Mixed mold mycotoxicosis: immunological changes in humans following

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1: Arch Environ Health. 2003 Jul;58(7):410-20.

Mixed mold mycotoxicosis: immunological changes in humans following

exposure in water-damaged buildings.

Gray MR, Thrasher JD, Crago R, Madison RA, Arnold L, AW,

Vojdani A.

Progressive Healthcare Group, Benson, Arizona, USA.

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The study described was part of a larger multicenter investigation

of patients with multiple health complaints attributable to

confirmed exposure to mixed-molds infestation in water-damaged

buildings. The authors present data on symptoms; clinical

chemistries; abnormalities in pulmonary function; alterations in T,

B, and natural killer (NK) cells; the presence of autoantibodies

(i.e., antinuclear autoantibodies [ANA], autoantibodies against

smooth muscle [ASM], and autoantibodies against central nervous

system [CNS] and peripheral nervous system [PNS] myelins). A total

of 209 adults, 42.7 +/- 16 yr of age (mean +/- standard deviation),

were examined and tested with (a) self-administered weighted health

history and symptom questionnaires; ( standardized physical

examinations; © complete blood counts and blood and urine

chemistries; (d) urine and fecal cultures; (e) thyroid function

tests (T4, free T3); (f) pulmonary function tests (forced vital

capacity [FVC], forced expiratory volume in 1 sec [FEV1.0], and

forced expiratory flow at 25%, 50%, 75%, and 25-75% of FVC [FEF25,

FEF50, FEF75, and FEF2(25-75)]); (g) peripheral lymphocyte

phenotypes (T, B, and NK cells) and mitogenesis determinations; and

(h) a 13-item autoimmune panel. The molds-exposed patients reported

a greater frequency and intensity of symptoms, particularly

neurological and inflammatory symptoms, when compared with controls.

The percentages of exposed individuals with increased lymphocyte

phenotypes were: B cells (CD20+), 75.6%; CD5+CD25+, 68.9%;

CD3+CD26+, 91.2%; CD8+HLR-DR+, 62%; and CD8+CD38+, 56.6%; whereas

other phenotypes were decreased: CD8+CD11b+, 15.6% and CD3-

CD16+CD56+, 38.5%. Mitogenesis to phytohemagglutinin was decreased

in 26.2% of the exposed patients, but only 5.9% had decreased

response to concanavalin A. Abnormally high levels of ANA, ASM, and

CNS myelin (immunoglobulins [ig]G, IgM, IgA) and PNS myelin (IgG,

IgM, IgA) were found; odds ratios for each were significant at 95%

confidence intervals, showing an increased risk for autoimmunity.

The authors conclude that exposure to mixed molds and their

associated mycotoxins in water-damaged buildings leads to multiple

health problems involving the CNS and the immune system, in addition

to pulmonary effects and allergies. Mold exposure also initiates

inflammatory processes. The authors propose the term \ " mixed mold

mycotoxicosis\ " for the multisystem illness observed in these

patients.