Abstract
Macrocyclic trichothecenes, mycotoxins produced by Stachybotrys chartarum, have been implicated in adverse reactions in individuals exposed to mold-contaminated environments. Cellular and humoral immune responses and the presence of trichothecenes were evaluated in patients with mold-related health complaints. Patients underwent history, physical examination, skin prick/puncture tests with mold extracts, immunological evaluations and their sera were analyzed for trichothecenes. T-cell proliferation, macrocyclic trichothecenes, and mold specific IgG and IgA levels were not significantly different than controls; however 70% of the patients had positive skin tests to molds. Thus, IgE mediated or other non-immune mechanisms could be the cause of their symptoms.
Highlights
The “mold related illness” (MRI) is a controversial condition consisting of primarily non-specific symptoms such as headache, rhinorrhea, fatigue, memory loss, and eye irritation [1,2,3,4,5,6]
The patients reported that sites of exposure were home (88%), school (3%), and work (9%)
Patients with mold related complaints reacted to Trichoderma (82% vs. 76% of non-symptomatic individuals), Alternaria alternata (55% vs. 41%; p < 0.05), Cladosporium herbarum (42% vs. 12%; p < 0.05), Stachybotrys chartarum (27% vs. 17%; p < 0.05), A. versicolor (21% vs. below detectable limits; p < 0.05) and A. flavus (12% vs. below detectable limits; p < 0.05)
Summary
The “mold related illness” (MRI) is a controversial condition consisting of primarily non-specific symptoms such as headache, rhinorrhea, fatigue, memory loss, and eye irritation [1,2,3,4,5,6]. There are three accepted pathophysiological mechanisms in mold induced disease These mechanisms include: (a) infection by the organism, (b) generation of a deleterious immune response (e.g., allergy or HP), and c) toxic-irritant effects from mold metabolites (e.g., mycelial components, mycotoxins, or volatile organic compounds) [7,8,9]. Immunological dysfunction has been proposed by those who have demonstrated immunological changes in patients after mold exposure [14] These changes include elevations of IgG, IgM, IgA, and. The objective of this study was to evaluate the signs, symptoms, serum immunologic markers including IgG, IgA, and IgE (the latter via skin testing), mold specific peripheral blood mononuclear cells (PBMC) proliferative responses, and serum macrocyclic trichothecene levels in individuals complaining of mold related symptoms
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