IgE-mediated allergy to fungal allergens in Finland with special reference to Alternaria alternata and Cladosporium herbarum.
BACKGROUND
Alternaria alternata and Cladosporium herbarum are common fungi in outdoor environments, but their clinical significance has not been elucidated in Finland.


OBJECTIVE
To evaluate the prevalence of IgE-mediated allergy and clinical outcomes caused by sensitization to fungal allergens in patients with suspected allergy.


METHODS
Skin prick tests (SPTs) were performed with C. herbarum in 6,376 patients and also with A. alternata in 1,504 of these patients. SPTs were repeated in 40 patients who showed a positive reaction to either allergen using commercial and in-house extracts. The association of SPT with allergen-specific IgE antibodies in serum was evaluated. Seven patients also underwent a conjunctival challenge test with these fungal allergens.


RESULTS
The prevalence of positive SPT results to A. alternata and C. herbarum was low (2.8% and 2.7%, respectively). Among the 40 patients, atopic eczema/dermatitis syndrome was found in 58%, asthma in 44%, and rhinitis in 31%. Most of the patients displayed SPT reactions also to several other fungal allergens, and 75% to 80% showed a positive SPT reaction to allergens of pet animals or pollens. Four patients had a positive reaction to A. alternata and 6 to C. herbarum in the conjunctival challenge test.


CONCLUSIONS
In the Finnish population with allergic symptoms, IgE-mediated sensitization to 2 common fungal allergens was rare and of minor clinical importance. SPT reactions to fungi are mostly observed in patients with multiple sensitivity to various allergens.
Reijula
Kari
K
Finnish Institute of Occupational Health, Helsinki, Finland. kari.reijula@ttl.fi
Leino
Marina
M
Mussalo-Rauhamaa
Helena
H
Nikulin
Marjo
M
Alenius
Harri
H
Mikkola
Jari
J
Elg
Peter
P
Kari
Osmo
O
Mäkinen-Kiljunen
Soili
S
Haahtela
Tari
T
D000485:Allergens / Q000276:immunology; D000528:Alternaria / Q000276:immunology*; D000818:Animals; D000829:Animals, Domestic / Q000276:immunology; D000946:Antigens, Fungal / Q000276:immunology*; D001249:Asthma / Q000276:immunology; D002963:Cladosporium / Q000276:immunology*; D003876:Dermatitis, Atopic / Q000276:immunology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology / Q000276:immunology*; D007073:Immunoglobulin E / Q000276:immunology*; D008297:Male; D011058:Pollen / Q000276:immunology; D012221:Rhinitis, Allergic, Perennial / Q000276:immunology; D012882:Skin Tests; D013045:Species Specificity
D000485:Allergens; D000946:Antigens, Fungal; D007073:Immunoglobulin E