Clinic of Respiratory Diseases and Allergy, University Medical Centre, Ljubljana, Slovenia.
Environ Health. 2011 Jan 20;10(1):8. doi: 10.1186/1476-069X-10-8.
There is increasing evidence that exposure to moulds (fungi) may influence the development of sarcoidosis. To assess the influence of the environmental exposure, a study was undertaken to determine the exposure to fungi in homes of subjects with sarcoidosis.
Subjects were patients with clinically established sarcoidosis recruited during the period September 2007 till June 2010. Of these 55 were newly diagnosed and currently under treatment for less than one year, 25 had been treated and had no recurrence and 27 had been treated but had recurrence of the disease. Controls were healthy subjects without any respiratory symptoms (n = 30). Samples of air (about 2.5 m3) were taken in the bedroom of the subjects using a portable pump and cellulose ester filters. The filters were analysed for the content of the enzyme N-acetylhexosaminidase (NAHA) as a marker of fungal cell biomass, using a specific substrate and a fluorescent technique and expressed as NAHA units (U)/m3.
Compared to controls, subjects undergoing treatment of the disease (newly diagnosed or with recurrence) had significantly higher activities of NAHA in their homes than controls (33.6 and 39.9 vs 10.0 U/m3, p < 0.001 and <0.001). Among controls only 5 out of 30 subjects had levels of NAHA above the second quartile value (14 U/m3). In homes of subjects with newly diagnosed disease with treatment less than one year, values above 14 NAHA U/m3 were found among 35 out of 55 and among those with recurrent disease among 18 out of 27.
The higher activities of NAHA enzyme found in homes of subjects with active and recurrent sarcoidosis suggest that exposure to fungi is related to the risk of sarcoidosis. Further environmental studies to assess the importance of this exposure for subjects with sarcoidosis are warranted. The results suggest that remedial actions in homes with high levels of fungi may be justified.
越来越多的证据表明，霉菌（真菌）暴露可能影响结节病的发展。为了评估环境暴露的影响，进行了一项研究，以确定结节病患者家中真菌的暴露情况。
研究对象为 2007 年 9 月至 2010 年 6 月期间临床确诊的结节病患者。其中，55 例为新诊断且目前接受治疗不到 1 年的患者，25 例为已接受治疗且无复发的患者，27 例为已接受治疗但疾病复发的患者。对照组为无任何呼吸道症状的健康受试者（n=30）。使用便携式泵和纤维素酯滤器在受试者的卧室中采集约 2.5 m3 的空气样本。使用特定的底物和荧光技术分析滤器中 N-乙酰己糖胺酶（NAHA）的含量作为真菌细胞生物量的标志物，并表示为 NAHA 单位（U）/m3。
与对照组相比，正在接受疾病治疗（新诊断或复发）的受试者家中的 NAHA 活性明显高于对照组（33.6 和 39.9 与 10.0 U/m3，p<0.001 和 <0.001）。在对照组中，只有 30 名受试者中有 5 名的 NAHA 水平高于第二四分位数值（14 U/m3）。在接受治疗不到 1 年的新发疾病患者家中，55 名患者中有 35 名患者的 NAHA 值高于 14 U/m3，在复发疾病患者中有 27 名患者中有 18 名患者的 NAHA 值高于 14 U/m3。
在活动性和复发性结节病患者家中发现的 NAHA 酶活性较高表明，真菌暴露与结节病的风险有关。需要进一步进行环境研究以评估这种暴露对结节病患者的重要性。结果表明，对真菌含量高的家庭采取补救措施是合理的。
