ROLE OF ALTERNARIA AND PENICILLIUM SPORES IN THE PATHOGENESIS OF ASTHMA

[摘要] 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 induced 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. Environment spore survey data were obtained and compared with the challenge doses for these spores. It was found that (1) immediate-type asthma was readily provoked by both whole spores and their extracts, (2) in some subjects fewer intact than extracted spores were required, (3) delayed-type asthma occurred only after whole spore challenges, (4) SGaw was the most sensitive and equally specific of the pulmonary function tests, and (5) provocative doses of spore equivalents were within natural exposure ranges. The study confirmed that Alternaria and Pencillium spores in relatively natural states and numbers were potent immunopathogenes for asthma.

[发布日期] 1985-12-01