Licorish K, Novey H S, Kozak P, Fairshter R D, Wilson A F
J Allergy Clin Immunol. 1985 Dec;76(6):819-25. doi: 10.1016/0091-6749(85)90755-9.
The ability to harvest spore-rich isolates of molds permitted quantitative studies of their role in the pathogenesis of asthma. Alternaria and Penicillium were selected as examples of ubiquitous molds that readily induce IgE antibodies and are of contrasting sizes. Extracts from those spores were prepared for skin tests and aerosol bronchial challenges. Intact spores were used in the same subjects in bronchial challenges delivered by a Spinhaler. Seven patients with a history of mild asthma received a total of 16 bronchial challenges with the mold to which they had been sensitized. Provocative doses in spore equivalents for a 35% drop in SGaw, 20% drop in FEV1, or 25% drop in PEFR were sought for each challenge. Density dependence-flow rates were also determined. Environmental spore survey data were obtained and compared with the challenge doses for these spores. It was found that immediate-type asthma was readily provoked by both whole spores and by their extracts, in some subjects fewer intact than extracted spores were required, delayed-type asthma occurred only after whole spore challenges, SGaw was the most sensitive and equally specific of the pulmonary function tests, and provocative doses of spore equivalents were within natural exposure ranges. The study confirmed that Alternaria and Penicillium spores in relatively natural states and numbers were potent immunopathogens for asthma.
获取富含孢子的霉菌分离株的能力使得对其在哮喘发病机制中的作用进行定量研究成为可能。链格孢属和青霉属被选为常见霉菌的例子，它们很容易诱导产生IgE抗体，且大小不同。制备这些孢子的提取物用于皮肤试验和气雾剂支气管激发试验。在支气管激发试验中，完整的孢子被用于同一受试者，通过Spinhaler进行给药。7名有轻度哮喘病史的患者共接受了16次针对其已致敏霉菌的支气管激发试验。每次激发试验都要寻找能使比气道传导率（SGaw）下降35%、第一秒用力呼气容积（FEV1）下降20%或呼气峰值流速（PEFR）下降25%的以孢子当量计的激发剂量。还测定了密度依赖性流速。获取环境孢子调查数据并与这些孢子的激发剂量进行比较。结果发现，全孢子及其提取物都很容易诱发速发型哮喘，在一些受试者中，诱发速发型哮喘所需的完整孢子比提取物少；迟发型哮喘仅在全孢子激发试验后出现；SGaw是肺功能测试中最敏感且同样具有特异性的指标；以孢子当量计的激发剂量在自然暴露范围内。该研究证实，处于相对自然状态和数量的链格孢属和青霉属孢子是哮喘的强效免疫病原体。
