Laboratory of Space and Environmental Medicine, Graduate School of Medicine, Teikyo University, Tokyo, 173-8605, Japan.
Mycopathologia. 2013 Dec;176(5-6):337-43. doi: 10.1007/s11046-013-9711-7. Epub 2013 Oct 25.
Chronic cough is a common symptom at outpatient care. An uncontrollable cough with difficulty in treatment is called chronic idiopathic cough. Recent reports have demonstrated that the presence of basidiomycetous fungi in sputum is an important clinical finding that assists in clarifying the cause of chronic cough in some cases. Research has suggested that Bjerkandera adusta is related to fungus-associated chronic cough (FACC). FACC is defined as a chronic cough associated with basidiomycetous fungi found in induced sputum and can be treated with antifungal medication. B. adusta is one of the basidiomycetous fungi that exist in cosmopolitan environments. The aim of this study was to develop a B. adusta detection method using polymerase chain reaction (PCR) with a specific primer set and to research the incidence of B. adusta in FACC. The new method successfully detected B. adusta from FACC patients. The incidence of B. adusta in FACC was 42.86 %. Antifungal drugs were effective in most cases. Significant differences in treatment duration between B. adusta patients and non-B. adusta patients were observed. It is therefore suggested that the presence of B. adusta may be one of the allergic intractable factors of chronic cough. This finding may provide identifiable differences in clinical manifestations between B. adusta and non-B. adusta in FACC and lead to possible differing remedies to treat the two forms. PCR can specifically detect B. adusta from patients suffering from chronic cough and provides a new diagnosis for FACC associated with B. adusta.
慢性咳嗽是门诊患者常见的症状。一种无法控制、治疗困难的咳嗽称为慢性特发性咳嗽。最近的报告表明，痰中存在担子菌真菌是协助明确某些情况下慢性咳嗽病因的重要临床发现。研究表明，双极海茨木霉与真菌相关的慢性咳嗽（FACC）有关。FACC 被定义为一种与在诱导痰中发现的担子菌真菌相关的慢性咳嗽，可以用抗真菌药物治疗。双极海茨木霉是存在于世界性环境中的担子菌真菌之一。本研究旨在开发一种使用特定引物对聚合酶链反应（PCR）检测双极海茨木霉的方法，并研究 FACC 中双极海茨木霉的发生率。该新方法成功地从 FACC 患者中检测到了双极海茨木霉。FACC 中双极海茨木霉的发生率为 42.86%。大多数情况下，抗真菌药物是有效的。双极海茨木霉患者和非双极海茨木霉患者的治疗持续时间存在显著差异。因此，双极海茨木霉的存在可能是慢性咳嗽过敏难治因素之一。这一发现可能为 FACC 中双极海茨木霉和非双极海茨木霉的临床表现提供可识别的差异，并为两种形式的治疗提供可能不同的方法。PCR 可以从患有慢性咳嗽的患者中特异性地检测到双极海茨木霉，为 FACC 提供了一种新的诊断方法。
