What Should Be Tested in Patients with Suspected Mold Exposure? Usefulness of Serological Markers for the Diagnosis

Overview

Journal Allergol Select

Specialty Allergy & Immunology

Date 2022 Apr 8

PMID 35392215

Authors

Sabine Kespohl

Verena Liebers

Silke Maryska

Ursula Meurer

Claudia Litzenberger

Rolf Merget

Monika Raulf

Affiliations

Soon will be listed here.

Abstract

The associations of mold exposure, IgE-mediated sensitization, inflammatory markers, and respiratory symptoms were analyzed in 46 exposed and 23 non-exposed individuals. Both exposure and clinical symptoms were assessed by questionnaire. Specific (s)IgE to mold mixture (mx1) was significantly higher and found more frequently in exposed (41%) than non-exposed individuals (17%), which was not observed for sIgG to mold mix (Gmx6). Notably, exposed asthmatics were more frequently sensitized to molds (55%) compared to exposed non-asthmatics (18%). In addition, the serum concentrations of club cell protein (CC16) were significantly lower in exposed subjects, especially in asthmatics. Positive associations were observed among mold sensitization, asthma, and mold exposure, but not in subjects with predominantly environmental sensitizations without mold sensitization. Thus, sIgE to mx1 but not sIgG to Gmx6 is a useful diagnostic marker to verify mold-associated respiratory symptoms.

Citing Articles

AWMF mold guideline "Medical clinical diagnostics for indoor mold exposure" - Update 2023 AWMF Register No. 161/001.

Hurrass J, Heinzow B, Walser-Reichenbach S, Aurbach U, Becker S, Bellmann R Allergol Select. 2024; 8:90-198.

PMID: 38756207 PMC: 11097193. DOI: 10.5414/ALX02444E.

Is in vitro cytokine release a suitable marker to improve the diagnosis of suspected mold-related respiratory symptoms? A proof-of-concept study.

Liebers V, Kespohl S, Borowitzki G, Stubel H, Raulf M Allergol Select. 2022; 6:133-141.

PMID: 35392213 PMC: 8982069. DOI: 10.5414/ALX02299E.

References

Vincent M, Corazza F, Chasseur C, Bladt S, Romano M, Huygen K . Relationship between mold exposure, specific IgE sensitization, and clinical asthma: A case-control study. Ann Allergy Asthma Immunol. 2018; 121(3):333-339. DOI: 10.1016/j.anai.2018.06.016. View

Garrett M, Rayment P, Hooper M, Abramson M, Hooper B . Indoor airborne fungal spores, house dampness and associations with environmental factors and respiratory health in children. Clin Exp Allergy. 1998; 28(4):459-67. DOI: 10.1046/j.1365-2222.1998.00255.x. View

Jaakkola M, Lajunen T, Jaakkola J . Indoor mold odor in the workplace increases the risk of Asthma-COPD Overlap Syndrome: a population-based incident case-control study. Clin Transl Allergy. 2020; 10:3. PMC: 6961379. DOI: 10.1186/s13601-019-0307-2. View

Tischer C, Hohmann C, Thiering E, Herbarth O, Muller A, Henderson J . Meta-analysis of mould and dampness exposure on asthma and allergy in eight European birth cohorts: an ENRIECO initiative. Allergy. 2011; 66(12):1570-9. DOI: 10.1111/j.1398-9995.2011.02712.x. View

Valkonen M, Taubel M, Pekkanen J, Tischer C, Rintala H, Zock J . Microbial characteristics in homes of asthmatic and non-asthmatic adults in the ECRHS cohort. Indoor Air. 2017; 28(1):16-27. DOI: 10.1111/ina.12427. View

LaKind J, Holgate S, Ownby D, Mansur A, Helms P, Pyatt D . A critical review of the use of Clara cell secretory protein (CC16) as a biomarker of acute or chronic pulmonary effects. Biomarkers. 2007; 12(5):445-67. DOI: 10.1080/13547500701359327. View

Mendell M, Mirer A, Cheung K, Tong M, Douwes J . Respiratory and allergic health effects of dampness, mold, and dampness-related agents: a review of the epidemiologic evidence. Environ Health Perspect. 2011; 119(6):748-56. PMC: 3114807. DOI: 10.1289/ehp.1002410. View

Madsen A, White J, Markouch A, Kadhim S, de Jonge N, Thilsing T . A cohort study of cucumber greenhouse workers' exposure to microorganisms as measured using NGS and MALDI-TOF MS and biomarkers of systemic inflammation. Environ Res. 2020; 192:110325. DOI: 10.1016/j.envres.2020.110325. View

Caillaud D, Leynaert B, Keirsbulck M, Nadif R . Indoor mould exposure, asthma and rhinitis: findings from systematic reviews and recent longitudinal studies. Eur Respir Rev. 2018; 27(148). PMC: 9489198. DOI: 10.1183/16000617.0137-2017. View

10.

Denning D, ODriscoll B, Powell G, Chew F, Atherton G, Vyas A . Randomized controlled trial of oral antifungal treatment for severe asthma with fungal sensitization: The Fungal Asthma Sensitization Trial (FAST) study. Am J Respir Crit Care Med. 2008; 179(1):11-8. DOI: 10.1164/rccm.200805-737OC. View

11.

Klimek L, Werfel T, Vogelberg C, Jung K . Authorised allergen products for intracutaneous testing may no longer be available in Germany: Allergy textbooks have to be re-written. Allergo J Int. 2015; 24(3):84-93. PMC: 4479459. DOI: 10.1007/s40629-015-0051-7. View

12.

Tischer C, Heinrich J . Exposure assessment of residential mould, fungi and microbial components in relation to children's health: achievements and challenges. Int J Hyg Environ Health. 2012; 216(2):109-14. DOI: 10.1016/j.ijheh.2012.05.002. View

13.

Broeckaert F, Bernard A . Clara cell secretory protein (CC16): characteristics and perspectives as lung peripheral biomarker. Clin Exp Allergy. 2000; 30(4):469-75. DOI: 10.1046/j.1365-2222.2000.00760.x. View

14.

. [Mold burden of interior rooms--report of findings, health evaluation and measures. Report of the "Methods and Quality Assurance in Environmental Medicine" Committee]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2007; 50(10):1308-23. DOI: 10.1007/s00103-007-0339-y. View

15.

Park H, Churg A, Wright J, Li Y, Tam S, Paul Man S . Club cell protein 16 and disease progression in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2013; 188(12):1413-9. PMC: 3917377. DOI: 10.1164/rccm.201305-0892OC. View

16.

Zock J, Jarvis D, Luczynska C, Sunyer J, Burney P . Housing characteristics, reported mold exposure, and asthma in the European Community Respiratory Health Survey. J Allergy Clin Immunol. 2002; 110(2):285-92. DOI: 10.1067/mai.2002.126383. View

17.

Raulf M, van Kampen V, Neumann H, Liebers V, Deckert A, Bruning T . Airway and Blood Inflammatory Markers in Waste Collectors. Adv Exp Med Biol. 2017; 1021:1-14. DOI: 10.1007/5584_2017_25. View

18.

Jaakkola M, Nordman H, Piipari R, Uitti J, Laitinen J, Karjalainen A . Indoor dampness and molds and development of adult-onset asthma: a population-based incident case-control study. Environ Health Perspect. 2002; 110(5):543-7. PMC: 1240846. DOI: 10.1289/ehp.02110543. View

19.

Nevalainen A, Taubel M, Hyvarinen A . Indoor fungi: companions and contaminants. Indoor Air. 2015; 25(2):125-56. DOI: 10.1111/ina.12182. View

20.

Norback D, Zock J, Plana E, Heinrich J, Svanes C, Sunyer J . Mould and dampness in dwelling places, and onset of asthma: the population-based cohort ECRHS. Occup Environ Med. 2013; 70(5):325-31. DOI: 10.1136/oemed-2012-100963. View