Rea William J, Didriksen Nancy, Simon Theodore R, Pan Yaqin, Fenyves Ervin J, Griffiths Bertie
Environmental Health Center-Dallas, Dallas, Texas 75231-4262, USA.
Arch Environ Health. 2003 Jul;58(7):399-405. doi: 10.1080/00039896.2003.11879140.
The authors studied 100 patients who had been exposed to toxic molds in their homes. The predominant molds identified were Alternaria, Cladosporium, Aspergillus, Penicillium, Stachybotrys, Curvularia, Basidiomycetes, Myxomycetes, smuts, Epicoccus, Fusarium, Bipolaris, and Rhizopus. A variety of tests were performed on all, or on subgroups of, these patients. Sensitivities and exposures were confirmed in all patients by intradermal skin testing for individual molds (44-98% positive), and by measurement of serum antibodies. Abnormalities in T and B cells, and subsets, were found in more than 80% of the patients. The findings of trichothecene toxin and breakdown products in the urine, serum antibodies to molds, and positive intradermal skin tests confirmed mycotoxin exposure. Respiratory signs (e.g., rhinorrhea, sinus tenderness, wheezing) were found in 64% of all patients, and physical signs and symptoms of neurological dysfunction (e.g., inability to stand on the toes or to walk a straight line with eyes closed, as well as short-term memory loss) were identified in 70% of all patients. Objective abnormal autonomic nervous system tests were positive in all 100 patients tested. Brain scans, conducted using triple-head single photon emission computed tomography, were abnormal in 26 (86%) of 30 (subgroup of the 100) patients tested. Objective neuropsychological evaluations of 46 of the patients who exhibited symptoms of neurological impairment showed typical abnormalities in short-term memory, executive function/judgment, concentration, and hand/eye coordination.
作者研究了100名在家中接触过有毒霉菌的患者。鉴定出的主要霉菌有链格孢属、枝孢属、曲霉属、青霉属、葡萄穗霉属、弯孢属、担子菌纲、黏菌纲、黑粉菌、埃皮球菌属、镰刀菌属、离蠕孢属和根霉属。对所有这些患者或其中的亚组进行了各种测试。通过对单个霉菌进行皮内皮肤测试(阳性率为44%-98%)以及测量血清抗体,证实了所有患者的敏感性和接触情况。80%以上的患者发现T细胞和B细胞及其亚群存在异常。尿液中玉米赤霉烯酮毒素及其分解产物、霉菌血清抗体以及皮内皮肤测试呈阳性的结果证实了霉菌毒素暴露。64%的患者出现呼吸道症状(如鼻溢、鼻窦压痛、喘息),70%的患者出现神经功能障碍的体征和症状(如无法用脚尖站立或闭眼走直线,以及短期记忆丧失)。在接受测试的所有100名患者中,自主神经系统客观测试均呈阳性。在接受测试的30名患者(100名患者中的亚组)中,26名(86%)使用三头单光子发射计算机断层扫描进行的脑部扫描结果异常。对46名出现神经功能损害症状的患者进行的客观神经心理学评估显示,在短期记忆、执行功能/判断力、注意力以及手/眼协调方面存在典型异常。