© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Indoor Air 2014; 24: 221–222 wileyonlinelibrary.com/journal/ina Printed in Singapore. All rights reserved

INDOOR AIR doi:10.1111/ina.12075

Letter to the Editor Fungi in homes – how do we measure? In a recent study in Indoor Air, no relation was found between domestic fungal exposure and asthma, rhinitis, and eczema (Choi et al., 2013). Although some early reviews did not find such a relationship (Institute of medicine, 2004), several later studies have confirmed a relationship between fungal exposure at home and airways inflammation and general symptoms (Lignell et al., 2005; M€ uller et al., 2002; Park and Cox-Ganser, 2011; Weinmayr et al., 2013). Particularly important are studies where an improvement in symptomatology and inflammatory cytokine status has been found after intervention against fungi (Roponen et al., 2013). The lack of a relationship in the study might be due to inadequate exposure determinations. The range of exposure variables might have been too small to detect effects according to the authors’ comment regarding ergosterol levels. Culturable fungi are a poor predictor of the exposure dose (Garrett et al., 1998). This descriptor does not account for dead cells or fractions of cells, which are not viable but retain their biological effect through different cell wall agents. Airborne fractions are particularly important as they may comprise a large proportion of the total cell biomass and easily penetrate into the lungs (Adhikari et al., 2011). Measurements of cell wall agents in terms of different glucans were taken using an immunoassay.

Unfortunately, the authors do not cite an extensive methodological study, where different methods to analyze glucan were compared (Iossifova et al., 2008). There were no correlations between the immune assay and a Limulus-based assay in floor dust by weight, and only a low correlation if the amount was expressed per surface area. The Limulus test had a higher sensitivity and specificity and was more accurate in measuring glucan standards. The sensitivity of the immune assay was too low to detect airborne samples, which from an inhalation point of view are more relevant. Furthermore, the authors do not cite any of the articles where a relation has been found between airway symptoms and fungi using the Limulus-based assay (e.g., Rylander et al., 1998; Yee et al., 2010). In view of these shortcomings, the study presents only a very weak evidence for the absence of a relation between fungal exposure and the studied diseases. R. Rylander BioFact Environmental Health Research Centre, Lerum, Sweden E-mail: [email protected]

References Adhikari, A., Reponen, T. and Rylander, R. (2011) Airborne fungal cell fragments in homes in relation to total fungal biomass, Indoor Air, 23, 142–147. Choi, H., Byrne, S., Suldrup Larsen, L., Sigsgaard, T., Thorne, P.S., Larsson, L., Sebastian, A. and Bornehag, C.-G. (2013) Residential culturable fungi, (1-3, 1-6)-b-glucan, and ergosterol concentrations in dust are not associated with asthma, rhinitis or eczema diagnosis in children, Indoor Air, doi:10.1111/ina.12068. Garrett, M.H., Rayment, P.R., Hooper, M.A., Abramson, M.J. and Hooper, B.M. (1998) Indoor air fungal spores, house dampness and associations with environmental factors and respiratory health in children, Clin. Exp. Allergy, 28, 459–467.

Institute of medicine (2004) Damp Indoor Spaces and Health, New York, The National Academies. Iossifova, Y., Reponen, T., Daines, M., Levin, L. and Kuhrana Hershey, G.K. (2008) Comparison of two analytical methods for detecting (1-3)-b-D-glucan in pure fungal cultures and in home dust samples, Open Allergy J., 1, 26–34. Lignell, U., Meklin, T., Putus, T., Vesp€ al€ ainen, A., Roponen, M., Torvinen, E., Reeslev, M., Pennanen, S., Hirvonen, M.-R., Kalliokoski, K. and Nevalainen, A. (2005) Microbial exposure symptoms and inflammatory mediators in nasal lavage fluid of kitchen and clerical personnel in schools, Int. J. Occ. Med. Env. Health, 18, 139–150. M€ uller, A., Lehmann, I., Seiffart, A., Diez, U., Wetzig, H., Borte, M. and Herbarth, O.

(2002) Increased incidence of allergic sensitisation and respiratory diseases due to mould exposure. Results of the Leipzig allergy risk children study, Int. J. Hyg. Environ. Health, 204, 363–365. Park, J.-H. and Cox-Ganser, J.M. (2011) Mold exposure and respiratory health in damp indoor environments, Frontiers in Biosci, E3, 757–771. Roponen, M., Meklin, T., Rintala, H., Hyv€ arinen, A. and Hirvonen, M.R. (2013) Effect of moisture damage intervention on the immunotoxic potential and microbial content of airborne particles and on occupants’ upper airway inflammatory response, Indoor Air, 23, 295–302. Rylander, R., Norrhall, M., Engdahl, U., Tuns€ ater, A. and Holt, P.G. (1998) Airways inflammation, atopy, and


Letter to the Editor (1?3)-ß-D-glucan exposures in two schools, Am. J. Respir. Crit. Care Med., 158, 1685–1687. Weinmayr, G., Gehring, U., Genumeit, J., B€ uchele, G., Kleiner, A., Siebers, R., Wickens, K., Crane, J., Brunekreef, B., Strachan, D. and the ISAAC phase two


study group. (2013) Dampness and moulds in relation to respiratory and allergic symptoms in children: results from phase two of the international study of asthma and allergies in childhood (ISAAC phase two), Clin. Exp. Allergy, 43, 762–774.

Yee, L.L., Yan, A.W. and Rylander, R. (2010) Otitis, rhinitis, and atopy in relation to domestic endotoxin and b-glucan exposure among children in Singapore, Env. Health Prev. Med., 15, 263–271.

Fungi in homes--how do we measure?

Fungi in homes--how do we measure? - PDF Download Free
53KB Sizes 0 Downloads 3 Views