Fungal Allergy: Pattern of sensitization over the past 11 years

Main Article Content

R. Fernández-Soto
E.M. Navarrete-Rodríguez
B.E. Del-Rio-Navarro
J.J. Luis Sienra-Monge
N.A. Meneses-Sánchez
O.J. Saucedo-Ramírez

Keywords

Fungi, Skin test, Alternaria, Aspergillus, Cladosporium, Penicillium

Abstract

Introduction and objectives: Although the prevalence of sensitization to fungi is not precisely known, it can reach 50% in inner cities and has been identified as a risk factor in the development of asthma. Whereas the prevalence of allergic diseases is increasing, it is unclear whether the same occurs with sensitization to fungi.


Patients and methods: A retrospective study was performed at the ‘‘Hospital Infantil de México Federico Gómez’’. From skin tests taken between 2004 and 2015, information was gathered about Alternaria alternata, Aspergillus fumigatus, Candida albicans, Cladosporium herbarum, Mucor mucedo and Penicillium notatum. The participating patients were 2-18 years old, presented some type of allergic condition, and underwent immediate hypersensitivity tests to the fungi herein examined. Descriptive analysis and chi-squared distribution were used.


Results: Of the 8794 patients included in the study, 14% showed a negative result to the entire panel of environmental allergens. The remaining 7565 individuals displayed sensitization to at least one fungus, which most frequently was Aspergillus, with a rate of 16.8%. When the patients were divided into age groups, the same trend was observed. The highest percentage of sensitization (58%) toward at least one type of fungus was found in 2014, and the lowest percentage (49.8%) in 2008.


Conclusion: The rate of sensitization to at least one type of fungus was presently over 50%, higher than that detected in other medical centers in Mexico. This rate was constant over the 11-year study, and Aspergillus exhibited the greatest frequency of sensitization among the patients.

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References

1. Simon-Nobbe B, Denk U, Pöll V, Rid R, Breitenbach M. The spectrum of fungal allergy. Int Arch Allergy Immunol. 2008;145:58-86.

2. Crameri R, Garbani M, Rhyner C, Huitema C. Fungi: the neglected allergenic sources. Allergy. 2014;69:176-85.

3. Mari A, Schneider P, Wally V, Breitenbach M, Simon-Nobbe B. Sensitization to fungi: epidemiology, comparative skin tests, and IgE reactivity of fungal extracts. Clin Exp Allergy. 2003;33:1429-38.

4. Twaroch TE, Curin M, Valenta R, Swoboda I. Mold allergens in respiratory allergy: from structure to therapy. Allergy Asthma Immunol Res. 2015;7:205-20.

5. Fukutomi Y, Taniguchi M. Sensitization to fungal allergens: resolved and unresolved issues. Allergol Int. 2015;64:321-31.

6. Pongracic JA, O’Connor GT, Muilenberg ML, Vaughn B, Gold DR, Kattan M, et al. Differential effects of outdoor versus indoor fungal spores on asthma morbidity in inner-city children. J Allergy Clin Immunol. 2010;125:593-9.

7. Zureik M, Neukirch C, Leynaert B, Liard R, Bousquet J, Neukirch F, et al. Sensitisation to airborne moulds and severity of asthma: cross sectional study from European Community respiratory health survey. BMJ. 2002;325:411-4.

8. Jo EJ, Kim MY, Lee SE, Lee SY, Kim MH, Song WJ, et al. Eosinophilic airway inflammation and airway hyperresponsiveness according to aeroallergen sensitization pattern in patients with lower airway symptoms. Allergy Asthma Immunol Res. 2014;6:39-46.

9. Targonski PV, Persky VW, Ramekrishnan V. Effect of environmental molds on risk of death from asthma during the pollen season. J Allergy Clin Immunol. 1995;95:955-61.

10. Jaakkola MS, Quansah R, Hugg TT, Heikkinen SA, Jaakkola JJ. Association of indoor dampness and molds with rhinitis risk: a systematic review and meta-analysis. J Allergy Clin Immunol. 2013;132:1099-110.

11. Meza-Velazquez MR, Espinosa-Padilla SE, Orozco-Martinez S, Huerta-Lopez Rosales-GMJ. Cambios en la sensibilidad a alergenos intradomiciliarios y extradomiciliarios en la ciudad de México: Estudio de 2 000 ninos ˜ a lo largo de 10 anos. ˜ Alerg Asma Inmunol Pediatr. 1999;8.

12. Bedolla-Barajas M, Hernández-Colin DD. Sensibilización a aeroalergenos en sujetos con rinitis alérgica que viven en la zona metropolitana de Guadalajara México. Rev Alergia Mex. 2010;57:50-6.

13. Bedolla-Barajas M, Hernandez-Colin DD, Sainz-Hernandez J, Morale-Romero J. Sensibilización a alergenos en adultos mexicanos con asma; la experiencia en un hospital escuela. Rev Alergia Mex. 2011;58:133-41.

14. Bedolla-Barajas M, Morales-Romero J, Hernández-Colín DD, Arévalo-Cruz D. Prevalencias de sensibilización a alergenos más comunes en adultos mayores del Occidente de México. Rev Alergia Mex. 2012;59.

15. Larenas-Linnemann DE, Fogelbach GA, Alatorre AM, Cruz AA, Colin DD, Pech JA, et al. Patterns of skin prick test positivity in allergic patients: usefulness of a nationwide SPT chart review. Allergol Immunopathol (Madr). 2011;39:330-6.

16. Rodríguez-Orozco AR, Moreno-Chimal K, Méndez-López TT, Gómez-Alonso C. Prevalencia comparada de sensibilización a géneros de hongos alergénicos en pacientes con alergias respiratorias provenientes de Michoacán y Altos de Jalisco-León Gto., anos ˜ 2004-2006 vs 2007-2009. Rev Mex Micol. 2010;32: 1-9.

17. Larenas-Linnemann DE, Fogelbach GA, Alatorre AM, Cruz AA, Colín DD, Pech JA, et al. Patterns of skin prick test positivity in allergic patients: usefulness of a nationwide SPT chart review. Allergol Immunopathol (Madr). 2011;39:330-6.

18. González-Díaz SN, Arias-Cruz A, Ibarra-Chávez JA, ElizondoVillarreal B, Rivero-Arias DM, Salinas-Díaz MR. Prevalencia de sensibilización a hongos en pacientes con alergia respiratoria. Rev Alerg Mex. 2016;63:143-53.

19. From: Instituto Nacional de Estadística y Geografía México. Available on: http://www.cuentame.inegi.org.mx.

20. Heinzerling L, Mari A, Bergmann KC, Bresciani M, Burbach G, Darsow U, et al. The skin prick test-European standards. Clin Transl Allergy. 2013;3:3. Allergy diagnostic testing: an updated practice parameter. Ann Allergy Asthma Immunol. 2008;100(Suppl 3): S1-148.

21. Moral L, Roig M, Garde J, Alós A, Toral T, Fuentes MJ. Allergen sensitization in children with asthma and rhinitis: marked variations related to age and microgeographical factors. Allergol Immunopathol (Madr). 2008;36:128-33.

22. Burge HA. An update on pollen fungal spore aerobiology. J Allergy Clin Immunol. 2002;110:544-52.

23. Heinzerling LM, Burbach GJ, Edenharter G, Bachert C, BindslevJensen C, Bonini S, Bousquet J, et al. GA(2)LEN skin test study I: GA(2)LEN harmonization of skin prick testing: novel sensitization patterns for inhalant allergens in Europe. Allergy. 2009;64:506-1498.

24. Arbes SJ Jr, Gergen PJ, Elliott L, Zeldin DC. Prevalences of positive skin test responses to 10 common allergens in the US population: results from the third National Health and Nutrition Examination Survey. J Allergy Clin Immunol. 2005;116: 377-83.

25. Li J, Sun B, Huang Y, Lin X, Zhao D, Tan G, et al. A multicentre study assessing the prevalence of sensitizations in patients with asthma and/or rhinitis in China. Allergy. 2009;64: 92-1083.

26. Rönmark E, Bjerg A, Perzanowski M, Platts-Mills T, Lundbäck B. Major increase in allergic sensitization in schoolchildren from 1996 to 2006 in northern Sweden. J Allergy Clin Immunol. 2009;124:357-63.

27. Broadfield E, McKeever TM, Scrivener S, Venn A, Lewis SA, Britton J. Increase in the prevalence of allergen skin sensitization in successive birth cohorts. J Allergy Clin Immunol. 2002;109:969-74.

28. Warm K, Lindberg A, Lundbäck B, Rönmark E. Increase in sensitization to common airborne allergens among adults - two population-based studies 15 years apart. Allergy Asthma Clin Immunol. 2013;9:20.

29. Resúmenes mensuales de Temperaturas y lluvias. Available from: http://smn.cna.gob.mx/es/climatologia/temperaturasy-lluvias/resumenes-mensuales-de-temperaturas-y-lluvias.