The principles of treatment of mold allergies are based on the maximum possible exclusion of contact with a significant fungal allergen, the use of corticosteroids and antihistamines, as well as anti-fungal drugs in the acute period.
Good results in treatment can be achieved with the help of allergen-specific therapy, which should be carried out for several years and can significantly reduce sensitization to a fungal allergen.
Mold allergy – the occurrence of hypersensitivity to pathogenic and conditionally pathogenic mold fungi that enter the body with inhaled atmospheric air, house dust, food.
According to statistics, mold fungi Cladosporium, Penicillium, Aspergillus and Alternaria make up about 75% of the total spore mass contained in ambient air and indoor air. Clinical manifestations of mold allergies are aggravated in the warm season in the presence of high humidity. As for the fungi of the genus Aspergillus and Penicillium, inside the premises they are more active in the fall and winter. A mycogenic infection, for example, bronchopulmonary aspergillosis, is especially dangerous for people with immunodeficiency states.
Causes of mold allergies
The main causative agents of fungal infection causing the development of allergic reactions are mold fungi Cladosporium (the maximum concentration is noted in the atmospheric air in the summer), Penicillium (64% of the entire spore mass of residential premises), Aspergillus (48% of all indoor spores) and Alternaria.
Warm air and high humidity are ideal conditions for mold growth in ambient air, on walls and in indoor air, as well as on food.
- Cladosporium herbarum is the most common type of fungal mold. It reproduces on plants, in spring and summer it forms spores, which, with inhaled air, penetrate into the upper respiratory tract, leading to the occurrence of allergic rhinitis and bronchial asthma.
- Penicillum notatum is a common cause of mold allergy. This type of fungus was discovered by the inventor of penicillin Fleming. Penicillum is more often found in dwellings – on the walls of rooms, in wallpaper, in house dust it is kept year-round. Causes damage to the respiratory tract and skin.
- Aspergillus fumigatus is another representative of mold fungi, a strong allergen. Often found on vegetables and fruits that have mechanical damage: pomegranate, carrots, tomatoes, causing them to quickly decay with the formation of black fluffy bloom (black rot). When these fruits are consumed, fumiglavin, an alkaloid with a pronounced hemolytic effect, enters the digestive tract. Aspergillus fumigatus is often parasitic in animals and humans. It is the causative agent of allergic bronchopulmonary aspergillosis. Possible cross-allergy to mold contained in cheeses, wine, yeast dough.
- Alternaria tenuis (black rot) is a frequent inhabitant of our bathrooms and shower rooms, especially dangerous in summer and autumn. Allergic reactions that occur can lead to the development of asthma and atopic dermatitis.
Pathogenesis of mold allergies
In the mechanism of development of mold allergy, both immediate and delayed reactions to fungal allergens, as well as their combination, can be observed.
In addition to the reaction of the immune system, causing inflammation of the mucous membrane of the respiratory tract and skin, the adverse effect is enhanced by the release of mold fungi during their life processes of proteolytic enzymes that damage cells, as well as various toxic substances.
Symptoms of mold allergies
The clinical symptoms of mold allergy depend on the type of pathogenic fungus and organ that it primarily affects. The most common allergic inflammation of the mucous membrane of the bronchi and lung tissue. At the same time, bronchospasm may develop with difficulty breathing, shortness of breath, dry, unproductive cough and repeated attacks of suffocation. Bronchial asthma is the most common manifestation of mold allergies.
Along with this, when exposure to the mucous membrane of the respiratory tract of mold Aspergillus fumigatus mold often develops a disease such as allergic bronchopulmonary aspergillosis. As a rule, it occurs in patients with asthma. At the same time, along with the symptoms of bronchial obstruction in the cold season, patients have a fever, chest pain, cough, hemoptysis appear, the general condition is disturbed with severe weakness, fatigue, decreased performance, and weight loss.
Fungal allergens Aspergillus fumigatus, Alternaria tenuis and other mold fungi can lead to the development of exogenous allergic alveolitis, which is characterized by allergic damage of lung tissue (mushroom grower disease, farmer’s lungs, bagassosis). The disease is acute and occurs with symptoms of bilateral pneumonia. In chronic course of the alveolitis, the main complaints are shortness of breath, aggravated by physical exertion, loss of appetite, weight loss.
Mold allergy with damage to the nasal cavity (rhinitis, allergic rhinoconjunctivitis) and skin (hyperemia, puffiness, maceration, papular and vesicular rash on the skin of the face, trunk and extremities) is more common as a result of exposure to Penicillum and Alternaria fungi.
Diagnosis of mold allergies
Diagnosis of mold allergies is based on a thorough collection of anamnestic data, examination of a patient by an allergist, immunologist, dermatologist, pulmonologist, otolaryngologist, infectious diseases specialist and other specialists, conducting a set of laboratory tests and allergy tests, additional diagnostic methods (ultrasound, chest X-ray, CT of the lungs, spirography, endoscopic examination of the nasopharynx, bronchus).
To clarify the diagnosis and determine the specific allergen, such methods are common in clinical allergology as skin allergy tests with fungal allergens, determination of the level of total immunoglobulin IgE in the blood serum, as well as specific immunoglobulins (IgE, IgG, IgA and IgM) to the most common mold fungi.
Sometimes in difficult diagnostic cases, it is possible to conduct a provocative inhalation test with fungal allergens (performed only in a specialized allergological center).
Differential diagnosis of mold allergy is carried out with allergic diseases and fungal infections of a different etiology, viral rhinoconjunctivitis, bronchitis and pneumonia, bronchial asthma, skin diseases.
Prognosis and prevention of mold allergies
Since this kind of allergy often occurs chronically and is not diagnosed for a long time, the quality of life and performance are significantly affected. After identification and elimination of the causally significant allergen, the state of health improves, but morphological changes that have developed in the lungs remain irreversible.
Preventive measures for the prevention of mold allergy include the elimination of prolonged contact with mold fungi at work and at home, the rejection of the use of products with mold (some types of cheese, fermented wines, sauerkraut, etc.), vegetables and fruits with signs of damage, thorough removing foci of fungal infection in residential areas, combating high humidity, strengthening the body’s defenses.
