Allergy Asthma Immunol Res.  2015 May;7(3):205-220. 10.4168/aair.2015.7.3.205.

Mold Allergens in Respiratory Allergy: From Structure to Therapy

• Twaroch TE
• Curin M
• Valenta R
• Swoboda I

• KMID: 2260457
• DOI: http://doi.org/10.4168/aair.2015.7.3.205

Abstract

Allergic reactions to fungi were described 300 years ago, but the importance of allergy to fungi has been underestimated for a long time. Allergens from fungi mainly cause respiratory and skin symptoms in sensitized patients. In this review, we will focus on fungi and fungal allergens involved in respiratory forms of allergy, such as allergic rhinitis and asthma. Fungi can act as indoor and outdoor respiratory allergen sources, and depending on climate conditions, the rates of sensitization in individuals attending allergy clinics range from 5% to 20%. Due to the poor quality of natural fungal allergen extracts, diagnosis of fungal allergy is hampered, and allergen-specific immunotherapy is rarely given. Several factors are responsible for the poor quality of natural fungal extracts, among which the influence of culture conditions on allergen contents. However, molecular cloning techniques have allowed us to isolate DNAs coding for fungal allergens and to produce a continuously growing panel of recombinant allergens for the diagnosis of fungal allergy. Moreover, technologies are now available for the preparation of recombinant and synthetic fungal allergen derivatives which can be used to develop safe vaccines for the treatment of fungal allergy.

Keyword

Fungal allergy; allergen structure; specific immunotherapy; recombinant allergens

MeSH Terms

Allergens*
Asthma
Climate
Clinical Coding
Cloning, Molecular
Diagnosis
DNA
Fungi*
Humans
Hypersensitivity*
Immunotherapy
Rhinitis
Skin
Vaccines
Allergens
DNA
Vaccines

Figure

• 

  Fig. 1 Seasonal variations influence the number of spores in the atmosphere. The climatic conditions in summer and autumn favour the growth of certain fungal species and the dispersal of spores. Exceptional high concentrations of spores from the species Alternaria and Cladosporium as well as from species of the phylum Basidiomycota can be found from June to October (modified after Lacey J, 1996).

• 

  Fig. 2 Geographical distribution of fungal allergy. Fungal allergy represents a worldwide health problem. The world map highlights in yellow all countries in which sensitization to fungi has been described.

• 

  Fig. 3 Fungal species as a source of type I allergy. The taxonomical tree includes all allergen producing fungal species that have been approved by the I.U.I.S. Allergen Nomenclature Sub-committee (http://www.allergen.org).

• 

  Fig. 4 Fungal spore seasons overlap with grass and weed pollen seasons. Diagnosis of fungal allergy is complicated by the fact that mould allergic patients are often polysensitized. Exacerbated allergic symptoms in summer and autumn might be due to fungal allergy, but can also arise from allergy to grasses and weeds like mugwort (Artemisia), ragweed (Ambrosia) or Parietaria. The intensity of allergen exposure to grasses, weeds and moulds is displayed in red for high exposure, orange for intermediate exposure and yellow for low exposure.

• 

  Fig. 5 Influence of strain variabilities and growth conditions on the presence of IgE binding proteins in extracts of Alternaria alternata. Four Alternaria strains, achieved by the Centraalbureau voor Schimmelcultures (CBS 103.33, CBS 795.72) and the American Type Culture Collection (ATCC 46582 and ATCC 96154) were grown on 3 different media (C, Czapek Dox agar; ME, Malt Extract agar; S, Sabauroud agar) for 2 or 4 weeks respectively. Protein extracts of the fungi were subjected to SDS-PAGE, blotted onto nitrocellulose membranes and incubated with the serum of an Alternaria-sensitized patient. Bound IgE antibodies were detected with 125I-labelled anti-human IgE antibodies and visualized by autoradiography

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