp f 4 (61.11% vs 33.33%, P < .05), and Asp f 6 (66.67% vs 14.81%, P < .001) in ABPA patients were higher than those in Af‐sensitized asthma patients. IgE levels of Asp f 1 (P < .05), Asp f 4 (P < .05), and Asp f 6 (P < .001) were higher in ABPA patients than in Af‐sensitized asthma patients. Optimal scale analysis showed that ABPA was more relevant to Af components (Cronbach's alpha = 90.7%). Conclusion The A fumigatus components and their relationships with various mycotic allergens were different in ABPA and Af‐sensitized asthma patients. This finding may help local doctors in the diagnosis and immunotherapy of fungal allergies.
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Affiliation(s)
- Wenting Luo
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Haisheng Hu
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zehong Wu
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Nili Wei
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Huimin Huang
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Peiyan Zheng
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yong Liu
- Department of Immunology, Guangzhou Kingmed Diagnostics Group Co., Ltd., Guangzhou, China
| | - Baoqing Sun
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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12
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Caraballo L, Valenta R, Puerta L, Pomés A, Zakzuk J, Fernandez-Caldas E, Acevedo N, Sanchez-Borges M, Ansotegui I, Zhang L, van Hage M, Abel-Fernández E, Karla Arruda L, Vrtala S, Curin M, Gronlund H, Karsonova A, Kilimajer J, Riabova K, Trifonova D, Karaulov A. The allergenic activity and clinical impact of individual IgE-antibody binding molecules from indoor allergen sources. World Allergy Organ J 2020; 13:100118. [PMID: 32373267 PMCID: PMC7195550 DOI: 10.1016/j.waojou.2020.100118] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/27/2020] [Accepted: 03/30/2020] [Indexed: 02/07/2023] Open
Abstract
A large number of allergens have been discovered but we know little about their potential to induce inflammation (allergenic activity) and symptoms. Nowadays, the clinical importance of allergens is determined by the frequency and intensity of their IgE antibody binding (allergenicity). This is a rather limited parameter considering the development of experimental allergology in the last 20 years and the criteria that support personalized medicine. Now it is known that some allergens, in addition to their IgE antibody binding properties, can induce inflammation through non IgE mediated pathways, which can increase their allergenic activity. There are several ways to evaluate the allergenic activity, among them the provocation tests, the demonstration of non-IgE mediated pathways of inflammation, case control studies of IgE-binding frequencies, and animal models of respiratory allergy. In this review we have explored the current status of basic and clinical research on allergenic activity of indoor allergens and confirm that, for most of them, this important property has not been investigated. However, during recent years important advances have been made in the field, and we conclude that for at least the following, allergenic activity has been demonstrated: Der p 1, Der p 2, Der p 5 and Blo t 5 from HDMs; Per a 10 from P. americana; Asp f 1, Asp f 2, Asp f 3, Asp f 4 and Asp f 6 from A. fumigatus; Mala s 8 and Mala s 13 from M. sympodialis; Alt a 1 from A. alternata; Pen c 13 from P. chrysogenum; Fel d 1 from cats; Can f 1, Can f 2, Can f 3, Can f 4 and Can f 5 from dogs; Mus m 1 from mice and Bos d 2 from cows. Defining the allergenic activity of other indoor IgE antibody binding molecules is necessary for a precision-medicine-oriented management of allergic diseases.
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Affiliation(s)
- Luis Caraballo
- Institute for Immunological Research, University of Cartagena, Cartagena, Colombia
- Corresponding author. Institute for Immunological Research, University of Cartagena, Cartagena de Indias, Colombia.
| | - Rudolf Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
- NRC Institute of Immunology FMBA of Russia, Moscow, Russian Federation
- Department of Clinical Immunology and Allergy, Laboratory of Immunopathology, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Leonardo Puerta
- Institute for Immunological Research, University of Cartagena, Cartagena, Colombia
| | - Anna Pomés
- Indoor Biotechnologies, Inc. Charlottesville, VA, USA
| | - Josefina Zakzuk
- Institute for Immunological Research, University of Cartagena, Cartagena, Colombia
| | | | - Nathalie Acevedo
- Institute for Immunological Research, University of Cartagena, Cartagena, Colombia
| | - Mario Sanchez-Borges
- Allergy and Clinical Immunology Department, Centro Médico Docente La Trinidad, Caracas, Venezuela
| | - Ignacio Ansotegui
- Department of Allergy & Immunology Hospital Quironsalud Bizkaia, Bilbao, Spain
| | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Marianne van Hage
- Department of Medicine Solna, Division of Immunology and Allergy, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Eva Abel-Fernández
- Inmunotek, Madrid, Spain and University of South Florida College of Medicine, Tampa, USA
| | - L. Karla Arruda
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Susanne Vrtala
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Mirela Curin
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Hans Gronlund
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Antonina Karsonova
- Department of Clinical Immunology and Allergy, Laboratory of Immunopathology, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Jonathan Kilimajer
- Inmunotek, Madrid, Spain and University of South Florida College of Medicine, Tampa, USA
| | - Ksenja Riabova
- Department of Clinical Immunology and Allergy, Laboratory of Immunopathology, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Daria Trifonova
- Department of Clinical Immunology and Allergy, Laboratory of Immunopathology, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Alexander Karaulov
- Department of Clinical Immunology and Allergy, Laboratory of Immunopathology, Sechenov First Moscow State Medical University, Moscow, Russia
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Onami JI, Kobayashi N, Watanabe M, Yamada O, Mizutani O, Yokoyama K, Haruo T, Chibana H, Kamata Y. An updated data portal for fungal allergens with curated information. Bioinformation 2019; 15:820-823. [PMID: 31902982 PMCID: PMC6936663 DOI: 10.6026/97320630015820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 12/09/2019] [Accepted: 12/10/2019] [Indexed: 11/23/2022] Open
Abstract
Allergens originating from fungal components abundantly exist in and around human life. We constructed a data portal specific for fungal allergens that includes genomic data from four Aspergillus species used by beverage industries. The fungal database contains the information of nucleotide sequences, which are similar to the coding region of already known allergens in the public database. The database will accelerate allergen identification and prediction in the fungal research field.
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Affiliation(s)
- Jun-ichi Onami
- Japan Science and Technology Agency Ringgold standard Institution, National Bioscience Database Center, Tokyo, Chiyoda-ku Japan
- National Institute of Health Sciences Ringgold standard Institution, Division of Microbiology Kawasaki, Kanagawa Japan
| | - Naoki Kobayashi
- Azabu University Ringgold standard Institution, School of Life and Environmental Science, Department of Food and Life Science Sagamihara, Kanagawa Japan
| | - Maiko Watanabe
- National Institute of Health Sciences Ringgold standard Institution, Division of Microbiology Kawasaki, Kanagawa Japan
| | - Osamu Yamada
- National Research Institute of Brewing Ringgold standard institution Hiroshima, Hiroshima Japan
| | - Osamu Mizutani
- University of the Ryukyus Ringgold standard Institution, Department of Bioscience and Biotechnology Nakagami-gun, Okinawa Japan
| | - Koji Yokoyama
- 6Chiba University Ringgold standard institution, Medical Mycology Research Center Chiba, Chiba Japan
| | - Takahashi Haruo
- National Institute of Health Sciences Ringgold standard Institution, Division of Microbiology Kawasaki, Kanagawa Japan
| | - Hiroji Chibana
- 6Chiba University Ringgold standard institution, Medical Mycology Research Center Chiba, Chiba Japan
| | - Yoichi Kamata
- Koshien University Ringgold Standard Institution, School of Nutrition Sciences, Department of Food Design Takarazuka, Hyogo Japan
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Čelakovská J, Bukač J, Vaňková R, Krcmova I, Krejsek J, Andrýs C. Sensitisation to molecular allergens of Alternaria alternata, Cladosporium herbarum, Aspergillus fumigatus in atopic dermatitis patients. FOOD AGR IMMUNOL 2019. [DOI: 10.1080/09540105.2019.1660624] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Affiliation(s)
- Jarmila Čelakovská
- Department of Dermatology and Venereology, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - Josef Bukač
- Department of Medical Biophysic, Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - Radka Vaňková
- Department of Clinical Immunology and Allergy, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - Irena Krcmova
- Department of Clinical Immunology and Allergy, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - Jan Krejsek
- Department of Clinical Immunology and Allergy, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - Ctirad Andrýs
- Department of Clinical Immunology and Allergy, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
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15
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San Segundo-Acosta P, Oeo-Santos C, Benedé S, de Los Ríos V, Navas A, Ruiz-Leon B, Moreno C, Pastor-Vargas C, Jurado A, Villalba M, Barderas R. Delineation of the Olive Pollen Proteome and Its Allergenome Unmasks Cyclophilin as a Relevant Cross-Reactive Allergen. J Proteome Res 2019; 18:3052-3066. [PMID: 31192604 DOI: 10.1021/acs.jproteome.9b00167] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Olive pollen is a major allergenic source worldwide due to its extensive cultivation. We have combined available genomics data with a comprehensive proteomics approach to get the annotated olive tree (Olea europaea L.) pollen proteome and define its complex allergenome. A total of 1907 proteins were identified by LC-MS/MS using predicted protein sequences from its genome. Most proteins (60%) were predicted to possess catalytic activity and be involved in metabolic processes. In total, 203 proteins belonging to 47 allergen families were found in olive pollen. A peptidyl-prolyl cis-trans isomerase, cyclophilin, produced in Escherichia coli, was found as a new olive pollen allergen (Ole e 15). Most Ole e 15-sensitized patients were children (63%) and showed strong IgE recognition to the allergen. Ole e 15 shared high sequence identity with other plant, animal, and fungal cyclophilins and presented high IgE cross-reactivity with pollen, plant food, and animal extracts.
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Affiliation(s)
- Pablo San Segundo-Acosta
- Departamento de Bioquímica y Biología Molecular, Facultad de Ciencias Químicas , Universidad Complutense de Madrid , E-28040 Madrid , Spain
| | - Carmen Oeo-Santos
- Departamento de Bioquímica y Biología Molecular, Facultad de Ciencias Químicas , Universidad Complutense de Madrid , E-28040 Madrid , Spain
| | - Sara Benedé
- Departamento de Bioquímica y Biología Molecular, Facultad de Ciencias Químicas , Universidad Complutense de Madrid , E-28040 Madrid , Spain
| | | | - Ana Navas
- Hospital Universitario Reina Sofía de Córdoba , E-14004 Córdoba , Spain
| | - Berta Ruiz-Leon
- Hospital Universitario Reina Sofía de Córdoba , E-14004 Córdoba , Spain
| | - Carmen Moreno
- Hospital Universitario Reina Sofía de Córdoba , E-14004 Córdoba , Spain
| | - Carlos Pastor-Vargas
- Department of Immunology , Instituto de Investigación Sanitaria Hospital Universitario Fundación Jiménez Díaz (IIS-FJD, UAM) , E-28040 Madrid , Spain
| | - Aurora Jurado
- Hospital Universitario Reina Sofía de Córdoba , E-14004 Córdoba , Spain
| | - Mayte Villalba
- Departamento de Bioquímica y Biología Molecular, Facultad de Ciencias Químicas , Universidad Complutense de Madrid , E-28040 Madrid , Spain
| | - Rodrigo Barderas
- Chronic Disease Programme (UFIEC) , Instituto de Salud Carlos III , Majadahonda, E-28220 Madrid , Spain
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16
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Raulf M. Immediate-Type Hypersensitivity by Occupational Materials. Contact Dermatitis 2019. [DOI: 10.1007/978-3-319-72451-5_73-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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17
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Allergen component analysis as a tool in the diagnosis and management of occupational allergy. Mol Immunol 2018; 100:21-27. [PMID: 29650229 DOI: 10.1016/j.molimm.2018.03.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 03/19/2018] [Indexed: 01/11/2023]
Abstract
We are now in the epoch of "molecular allergology" and numerous clinically relevant allergenic molecules are available improving the performance of in vitro allergen tests and allergen detection methods. This review is focusing on characterized occupational allergens and their implementation into the in vitro diagnosis for occupational allergy and in allergen detection methods. More than 400 occupational agents are identified and documented as being 'respiratory sensitizers', but currently only a limited number of them are characterized on the molecular level and available for routine diagnosis as native or recombinant allergens. One exception, however, is natural rubber latex (NRL) from Hevea brasiliensis still remaining an important occupational allergen source. Characterization of 15 NRL allergens led to the development of assays for the determination of allergen content of NRL materials and the implementation of component-resolved diagnosis (CRD) for specific IgE antibody measurement. Microarray or singleplex using recombinant or native allergens are reliable tools for NRL allergy diagnosis. In addition, NRL allergy is an excellent model for improving extract-based specific IgE measurement by amplification of NRL extract preparation with stable recombinant major allergen rHev b 5. Despite the many efforts to characterize the occupationally relevant wheat allergens for baker's asthma, the most frequently occurring forms of occupational asthma, the results are highly diverse. Wheat sensitization profiles of bakers showed great interindividual variability and no wheat allergen could be classified as the major allergen. For diagnosis of baker's asthma, a whole wheat extract is still the best option for specific IgE determination. But single wheat allergens might help to discriminate between wheat-induced food allergy, grass pollen allergy and baker's asthma. For workplace-related allergens like coffee, wood, soybean, seafood and moulds allergens are characterized and few of them are available, but their relevance for occupational sensitization routes should be verified in the further studies.
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18
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Abstract
PURPOSE OF REVIEW Numerous clinically relevant allergenic molecules enhance the performance of specific (s) IgE tests and improve the specificity of allergy diagnosis. This review aimed to summarize our current knowledge of the high-molecular-weight allergens involved in the development of occupational asthma and rhinitis and to critically analyze the contribution of component-resolved diagnosis in the management of these conditions. RECENT FINDINGS There is a lack of standardization and validation for most available extracts of occupational agents, and assessment of sIgE reactivity to occupational allergen components has been poorly investigated, with the notable exception of natural rubber latex (NRL) and wheat flour. In the case of NRL, the application of recombinant single allergens and amplification of natural extracts with stable recombinant allergens improved the test sensitivity. IgE-sensitization profile in patients with baker's asthma showed great interindividual variation, and extract-based diagnostic is still recommended. For other occupational allergens, it remains necessary to evaluate the relevance of single allergen molecules for the sensitization induced by occupational exposure. Progress has been made to characterize occupational allergens especially NRL and wheat, although there is still an unmet need to increase the knowledge of occupational allergens, to include standardized tools into routine diagnostic, and to evaluate their usefulness in clinical practice.
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Affiliation(s)
- Monika Raulf
- Institute of Prevention and Occupational Medicine of the German Social accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bochum, Germany.
| | - Santiago Quirce
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ) and CIBER of Respiratory diseases (CIBERES), Madrid, Spain
| | - Olivier Vandenplas
- Centre Hospitalier Universitaire UCL Namur, Department of Chest Medicine, Université Catholique de Louvain, Yvoir, Belgium
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19
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Wiesmüller GA, Heinzow B, Aurbach U, Bergmann KC, Bufe A, Buzina W, Cornely OA, Engelhart S, Fischer G, Gabrio T, Heinz W, Herr CEW, Kleine-Tebbe J, Klimek L, Köberle M, Lichtnecker H, Lob-Corzilius T, Merget R, Mülleneisen N, Nowak D, Rabe U, Raulf M, Seidl HP, Steiß JO, Szewzyk R, Thomas P, Valtanen K, Hurrass J. Kurzfassung der AWMF-Leitlinie medizinisch klinische Diagnostik bei Schimmelpilzexposition in Innenräumen. ALLERGO JOURNAL 2017. [DOI: 10.1007/s15007-017-1382-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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20
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Wiesmüller GA, Heinzow B, Aurbach U, Bergmann KC, Bufe A, Buzina W, Cornely OA, Engelhart S, Fischer G, Gabrio T, Heinz W, Herr CEW, Kleine-Tebbe J, Klimek L, Köberle M, Lichtnecker H, Lob-Corzilius T, Merget R, Mülleneisen N, Nowak D, Rabe U, Raulf M, Seidl HP, Steiß JO, Szewszyk R, Thomas P, Valtanen K, Hurraß J. Abridged version of the AWMF guideline for the medical clinical diagnostics of indoor mould exposure: S2K Guideline of the German Society of Hygiene, Environmental Medicine and Preventive Medicine (GHUP) in collaboration with the German Association of Allergists (AeDA), the German Society of Dermatology (DDG), the German Society for Allergology and Clinical Immunology (DGAKI), the German Society for Occupational and Environmental Medicine (DGAUM), the German Society for Hospital Hygiene (DGKH), the German Society for Pneumology and Respiratory Medicine (DGP), the German Mycological Society (DMykG), the Society for Pediatric Allergology and Environmental Medicine (GPA), the German Federal Association of Pediatric Pneumology (BAPP), and the Austrian Society for Medical Mycology (ÖGMM). ALLERGO JOURNAL INTERNATIONAL 2017; 26:168-193. [PMID: 28804700 PMCID: PMC5533814 DOI: 10.1007/s40629-017-0013-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This article is an abridged version of the AWMF mould guideline "Medical clinical diagnostics of indoor mould exposure" presented in April 2016 by the German Society of Hygiene, Environmental Medicine and Preventive Medicine (Gesellschaft für Hygiene, Umweltmedizin und Präventivmedizin, GHUP), in collaboration with the above-mentioned scientific medical societies, German and Austrian societies, medical associations and experts. Indoor mould growth is a potential health risk, even if a quantitative and/or causal relationship between the occurrence of individual mould species and health problems has yet to be established. Apart from allergic bronchopulmonary aspergillosis (ABPA) and mould-caused mycoses, only sufficient evidence for an association between moisture/mould damage and the following health effects has been established: allergic respiratory disease, asthma (manifestation, progression and exacerbation), allergic rhinitis, hypersensitivity pneumonitis (extrinsic allergic alveolitis), and increased likelihood of respiratory infections/bronchitis. In this context the sensitizing potential of moulds is obviously low compared to other environmental allergens. Recent studies show a comparatively low sensitizing prevalence of 3-10% in the general population across Europe. Limited or suspected evidence for an association exist with respect to mucous membrane irritation and atopic eczema (manifestation, progression and exacerbation). Inadequate or insufficient evidence for an association exist for chronic obstructive pulmonary disease, acute idiopathic pulmonary hemorrhage in children, rheumatism/arthritis, sarcoidosis and cancer. The risk of infection posed by moulds regularly occurring indoors is low for healthy persons; most species are in risk group 1 and a few in risk group 2 (Aspergillus fumigatus, A. flavus) of the German Biological Agents Act (Biostoffverordnung). Only moulds that are potentially able to form toxins can be triggers of toxic reactions. Whether or not toxin formation occurs in individual cases is determined by environmental and growth conditions, above all the substrate. In the case of indoor moisture/mould damage, everyone can be affected by odour effects and/or mood disorders. However, this is not a health hazard. Predisposing factors for odour effects can include genetic and hormonal influences, imprinting, context and adaptation effects. Predisposing factors for mood disorders may include environmental concerns, anxiety, condition, and attribution, as well as various diseases. Risk groups to be protected particularly with regard to an infection risk are persons on immunosuppression according to the classification of the German Commission for Hospital Hygiene and Infection Prevention (Kommission für Krankenhaushygiene und Infektionsprävention, KRINKO) at the Robert Koch- Institute (RKI) and persons with cystic fibrosis (mucoviscidosis); with regard to an allergic risk, persons with cystic fibrosis (mucoviscidosis) and patients with bronchial asthma should be protected. The rational diagnostics include the medical history, physical examination, and conventional allergy diagnostics including provocation tests if necessary; sometimes cellular test systems are indicated. In the case of mould infections the reader is referred to the AWMF guideline "Diagnosis and Therapy of Invasive Aspergillus Infections". With regard to mycotoxins, there are currently no useful and validated test procedures for clinical diagnostics. From a preventive medicine standpoint it is important that indoor mould infestation in relevant dimension cannot be tolerated for precautionary reasons. With regard to evaluating the extent of damage and selecting a remedial procedure, the reader is referred to the revised version of the mould guideline issued by the German Federal Environment Agency (Umweltbundesamt, UBA).
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Affiliation(s)
- Gerhard A. Wiesmüller
- Institute for Occupational Medicine and Social Medicine, University Hospital, Medical Faculty, RWTH Aachen University, Aachen, Germany
- Department of Infection Control and Environmental Hygiene, Cologne Health Authority, Neumarkt 15–21, 50667 Cologne, Germany
| | - Birger Heinzow
- Formerly: Regional Social Security Authorities (LAsD) for Schleswig-Holstein, Kiel, Germany
| | - Ute Aurbach
- Department of Microbiology and Mycology, Dr. Wisplinghoff Laboratory, Cologne, Germany
| | | | - Albrecht Bufe
- Experimental Pneumology, Ruhr University, Bochum, Germany
| | - Walter Buzina
- Institute for Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Oliver A. Cornely
- Department I for Internal Medicine and Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Steffen Engelhart
- Institute for Hygiene and Public Health, Bonn University Hospital, Bonn, Germany
| | - Guido Fischer
- Baden-Württemberg Regional Health Authorities at the Regional Council Stuttgart, Stuttgart, Germany
| | - Thomas Gabrio
- Formerly: Baden-Württemberg Regional Health Authorities at the Regional Council in Stuttgart, Stuttgart, Germany
| | - Werner Heinz
- Medical Clinic and Outpatient Clinic II with Special Focus on Infectiology, Würzburg University Hospital, Würzburg, Germany
| | - Caroline E. W. Herr
- Bavarian Office for Health and Food Safety, Munich, Germany
- Adj. Prof. “Hygiene and Environmental Medicine”, Ludwig-Maximilian University, Munich, Germany
| | | | - Ludger Klimek
- Wiesbaden Centre for Rhinology and Allergology, Wiesbaden, Germany
| | - Martin Köberle
- Clinic and Outpatient Clinic for Dermatology and Allergology am Biederstein, Technical University of Munich, Munich, Germany
| | - Herbert Lichtnecker
- Medical Institute for Environmental and Occupational Medicine MIU GmbH, Erkrath, Germany
| | | | - Rolf Merget
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | | | - Dennis Nowak
- Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, Member of the German Centre for Lung Research, Munich University Hospital, Munich, Germany
| | - Uta Rabe
- Centre for Allergology and Asthma, Johanniter Hospital im Fläming Treuenbrietzen GmbH, Treuenbrietzen, Germany
| | - Monika Raulf
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Hans Peter Seidl
- Formerly: Chair of Microbiology and Clinic and Outpatient Clinic for Dermatology and Allergology am Biederstein, Technical University of Munich, Munich, Germany
| | - Jens-Oliver Steiß
- Centre for Pediatric and Adolescent Medicine, University Hospital Gießen and Marburg GmbH, Gießen, Germany
- Specialist Practice for Allergology and Pediatric Pneumology, Fulda, Germany
| | - Regine Szewszyk
- FG (specialist field) II 1.4 Microbiological Risks, Federal Environmental Agency, Berlin, Germany
| | - Peter Thomas
- Department and Outpatient Clinic for Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany
| | - Kerttu Valtanen
- FG (specialist field) II 1.4 Microbiological Risks, Federal Environmental Agency, Berlin, Germany
| | - Julia Hurraß
- Department of Infection Control and Environmental Hygiene, Cologne Health Authority, Neumarkt 15–21, 50667 Cologne, Germany
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21
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Allergen component analysis as a tool in the diagnosis of occupational allergy. Curr Opin Allergy Clin Immunol 2016; 16:93-100. [PMID: 26866431 DOI: 10.1097/aci.0000000000000246] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
PURPOSE OF REVIEW Rapid developments have been seen in molecular allergy diagnosis, based on the detection and quantification of specific IgE to single allergens. This review summarizes and discusses studies on allergen component analysis as a tool in the diagnosis of occupational allergy. RECENT FINDINGS More than 400 agents are identified as sensitizers of occupational asthma, but only very few are characterized on the molecular level and available for routine diagnosis. Baker's asthma is one of the most frequently occurring forms of occupational asthma caused by workplace-related inhalation of cereal flour mainly wheat. Wheat sensitization profiles of bakers show great interindividual variability and no wheat allergen could be classified as the major allergen. Component-resolved diagnosis is a useful tool for diagnosing natural rubber latex (NRL) allergy. In cases with unexpected high-latex IgE but without clinical symptoms application of crossreactive carbohydrate determinants are helpful to clarify the cause of IgE binding. SUMMARY Latex is an excellent model for component-resolved diagnosis and demonstrates well how to improve the diagnosis by using single allergens. For diagnosis of baker's asthma, a whole wheat extract is still the best option for specific IgE determination, but single wheat allergens might help to discriminate between wheat-induced food allergy, grass-pollen allergy, and baker's asthma. New diagnostic tools and platforms are promising, but further knowledge of molecules relevant for occupational asthma (as in wood dust allergens, enzymes, laboratory animal allergens, etc.) and for occupational hypersensitivity pneumonitis is necessary to improve and standardize the diagnostic tools.
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22
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Hurraß J, Heinzow B, Aurbach U, Bergmann KC, Bufe A, Buzina W, Cornely OA, Engelhart S, Fischer G, Gabrio T, Heinz W, Herr CEW, Kleine-Tebbe J, Klimek L, Köberle M, Lichtnecker H, Lob-Corzilius T, Merget R, Mülleneisen N, Nowak D, Rabe U, Raulf M, Seidl HP, Steiß JO, Szewszyk R, Thomas P, Valtanen K, Wiesmüller GA. Medical diagnostics for indoor mold exposure. Int J Hyg Environ Health 2016; 220:305-328. [PMID: 27986496 DOI: 10.1016/j.ijheh.2016.11.012] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 11/29/2016] [Indexed: 01/24/2023]
Abstract
In April 2016, the German Society of Hygiene, Environmental Medicine and Preventative Medicine (Gesellschaft für Hygiene, Umweltmedizin und Präventivmedizin (GHUP)) together with other scientific medical societies, German and Austrian medical societies, physician unions and experts has provided an AWMF (Association of the Scientific Medical Societies) guideline 'Medical diagnostics for indoor mold exposure'. This guideline shall help physicians to advise and treat patients exposed indoors to mold. Indoor mold growth is a potential health risk, even without a quantitative and/or causal association between the occurrence of individual mold species and health effects. Apart from the allergic bronchopulmonary aspergillosis (ABPA) and the mycoses caused by mold, there is only sufficient evidence for the following associations between moisture/mold damages and different health effects: Allergic respiratory diseases, asthma (manifestation, progression, exacerbation), allergic rhinitis, exogenous allergic alveolitis and respiratory tract infections/bronchitis. In comparison to other environmental allergens, the sensitizing potential of molds is estimated to be low. Recent studies show a prevalence of sensitization of 3-10% in the total population of Europe. The evidence for associations to mucous membrane irritation and atopic eczema (manifestation, progression, exacerbation) is classified as limited or suspected. Inadequate or insufficient evidence for an association is given for COPD, acute idiopathic pulmonary hemorrhage in children, rheumatism/arthritis, sarcoidosis, and cancer. The risk of infections from indoor molds is low for healthy individuals. Only molds that are capable to form toxins can cause intoxications. The environmental and growth conditions and especially the substrate determine whether toxin formation occurs, but indoor air concentrations are always very low. In the case of indoor moisture/mold damages, everyone can be affected by odor effects and/or impairment of well-being. Predisposing factors for odor effects can be given by genetic and hormonal influences, imprinting, context and adaptation effects. Predisposing factors for impairment of well-being are environmental concerns, anxieties, conditioning and attributions as well as a variety of diseases. Risk groups that must be protected are patients with immunosuppression and with mucoviscidosis (cystic fibrosis) with regard to infections and individuals with mucoviscidosis and asthma with regard to allergies. If an association between mold exposure and health effects is suspected, the medical diagnosis includes medical history, physical examination, conventional allergy diagnosis, and if indicated, provocation tests. For the treatment of mold infections, it is referred to the AWMF guidelines for diagnosis and treatment of invasive Aspergillus infections. Regarding mycotoxins, there are currently no validated test methods that could be used in clinical diagnostics. From the perspective of preventive medicine, it is important that mold damages cannot be tolerated in indoor environments.
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Affiliation(s)
- Julia Hurraß
- Abteilung Infektions- und Umwelthygiene, Gesundheitsamt der Stadt Köln, Germany.
| | - Birger Heinzow
- Formerly: Landesamt für soziale Dienste (LAsD) Schleswig-Holstein, Kiel, Germany
| | - Ute Aurbach
- Abteilung Mikrobiologie und Mykologie, Labor Dr. Wisplinghoff, Köln, Germany
| | | | - Albrecht Bufe
- Experimentelle Pneumologie, Ruhr-Universität Bochum, Germany
| | - Walter Buzina
- Institut für Hygiene, Mikrobiologie und Umweltmedizin, Medizinische Universität Graz, Austria
| | - Oliver A Cornely
- Klinik I für Innere Medizin, ZKS Köln und Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Universität zu Köln, Germany
| | - Steffen Engelhart
- Institut für Hygiene und Öffentliche Gesundheit, Universitätsklinikum Bonn, Germany
| | - Guido Fischer
- Landesgesundheitsamt Baden-Württemberg im Regierungspräsidium Stuttgart, Germany
| | - Thomas Gabrio
- Formerly: Landesgesundheitsamt Baden-Württemberg im Regierungspräsidium Stuttgart, Germany
| | - Werner Heinz
- Medizinische Klinik und Poliklinik II, Schwerpunkt Infektiologie, Universitätsklinikum Würzburg, Germany
| | - Caroline E W Herr
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, München, Germany; Ludwig-Maximilians-Universität München, apl. Prof. "Hygiene und Umweltmedizin", Germany
| | | | - Ludger Klimek
- Zentrums für Rhinologie und Allergologie, Wiesbaden, Germany
| | - Martin Köberle
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München, Germany
| | | | | | - Rolf Merget
- Institut für Prävention und Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung, Institut der Ruhr-Universität Bochum (IPA), Germany
| | | | - Dennis Nowak
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Mitglied Deutsches Zentrum für Lungenforschung, Klinikum der Universität München, Germany
| | - Uta Rabe
- Zentrum für Allergologie und Asthma, Johanniter-Krankenhaus im Fläming Treuenbrietzen GmbH, Treuenbrietzen, Germany
| | - Monika Raulf
- Institut für Prävention und Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung, Institut der Ruhr-Universität Bochum (IPA), Germany
| | - Hans Peter Seidl
- Formerly: Lehrstuhl für Mikrobiologie sowie Dermatologische Klinik der Technischen Universität München, Germany
| | - Jens-Oliver Steiß
- Zentrum für Kinderheilkunde und Jugendmedizin, Universitätsklinikum Gießen und Marburg GmbH, Gießen, Germany
| | - Regine Szewszyk
- Umweltbundesamt, FG II 1.4 Mikrobiologische Risiken, Berlin, Germany
| | - Peter Thomas
- Klinik und Poliklinik für Dermatologie und Allergologie der Ludwig-Maximilians-Universität München, Germany
| | - Kerttu Valtanen
- Umweltbundesamt, FG II 1.4 Mikrobiologische Risiken, Berlin, Germany
| | - Gerhard A Wiesmüller
- Abteilung Infektions- und Umwelthygiene, Gesundheitsamt der Stadt Köln, Germany; Institut für Arbeitsmedizin und Sozialmedizin, Medizinische Fakultät der RWTH Aachen, Germany
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