Alternaria and asthma

[Guest guest]

There is an interesting article about the common mold Alternaria and its

association with asthma at:

http://www.aaaai.org/aadmc/currentliterature/selectedarticles/1998archive/altern\

aria.html

6/15/98

Alternaria sensitivity as a risk factor in asthma

Summary

It has been recognized increasingly in recent years that respiratory infections

may trigger flare-ups of childhood asthma but that allergies to airborne agents,

particularly indoor allergens such as dust

mites,roaches and proteins from pets play a major predisposing role in the

asthma of many children. In the current report, Platts-Mills and colleagues

describe an increased frequency of sensitization to

alternaria, an airborne mold, in the asthmatics in 2 geographic regions with

quite different weather characteristics (Charlottesville,VA and Los Alamos, NM).

However, such increased frequency of alternaria sensitization was not seen in

asthmatics in some other regions investigated, such as Atlanta. The authors

concluded that sensitivity to alternaria is an independent risk factor for

asthma in some locations within the USA.

Reference

J. Allergy Clin. Immunol 1998;101:620-32

Editor's Comments

The findings reported here are of considerable interest and potential

importance. Alternaria has been considered one of the most important mold (from

the standpoint of inhalant allergies) in many regions of the USA. Like most

airborne molds, the source of alternaria is outdoors, then entering dwellings

through open windows and doors. Most investigators have felt that alternaria

(like many other molds)

proliferate best in a humid environment, as do dust mites. Thus, the general

recommendation is to maintain a relative humidity of < 50% at all times,

sometimes confounded when humidifiers are run continuously in the bedrooms of

asthmatic patients.

Therefore, it was surprising that alternaria sensitization was increased in

the asthmatics living in the relatively dry environs of Los Alamos (where dust

mites are less prevalent than in more humid areas). It would be of considerable

interest to obtain continuous household monitoring of airborne levels of

alternaria allergens in the regions studied and compare such findings with the

degree of sensitization to

this mold. Of course, it is possible that sensitization to other molds and other

aeroallergens may be playing a pathogenic role, making it difficult to correlate

these findings to asthma severity in individual patients.

It is of note that sensitivity to alternaria is one of the few mold allergies

in which there is evidence from good studies that allergy injection therapy is

beneficial (when avoidance is not feasible or sufficient).

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