Airborne Fungal Diseases
Molds reproduce by releasing spores into the air. The main route of entry of mold spores is through respiration of dust particles contaminated with the fungi. The ubiquitous presence of fungi in both indoor and outdoor environments is a potential health threat that is poorly understood and almost ignored in community medicine.
Many species of fungi around the home grow on food and other organic materials such as damp paper, textiles and wood. Fungi produce allergens, enzymatic proteins, toxins and volatile organic compounds that cause respiratory disease. Various strains of airborne molds have been implicated as the cause of asthma and hypersensitivity pneumonitis. Chronic nose and sinus inflammation have been linked to airborne fungi. Shin et al, for example, demonstrated immune responses to Alternaria by finding elevated levels of IL-5 and IL-13.
Green et al suggested that 100 genera of fungal conidia are currently recognized as sources of allergens, but the real number of fungal allergens is much greater: different components of fungal growth such as fungal hyphae and fragmented conidia are airborne and may become allergenic. Most wild species are not detected by standard culture techniques. In addition, inhaled spores of pathogenic fungi grow in the lung and other organs, establishing chronic and sometimes lethal infections that are difficult to diagnose. There is an overlap of allergic hypersensitivity diseases with infection caused by the fungi that infect by spore inhalation.
Fungi produce toxins that are released into the air. Bünger et al studied five toxigenic airborne moulds of the genera Aspergillus and Penicillium collected at composting plants: sterigmatocystin, fumagillin, verruculogen, penitrem A, and roquefortine C. All five extracts caused toxic effects to cultured cells. They suggested that mycotoxins may be involved in producing the lung diseases from the inhalation of organic dust. Panaccione and Coyle reported finding ergot alkaloids associated with Aspergillus fumigatus. Ergot molds produce an array of potent chemicals. The hallucinogen, LSD, was derived from ergot alkaloids.
Kodama and McGee found sixteen types of indoor airborne fungi. The main species belong to the families: Aspergillus, Penicillium, Cladosporium, Mucor, Stachybotrys, Absidia, Alternaria, Fusarium and Cryptostroma. The greatest health risks are Candida, Aspergillus, Histoplasma and Penicillium. The two most prevalent fungal infections in hospitals are caused by Candida and Aspergillus species. These organisms can occur naturally in the exterior environment and enter as spores or active fungi attached to dust particles.
Rainer J; Peintner U; Pöder R. Biodiversity and concentration of airborne fungi in a hospital environment. Mycopathologia. 2001; 149(2):87-97 (ISSN: 0301-486X)
Augustowska M; Dutkiewicz J. Variability of airborne microflora in a hospital ward within a period of one year . Variability of airborne microflora in a hospital ward within a period of one year.Ann Agric Environ Med. 2006; 13(1):99-106 (ISSN: 1232-1966)
Shelton BG; Kirkland KH; Flanders WD; Morris GK. Profiles of airborne fungi in buildings and outdoor environments in the United States. Appl Environ Microbiol. 2002; 68(4):1743-53 (ISSN: 0099-2240)
Shin SH et al /Chronic rhinosinusitis: an enhanced immune response to ubiquitous airborne fungi. J Allergy Clin Immunol. 2004; 114(6):1369-75 (ISSN: 0091-6749)
Bünger J et al. Cytotoxicity of occupationally and environmentally relevant mycotoxins. Toxicology. 2004; 202(3):199-211 (ISSN: 0300-483X)
Panaccione DG; Coyle CM Abundant respirable ergot alkaloids from the common airborne fungus Aspergillus fumigatus. Appl Environ Microbiol. 2005; 71(6):3106-11
Anthony Montanaro. The Impact of Environmental Molds in the Home 60th Annual Meeting of the American College of Allergy, Asthma and Immunology Medscape Allergy & Clinical Immunology, Nov 2002
Geiser M. et al Interaction of fungal spores with the lungs: distribution and retention of inhaled puffball (Calvatia excipuliformis) spores. J Allergy Clin Immunol. 2000; 106(1 Pt 1):92-100
A profusion of fungi exists in the environment. Some fungi are able to cause an invasive infection in otherwise healthy individuals. Other fungi are opportunistic fungi that become invasive when immune defenses are compromised. Diagnosis of fungal infection is difficult. There are many problems when you try to connect a test result to a disease. Fungi are so abundant and there are so many varieties in every environment that it is seldom easy to pick just one cause among many. Fungi are inhaled and ingested. Foods always contain fungal spores and actively growing molds. Attempts to culture fungi often fail; only a small number grow in the culture media commonly used. Some new methods of detecting fungal DNA may be useful but development of reliable tests is slow and expensive.
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