Environmental Health Center-Dallas, Dallas, Texas.
Clin Ther. 2018 Jun;40(6):889-893. doi: 10.1016/j.clinthera.2018.05.003. Epub 2018 May 31.
The goal of this study was to present the results of treatment of 100 chemically sensitive and chronically mold-exposed patients, who continued to be disabled even after decontamination of their houses or work places or they were physically removed from their sources of mold.
Molds were identified, serum anti-mold immunoglobulin G antibodies were measured, patients were skin-tested, immunologic abnormalities were recorded, and objective neurologic tests were performed in a subset of patients.
Patient sensitivities and exposures were confirmed by measuring serum immunoglobulin G anti-mold antibodies, intradermal skin testing, and trichothecene toxin breakdown products in the urine. Patients were positive (44%-98%) for individual molds. Abnormalities in T and B cells were found in >80% of patients. Respiratory signs were present in 64% of all patients, and physical signs and symptoms of neurologic dysfunction were present in 70%. Objective autonomic nervous system test results were abnormal in almost 100% of patients tested. Objective neuropsychological evaluations were conducted in 46 of the patients who exhibited symptoms of neurologic impairment and showed typical abnormalities in short-term memory, executive function/judgment, concentration, and hand/eye coordination. Patients (N = 100) with documented mold exposure were divided into 3 groups: (1) those who improved easily, with mold avoidance and antigen injections; (2) those who improved after desensitization to their mold antigens plus additional mycotoxin antigens; and (3) those who had their regular mold antigens, additional mycotoxin antigens, along with regimens that included sauna, oxygen therapy, and nutrients. Approximately 85% of all patients cleared completely; 14% had partial improvement, and 1% remained unchanged.
Exposure to molds has been increasingly recognized as a major reason for patients presenting with multiple organ symptoms that could not otherwise be explained. Early diagnosis and appropriate treatment could be very successful.
本研究旨在介绍 100 例对化学物质敏感且长期暴露于霉菌环境的患者的治疗结果。这些患者即使在房屋或工作场所的污染得到清除，或远离霉菌污染源后，仍持续出现残疾。
鉴定霉菌，测量血清抗霉菌免疫球蛋白 G 抗体，对患者进行皮肤测试，记录免疫异常，并在部分患者中进行客观神经学测试。
通过测量血清免疫球蛋白 G 抗霉菌抗体、皮内皮肤测试和尿中三烯毒素分解产物，证实了患者的敏感性和暴露情况。患者对个别霉菌呈阳性（44%-98%）。>80%的患者存在 T 细胞和 B 细胞异常。64%的所有患者存在呼吸道体征，70%的患者存在身体体征和神经功能障碍症状。几乎所有接受测试的患者的自主神经系统测试结果均异常。对表现出神经损伤症状的 46 例患者进行了客观神经心理学评估，这些患者表现出典型的短期记忆、执行功能/判断、注意力和手眼协调能力异常。将有记录的霉菌暴露的患者分为 3 组：（1）避免接触霉菌和注射抗原后很容易改善的患者；（2）对霉菌抗原进行脱敏治疗后再加上其他霉菌毒素抗原治疗后改善的患者；（3）常规使用霉菌抗原、其他霉菌毒素抗原，并加上桑拿、氧气治疗和营养物治疗的患者。大约 85%的患者完全缓解；14%的患者部分改善，1%的患者无变化。
对霉菌的暴露已被越来越多地认为是导致出现多种器官症状的主要原因，这些症状无法用其他方式解释。早期诊断和适当的治疗可能非常成功。
