Abstract
Among potential environmental harmful factors, fungi deserve special consideration. Their intrinsic ability to actively germinate or infect host tissues might determine a prominent trigger in host defense mechanisms. With the appearance of fungi in evolutionary history, other organisms had to evolve strategies to recognize and cope with them. Existing controversies around dampness and mold hypersensitivity syndrome (DMHS) can be due to the great variability of clinical symptoms but also of possible eliciting factors associated with mold and dampness. An hypothesis is presented, where an evolutionary analysis of the different response patterns seen in DMHS is able to explain the existing variability of disease patterns. Classical interpretation of immune responses and symptoms are addressed within the field of pathophysiology. The presented evolutionary analysis seeks for the ultimate causes of the vast array of symptoms in DMHS. Symptoms can be interpreted as induced by direct (toxic) actions of spores, mycotoxins, or other fungal metabolites, or on the other side by the host-initiated response, which aims to counterbalance and fight off potentially deleterious effects or fungal infection. Further, individual susceptibility of immune reactions can confer an exaggerated response, and magnified symptoms are then explained in terms of immunopathology. IgE-mediated allergy fits well in this scenario, where individuals with an atopic predisposition suffer from an exaggerated response to mold exposure, but studies addressing why such responses have evolved and if they could be advantageous are scarce. Human history is plenty of plagues and diseases connected with mold exposure, which could explain vulnerability to mold allergy. Likewise, multiorgan symptoms in DMHS are analyzed for its possible adaptive role not only in the defense of an active infection, but also as evolved mechanisms for avoidance of potentially harmful environments in an evolutionary past or present setting.
Highlights
After several decades of research in the field, the systemic health effects of mold exposure still seem to be a controversial issue
The presented evolutionary analysis of dampness and mold hypersensitivity syndrome (DMHS) shows evidence that the relationship between fungi, mold, and humans has provided us over eons of time with important defense mechanisms, without these we would not have survived as a species
Innate and adaptive immune defense mechanisms as well as a neuroendocrine system aimed at avoiding contact with potentially harmful fungi have a great interindividual variability, but display a mainly pro-inflammatory or exaggerated potential in those patients suffering from DMHS
Summary
Instituto de Investigación Sanitaria, Hospital Universitario de la Princesa, Servicio de Alergia, Madrid, Spain. Among potential environmental harmful factors, fungi deserve special consideration. Their intrinsic ability to actively germinate or infect host tissues might determine a prominent trigger in host defense mechanisms. An hypothesis is presented, where an evolutionary analysis of the different response patterns seen in DMHS is able to explain the existing variability of disease patterns. Individual susceptibility of immune reactions can confer an exaggerated response, and magnified symptoms are explained in terms of immunopathology. Multiorgan symptoms in DMHS are analyzed for its possible adaptive role in the defense of an active infection, and as evolved mechanisms for avoidance of potentially harmful environments in an evolutionary past or present setting
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
