[Animals and fungi as allergy inducers].
Pets particularly dog and cat are the men's best friend. In the daily practice respiratory allergy to animal proteins are not uncommon and in some areas the frequency is even higher than allergy to house dust mites. In Switzerland nearly half of the households keeps some kind of a domestic animal with cats followed by dogs as the principal pets. Because the exposure to domestic animals is perennial, allergic symptoms such as rhinoconjunctivitis or asthma usually are less acute than due to pollen or an occupational allergen. The best and most effective management of a domestic animal allergy is to avoid having contact with the relevant pet. Because of personal and emotional conflicts other strategies are employed to reduce allergen levels of the pet such as by washing or by restriction of the territory. For many years, fungal spores have been recognized as potential causes of respiratory allergies. Besides the more community recognized microfungi or molds such as Alternaria alternata, Aspergillus fumigatus or Cladosporium herbarum the class of basidiomycetes--physically the largest and morphologically the most complex fungi--are known to produce allergic symptoms. This class consists of about 14,000 species, including mushrooms, bracket fungi, puffballs, toad stools and jelly fungi, as well as the plant-pathogenic rusts and smuts. Clinically, symptoms due to fungal allergens are not distinguishable from those due to pollen, however, in recent years asthma attacks particularly in young people have been associated with high spore counts in the air. Upon contact fungal components may cause eczema or trigger inflammatory skin eruptions in a subgroup of patients with atopic eczema. Though food allergies to mushrooms are largely anecdotal, a few well documented cases mainly due to Boletus edulis (king bolete or cepe) have been published recently. Since fungal spores are ubiquitous atmospheric components avoidance measures are often not achievable. Nevertheless, some preventive steps especially at home may help to control growth of molds. Specific immunotherapy may be indicated for both domestic animal and fungal (mold) allergies in certain circumstances. Clinical relevance, however, needs to be demonstrated by an accurate allergological assessment.
Helbling
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Allergologisch-Immunologische Poliklinik, Klinik für Rheumatologie, Immunologie und Allergologie, Inselspital Bern. arthur.helbling@insel.ch
D000818:Animals; D000829:Animals, Domestic; D001249:Asthma / Q000209:etiology* / Q000628:therapy; D002415:Cats; D003876:Dermatitis, Atopic / Q000209:etiology* / Q000628:therapy; D004285:Dogs; D005658:Fungi; D006801:Humans; D012221:Rhinitis, Allergic, Perennial / Q000209:etiology* / Q000628:therapy; D006255:Rhinitis, Allergic, Seasonal / Q000209:etiology* / Q000628:therapy; D012307:Risk Factors; D013557:Switzerland