title: Does Spore Count Matter in Fungal Allergy?: The Role of Allergenic Fungal Species.
abstract: OBJECTIVE
  Fungi have been known to be important aeroallergens for hundreds of years. Most studies have focused on total fungal concentration; however, the concentration of specific allergenic fungi may be more important on an individual basis.
  
  
  METHODS
  Ten fungal allergic patients and 2 non-fungal allergic patients were enrolled. The patients with a decrease in physician or patient global assessment by more than 50% of their personal best were considered to have an exacerbation of allergic symptoms and to be in the active stage. Those who maintained their physician and patient global assessment scores at their personal best for more than 3 months were considered to be in the inactive stage. The concentrations of dominant fungi in the patients' houses and outdoors were measured by direct and viable counts at active and inactive stages.
  
  
  RESULTS
  The exacerbation of allergic symptoms was not correlated with total fungal spore concentration or the indoor/outdoor ratio (I/O). Specific fungi, such as Cladosporium oxysporum (C. oxyspurum), C. cladosporioides, and Aspergillus niger (A. niger), were found to be significantly higher concentrations in the active stage than in the inactive stage. Presumed allergenic spore concentration threshold levels were 100 CFU/m³ for C. oxysporum, and 10 CFU/m³ for A. niger, Penicillium brevicompactum and Penicillium oxalicum.
  
  
  CONCLUSIONS
  The major factor causing exacerbation of allergic symptoms in established fungal allergic patients may be the spore concentration of specific allergenic fungi rather than the total fungal concentration. These results may be useful in making recommendations as regards environmental control for fungal allergic patients.
authors.affiliation: Department of Life Science, Tunghai University, Taichung, Taiwan.
authors.forename: Wan Rou
authors.initials: WR
authors.lastname: Lin
authors.affiliation: Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan. ysanne@vghtc.gov.tw.|Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Yi Hsing
authors.initials: YH
authors.lastname: Chen
authors.affiliation: Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Mey Fann
authors.initials: MF
authors.lastname: Lee
authors.affiliation: The Environmental Analysis Laboratory, Taoyuan, Taiwan.
authors.forename: Ling Yi
authors.initials: LY
authors.lastname: Hsu
authors.affiliation: Department of Life Science, Tunghai University, Taichung, Taiwan.
authors.forename: Chih Jen
authors.initials: CJ
authors.lastname: Tien
authors.affiliation: Department of Life Science, Tunghai University, Taichung, Taiwan.
authors.forename: Feng Ming
authors.initials: FM
authors.lastname: Shih
authors.affiliation: Department of Life Science, Tunghai University, Taichung, Taiwan.
authors.forename: Shih Ching
authors.initials: SC
authors.lastname: Hsiao
authors.affiliation: Department of Life Science, Tunghai University, Taichung, Taiwan. phwang@thu.edu.tw.
authors.forename: Pi Han
authors.initials: PH
authors.lastname: Wang
keywords: Fungal allergy; I/O ratio; airborne fungal spore; household; spore count; threshold level