Abel-Fernández Eva, Martínez María José, Galán Tania, Pineda Fernando
Applied Science, Inmunotek S.L., Parque Científico Tecnológico Alcalá de Henares, 28805 Madrid, Spain.
J Fungi (Basel). 2023 May 18;9(5):582. doi: 10.3390/jof9050582.
Fungal allergy is the third most frequent cause of respiratory pathologies and the most related to a poor prognosis of asthma. The genera and are the most frequently associated with allergic respiratory diseases, with being the one with the highest prevalence of sensitization. is an outdoor fungus whose spores disseminate in warm and dry air, reaching peak levels in temperate summers. can also be found in damp and insufficiently ventilated houses, causing what is known as sick building syndrome. Thus, exposure to fungal allergens can occur outdoors and indoors. However, not only spores but also fungal fragments contain detectable amounts of allergens and may function as aeroallergenic sources. Allergenic extracts of hyphae and spores are still in use for the diagnosis and treatment of allergic diseases but are variable and insufficiently standardised, as they are often a random mixture of allergenic ingredients and casual impurities. Thus, diagnosis of fungal allergy has been difficult, and knowledge about new fungal allergens is stuck. The number of allergens described in Fungi remains almost constant while new allergens are being found in the Plantae and Animalia kingdoms. Given Alt a 1 is not the unique allergen eliciting allergy symptoms, component-resolved diagnosis strategies should be applied to diagnose fungal allergy. To date, twelve allergens are accepted in the WHO/IUIS Allergen Nomenclature Subcommittee, many of them are enzymes: Alt a 4 (disulfide isomerase), Alt a 6 (enolase), Alt a 8 (mannitol de-hydrogenase), Alt a 10 (aldehyde dehydrogenase), Alt a 13 (glutathione-S-transferase) and Alt a MnSOD (Mn superoxide dismutase), and others have structural and regulatory functions such as Alt a 5 and Alt a 12, Alt a 3, Alt a 7. The function of Alt a 1 and Alt a 9 remains unknown. Other four allergens are included in other medical databases (e.g., Allergome): Alt a NTF2, Alt a TCTP, and Alt a 70 kDa. Despite Alt a 1 being the major allergen, other allergens, such as enolase, Alt a 6 or MnSOD, Alt a 14 have been suggested to be included in the diagnosis panel of fungal allergy.
真菌过敏是呼吸道疾病的第三大常见病因,也是与哮喘预后不良关联最大的病因。曲霉属和青霉属是最常与过敏性呼吸道疾病相关的属,其中曲霉属致敏率最高。曲霉是一种室外真菌,其孢子在温暖干燥的空气中传播,在温带夏季达到峰值水平。曲霉也可在潮湿且通风不足的房屋中发现,引发所谓的“病态建筑综合征”。因此,接触真菌过敏原可发生在室外和室内。然而,不仅孢子,真菌碎片也含有可检测到的过敏原,可能成为空气传播过敏原的来源。烟曲霉的菌丝和孢子的变应原提取物仍用于过敏性疾病的诊断和治疗,但由于它们往往是变应原成分和偶然杂质的随机混合物,所以具有变异性且标准化不足。因此,真菌过敏的诊断一直很困难,关于新型真菌过敏原的知识也停滞不前。在真菌中描述的过敏原数量几乎保持不变,而在植物界和动物界却不断发现新的过敏原。鉴于Alt a 1并非引发过敏症状的唯一烟曲霉过敏原,应采用组分分辨诊断策略来诊断真菌过敏。迄今为止,世界卫生组织/国际免疫学会变应原命名小组委员会认可了12种烟曲霉过敏原,其中许多是酶:Alt a 4(二硫键异构酶)、Alt a 6(烯醇酶)、Alt a 8(甘露醇脱氢酶)、Alt a 10(醛脱氢酶)、Alt a 13(谷胱甘肽-S-转移酶)和Alt a MnSOD(锰超氧化物歧化酶),其他一些具有结构和调节功能,如Alt a 5和Alt a 12、Alt a 3、Alt a 7。Alt a 1和Alt a 9的功能尚不清楚。其他四种过敏原包含在其他医学数据库(如Allergome)中:Alt a NTF2、Alt a TCTP和Alt a 70 kDa。尽管Alt a 1是主要过敏原,但其他过敏原,如烯醇酶(Alt a 6)或锰超氧化物歧化酶(Alt a 14),也被建议纳入真菌过敏的诊断指标中。