Ogawa Haruhiko, Fujimura Masaki, Takeuchi Yasuo, Makimura Kouichi, Satoh Kazuo
Division of Pulmonary Medicine, Ishikawa-ken Saiseikai Kanazawa Hospital Kanazawa, Japan.
Med Mycol J. 2011;52(3):205-12. doi: 10.3314/mmj.52.205.
The aim of the present study was to clarify the influence of sensitization to Bjerkandera adusta (B. adusta) on the clinical manifestation in patients with fungus-associated chronic cough (FACC).
Seventeen patients with FACC who underwent bronchoprovocation tests using an antigenic solution of B. adusta were selected from among 21 FACC patients. We compared the allergological findings and clinical characteristics of the FACC patients who showed a positive reaction to the bronchoprovocation test (Allergic fungal cough sensitized to B. adusta; AFC-Bj) with the remaining FACC patients (non AFC-Bj) retrospectively.
The eleven patients with AFC-Bj had a median age of 52 (range, 22-70) years, and 45.5% were female. The respective values for six patients with non AFC-Bj were 47.5 (range, 36-60) years of age, and 33.3% were female. The positive ratios for an immediate cutaneous reaction (45.5%; p<0.05) and the lymphocyte stimulation test (63.6%; p<0.05) to B. adusta were found to be significantly higher in the AFC-Bj group than in the non AFC-Bj group. The total time required for complete remission of cough symptoms was longer (median 20, range 12-43 weeks; p=0.0009), and the recurrence ratio of coughing was more frequent in the AFC-Bj group in comparison to those in non AFC-Bj group (2, range 1-3 times and 0.5, range 0-1 times, respectively).
This study demonstrated that B. adusta, a basidiomycetous is an environmental fungus attracting attention because of its possible role in enhancing the cough severity of FACC patients via the sensitization to this fungus.
本研究旨在阐明对烟管菌（Bjerkandera adusta，B. adusta）致敏对真菌相关性慢性咳嗽（FACC）患者临床表现的影响。
从21例FACC患者中选取17例接受了使用烟管菌抗原溶液进行支气管激发试验的患者。我们回顾性比较了支气管激发试验呈阳性反应的FACC患者（对烟管菌致敏的变应性真菌性咳嗽；AFC-Bj）与其余FACC患者（非AFC-Bj）的变应性学检查结果和临床特征。
11例AFC-Bj患者的中位年龄为52岁（范围22-70岁），女性占45.5%。6例非AFC-Bj患者的相应数值分别为47.5岁（范围36-60岁），女性占33.3%。发现AFC-Bj组对烟管菌的即刻皮肤反应阳性率（45.5%；p<0.05）和淋巴细胞刺激试验阳性率（63.6%；p<0.05）显著高于非AFC-Bj组。AFC-Bj组咳嗽症状完全缓解所需的总时间更长（中位时间20周，范围12-43周；p=0.0009），且与非AFC-Bj组相比，AFC-Bj组咳嗽复发率更高（分别为2次，范围1-3次和0.5次，范围0-1次）。
本研究表明，担子菌纲的烟管菌是一种环境真菌，因其可能通过使FACC患者对该真菌致敏而加重咳嗽严重程度，从而受到关注。
