A COMPARISON BETWEEN THE SUMMER AND AUTUMN AIR-SPORAS AT LONDON AND LIVERPOOL

Outdoor Mold and Respiratory Health: State of Science of Epidemiological Studies

BACKGROUND

Fungal spores are the predominant biological particulates in outdoor air. However, in contrast to pollens or outdoor air pollution, little is known about their respiratory health risks.

OBJECTIVES

The objectives were to conduct the first review of epidemiological studies on the short- and long-term effects of outdoor mold exposure on respiratory health in children and adults.

METHODS

Health outcomes included asthma, lung function, and rhinitis. Cross-sectional and longitudinal epidemiological studies using quantitative measures of outdoor mold exposure (optical microscopy, culture-based methods) were selected, providing that important confounding factors including temporal trends or meteorological factors were accounted for. A systematic literature search was performed up to June 2020, leading to the selection of 37 publications.

RESULTS

Most studies were longitudinal and investigated short-term effects. There is evidence of an association between outdoor fungal exposure and an increase in asthma exacerbation among children for total spores, 2 phyla (ascomycetes, basidiomycetes), and 2 taxa (Cladosporium, Alternaria). A few studies also suggested an association for Coprinus, Ganoderma, Aspergillus-Penicillium, Botrytis, and Epicoccum in children, but this needs to be confirmed. Some studies reported mold associations with rhinitis, lung function, and among adults, but these were few in number or inconsistent.

DISCUSSION

Further ecological studies in different regions that measure exposure to all taxa over several years are required to better understand their impact on rhinitis, asthma exacerbations and lung function. Larger panel studies are necessary to identify threshold effects in susceptible individuals. Finally, further research should assess the long-term effects of outdoor mold.

Ingestive and inhalative allergy to the mushroom Boletus edulis

This is the first report on inhalative and ingestive allergy to the common edible mushroom Boletus edulis (Be) (English, edible boletus; German, Steinpilz; French, bolet; Italian, porcino or boleto) belonging to the class Basidiomycetes. Four cases observed in our allergy unit are presented, showing different clinical manifestations of this rare allergy: as an occupational problem or life-threatening anaphylactic reactions after eating Be. In all cases, skin prick-to-prick tests with raw Be were strongly positive: in three cases, specific IgE against Be could be found. The symptoms were reproducible after an inhalation challenge test. It is noteworthy that not only can Basidiomycetes cause airborne allergy but also that edible mushrooms from this class can cause inhalative and intestinal allergy. The two patients with strong anaphylactic reactions demonstrate that Be may have great allergenic potential.

Fungal spore concentrations in the atmosphere at the Anatolia quarter of Istanbul, Turkey

In this research, spore concentrations of Cladosporium, Alternaria, Epicoccum, Botrytis, Leptosphaeria, Polythrincium, ascospores, Aspergillus, Penicillium, basidiospores, uredospores, Ustilago, Torula, Erysiphe, Ganoderma, Hyaline indeterminate and others in the atmosphere have been determined, and comparisons have been made between locations with both low and high spore concentrations. The importance of these air-borne fungal spores which cause allergy and asthma are emphasized in the paper from the viewpoint of human health.

Prevalence of basidiomycete allergy in the USA and Europe and its relationship to allergic respiratory symptoms

A total of 701 adults living in the USA or Western Europe who had symptoms of allergic respiratory disease were skin prick tested with extracts prepared from eight basidiomycetes species and four Fungi Imperfecti species. In these subjects, the presence of asthma, rhinitis, or both was determined by questionnaire. Overall, 178/701 (25.4%) of the participants reacted to at least one basidiomycete extract. There was no difference in the prevalence of reactivity detected in the USA and Europe (P < 0.005); however, the prevalence of reactors in individual centers from both areas varied significantly. Psilocybe cubensis was the most potent allergen source in both the USA (12.3% reacted) and Europe (16.0%). Pleurotus ostreatus was second overall (10.6%) and in the USA (10.7%), and third in Europe (10.3%). Pisolithus tinctorius and Coprinus quadrifidus produced the least potent allergens, with only 5.4% of the population reacting. There was a significant relationship (P < 0.005) between basidiospore reactivity and the presence of atopy, asthma, and asthma and rhinitis. Basidiospore reactivity was not associated with the presence of rhinitis alone (P = 0.312). These results suggest that basidiomycetes are important sources of aeroallergens in geographically disparate regions and may be particularly important in patients with asthma.

Abundance of airborne Penicillium CFU in relation to urbanization in Mexico City

Air was sampled simultaneously at three localities in Mexico City differing in urbanization index and air pollution level on 22 days during a period covering both dry and rainy seasons. An Andersen two-stage microbial sampler was used for 15 min at 28 liters min-1 to isolate culturable fungi on malt extract agar. After exposure, plates were incubated at 25 degrees C for 48 to 72 h before colonies were counted and identified to give concentrations of total fungal spores and of Penicillium spp., expressed as CFU per cubic meter of air. Total fungi numbered 91 to 602 CFU m-3 in Tlalpan Borough (southern area), 40 to 264 CFU m-3 in Cuauhtémoc Borough (downtown), and 26 to 495 CFU m-3 in Gustavo A. Madero Borough (northern area). Although Penicillium spp. were the second most frequently isolated fungal genus, concentrations were small, with a maximum of only 133 CFU m-3. Twice as many colonies were isolated in the southern area, with an urbanization index of 0.25 (arithmetic mean, 41 CFU m-3), as at other sampling stations with greater urbanization indices (arithmetic means, 19 and 20 CFU m-3). In the downtown area, with an urbanization index of 1.0, Penicillium spp. were more numerous than any other genus and formed 25% of the total fungal count compared with 14 and 17% in the other areas. Concentrations of airborne Penicillium spp. did not differ significantly between rainy and dry seasons.(ABSTRACT TRUNCATED AT 250 WORDS)

Basidiomycete allergens: comparison of three Ganoderma species

High atmospheric concentrations of basidiospores occur in various parts of the world. Ganoderma basidiospores are distinctive, easily identifiable in aeroallergen surveys, and widely abundant. Previous studies showed that Ganoderma basidiospores caused respiratory allergies. Thus, we investigated various extracts (spore, cap, and/or mycelial) of G. meredithae, G. lucidum, and G. applanatum for allergen components. Analyses included radioallergosorbent test (RAST) inhibition and IgE blots from isoelectric focusing (IEF) and SDS-PAGE. RAST inhibition with spores and caps of G. meredithae and G. lucidum showed that spores inhibited caps better than caps inhibited spores. Species differences were minor. Coomassie blue (CB) staining of IEF gels detected at least 23 protein bands (pI 3.6-6.6) in caps of G. meredithae and G. lucidum. G. meredithae spore extracts contained 17 of these (pI 3.6-5.0, 6.6). Spores and caps of G. meredithae contained 13 and 11 allergen bands, respectively, on IEF blots. SDS-PAGE of G. meredithae spore and cap showed one and four bands, respectively, by CB staining, but IgE blots showed 13 bands in cap and 17 in spore. Culture mycelia of G. lucidum and G. applanatum attained significant and essentially constant RAST activity by day 4. Activity was also present in culture supernatant by day 4. Blots of mycelium and supernatant detected a single allergen in day-8 mycelia and subsequently six allergen bands in day-16 mycelia and eight in day-16 supernatant (one appeared as a doublet). These data show that Ganoderma extracts contain a complex mixture of allergens. Differences among species were minor; spores and mycelia are apparently better sources of allergens than caps.

Oilseed rape--a new allergen?

Oilseed rape (Brassica napus) is a commonly grown crop in Europe and it has been suggested that its pollen may be a potent new allergen. The prevalence of sensitization in a normal exposed population and an objective study of those patients found to be allergic to the rape pollen is described. The results show a low prevalence of allergy to oilseed rape pollen (less than 0.2%) unless the subjects were occupationally exposed. Those affected, with one exception, were already atopic and allergic to other pollens. The role of volatile materials given off by the plant remains to be elucidated.

Bronchoprovocation studies in basidiospore-sensitive allergic subjects with asthma

Bronchoprovocation challenge with basidiospore extracts was performed in eight subjects with asthma and with positive wheal-and-flare skin reactivity and RAST to basidiospore allergens. Five of the eight patients demonstrated a significant decrease in FEV1 ranging from 20% to 47% after basidiospore-extract challenge. Both immediate and late-phase reactivity was observed. Six atopic control subjects with asthma and with negative skin reactivity to basidiospore extracts did not exhibit significant bronchospasm after basidiospore challenge. These results demonstrate that basidiospore extracts can induce bronchospasm in subjects with asthma who demonstrate IgE antibodies to basidiospore allergens.

Fungal air-borne spores as health risk factors among workers in alimentary industries

A survey to evaluate the occurrence of air-borne fungal spores in two different food industries, dairies and bakeries, was conducted. Our data revealed considerable fungal pollution in the environments of both industries, as well as some differences in the distribution of the genera of fungi recovered. Noteworthy was the frequent finding of numerous fungi frequently responsible for allergic rhinitis, asthma and other diseases, or well-known for their production of mycotoxins in foods or characterized by their degradative activity against various substances. Aspergillus, Candida, Fusarium, Geotrichum, Mucor and Penicillium were the most common genera identified in dairies while Alternaria, Aspergillus, Botrytis, Candida, Cladosporium, Penicillium and Saccharomyces occurred more frequently in bakeries. The survey showed that fungi can play a significant role in allergic and non-allergic diseases in modern working environments.

Grass pollen concentrations in the U.K

A CENSUS of grass pollen concentrations was under taken at 9 sites throughout the U.K. in 1977. Large differences were noted between concentrations on indi vidual days and peak concentrations occurred later at the Northern sites.

City spore concentrations in the European Economic Community (EEC). IV. Summer weed pollen (Rumex, Plantago, Chenopodiaceae, Artemisia), 1976 and 1977

This paper describes observations on the airborne pollen concentrations of four anemophilous weeds of very common occurrence in Western Europe, viz. Rumex spp .(sorrel and dock), Plantago spp. (plantain), Chenopodiaceae (goosefoot family) and Artemisia spp. (mugwort). Comparative results are recorded from London, Leiden, Brussels, Munich and Marseilles for the summers of 1976 and 1977 and this study is one of a series involving international collaboration between workers in cities of the European Economic Community. The literature on the clinical significance of summer weed pollen is reviewed and it is concluded that the pollen of Artemisia is likely to be of importance in areas where the weed is of common occurrence in late summer. The pollen of the other summer weeds is unlikely to be important, but may contribute to the problems of the pollen sensitive patient under exceptional circumstances.

Aerobiological studies based in Derby. II. Simultaneous pollen and spore sampling at eight sites within a 60 km radius

In order to determine whether a sampling site in the centre of Derby, where air sampling had been carried out for five summers, really provided valid aerobiological data for the surrounding area, eight identical volumetric spore traps were operated simultaneously during the summer of 1969 at various sites up to 56 km from Derby. For most pollen and spore types, total numbers and seasonal pattern at all the sampling sites were found to be similar, although a few extreme and unexpected variations were noted. Figures varied somewhat in different types of site, and local effects are emphasized.

Grass pollen content of the air in the Bristol Channel region in 1976

The grass pollen content of the air at four sites bordering the Bristol Channel (at Bristol, Cardiff, Penarth and Penmaen) was studied. The trap at Penmaen was situated at an official climatological station which provided the meteorological data used in the surveys. Although at certain times large differences could be seen between the concentrations of grass pollen at the different sites, overall the findings for the four sites were similar. Changes in the atmospheric pollen concentration related to variations in meteorological conditions. At the peak of the season high concentrations of grass pollen persisted throughout the night.

Seasonal nephrotic syndrome. Description and immunological findings

Three cases are described showing a seasonal exacerbation of their nephrotic syndrome in association with an atopic trait and grass pollen allergy. The first patient has a history of four consecutive seasonal relapses each requiring steroid therapy. Following a course of desensitization injections he has now been free of relapse for 3 consecutive years. The second patient has also had a recurrent steroid-sensitive nephrotic syndrome often associated with the pollen season and allergic rhinitis. In this patient a course of cyclophosphamide has reduced his tendency to relapse. The third patient who has been on continuous prednisone therapy shows a seasonal increase in proteinuria. Serum changes in the first two patients include: a seasonal rise in total and grass pollen specific IgE; the continued presence of grass pollen specific IgG throughout the year but with a reduction during the pollen season in association with a more pronounced fall in the total IgG level; a depression in the C3 level in association with each major relapse; a mild rise in the I-K titre and a positive result in the Clq test for circulating complexes. A renal biopsy performed on the first patient when in relapse showed minor histological changes only and IgG, IgM, IgA, IgD, IgE, C3 and fibrinogen were undetectable by immunofluorescent examination. The probable mechanism for the development of proteinuria in these patients is discussed.