Is Bjerkandera adusta Important to fungus-associated chronic cough as an allergen? Eight cases' reports.
BACKGROUND
Recently, we have reported a new clinical disease concept called fungus-associated chronic cough (FACC), which entailed the following manifestations: (1) chronic cough; (2) the presence of environmental fungi, particularly basidiomycetous (BM) fungi, in the sputum; and (3) good clinical response to antifungal drugs. To clarify the relationship between the exposure to environmental fungi and the development of cough attacks, we reviewed the clinical records of patients with FACC and performed a molecular biological analysis of the BM fungi.


METHODS
We successfully selected 8 patients with chronic cough, wherein a sputum culture yielded B. adusta beforehand; moreover, we conducted allergological tests such as the immediate-type skin test, a serological test, bronchoprovocation test, and lymphocyte stimulation test (LST), using the antigenic solution of B. adusta. The efficacy of individualized therapy and the clinical manifestations in the eight patients were examined.


RESULTS
All the eight patients were diagnosed with FACC. Although three patients who did not show a positive reaction to the bronchoprovocation test or LST showed excellent clinical response to anti-fungal drugs; other 5 patients who showed a positive reaction to the bronchoprovocation test and/or LST seemed to be more intractable because of taking a longer time for complete remission and more frequent recurrence of cough.


CONCLUSIONS
It was suggested that so-called allergic fungal cough (AFC), which is characterized by sensitization to B. adusta, may be included in a part of chronic intractable cough.
Division of Pulmonary Medicine, Ishikawa-ken Saiseikai Kanazawa Hospital, Kanazawa, Japan.
Haruhiko
H
Ogawa
Masaki
M
Fujimura
Yasuo
Y
Takeuchi
Koichi
K
Makimura
D000328:Adult; D000368:Aged; D000485:Allergens / Q000276:immunology; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001985:Bronchial Provocation Tests; D055453:Coriolaceae / Q000276:immunology* / Q000302:isolation & purification; D003371:Cough / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D004271:DNA, Fungal / Q000737:chemistry / Q000235:genetics; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012882:Skin Tests; D013183:Sputum / Q000382:microbiology; D055815:Young Adult
D000485:Allergens; D000935:Antifungal Agents; D004271:DNA, Fungal; D017964:Itraconazole; D000666:Amphotericin B