Portnoy Jay M, Barnes Charles S, Kennedy Kevin
Section of Allergy, Asthma, and Immunology, Children's Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO 64108, USA.
Curr Allergy Asthma Rep. 2008 Mar;8(1):71-8. doi: 10.1007/s11882-008-0013-y.
Fungal exposure is hypothesized (controversially) to contribute to asthma development and to trigger symptoms in patients with asthma. The ubiquity of environmental fungal exposure makes a careful review of evidence essential. Evidence that exposure to high concentrations of fungal spores, antigens, or metabolites is associated with asthma development is limited. However, because mechanisms of asthma genesis are poorly understood, so too are the mechanisms of this potential association. This association is not proof of causality. Stronger evidence supports the hypothesis that fungal exposure triggers symptoms in asthmatic individuals. Proposed mechanisms have been tested and correlations between exposure and symptoms demonstrated. Though some correlations remain speculative, controlled studies could test such hypotheses. Because asthma is common and fungal exposure is ubiquitous, it is surprising that asthmatics don't have more symptoms when exposed to fungi. Fortunately, symptoms are dose dependent, creating an opportunity to develop clinically effective interventions. Given the right guidance, even patients with severe asthma can create healthy indoor environments.
(存在争议地)据推测,接触真菌会促使哮喘发病,并引发哮喘患者的症状。由于环境中普遍存在真菌接触情况,因此仔细审查相关证据至关重要。接触高浓度真菌孢子、抗原或代谢产物与哮喘发病相关的证据有限。然而,由于哮喘发病机制尚不清楚,这种潜在关联的机制也同样不明。这种关联并非因果关系的证据。有更强的证据支持这样的假说,即接触真菌会引发哮喘患者的症状。已对提出的机制进行了测试,并证实了接触与症状之间的相关性。尽管有些相关性仍属推测,但对照研究可以检验此类假说。由于哮喘很常见,且真菌接触无处不在,令人惊讶的是哮喘患者接触真菌时并未出现更多症状。幸运的是,症状具有剂量依赖性,这为开发临床有效的干预措施创造了机会。在正确的指导下,即使是重度哮喘患者也能营造健康的室内环境。