Stemphylium herbarum
Summary
Stemphylium herbarum (Pleospora herbarum) is a ubiquitous mold of the order Pleosporales, mostly found in plant materials and soil worldwide. It is a well-known plant pathogen. The particles causing allergic reactions are spores found in the environment.
Stemphylium spp. may be involved in the development of asthma. Cross reactivity with other molds, especially if taxonomically close, may occur.
Epidemiology
Worldwide distribution
There is a lack of specific reports of allergic disease attributed to Stemphylium spp.; however, its involvement in developing symptoms of asthma has been hypothesized.
Risk factors
Being male and black ethnicity both appear to be risk factors for asthma and fungal sensitization.
Route Of Exposure
Main
Inhalation.
Clinical Relevance
Asthma
An association between severe asthma and fungal sensitization was demonstrated in a study that included Stemphylium herbarum Fungal extracts, including S. herbarum, have been found to be sensitizing agents in asthmatic children.
Diagnostics
Main methods
Gravity-based petri plate method, Lanzoni and Burkard samplers.
The presence of allergen-specific antibodies is usually determined by skin prick tests (SPTs) and serology for IgE. In a study of 307 asthmatic patients, 55.8% tested positive for S. herbarum-specific IgE. Stemphylium was among one of the most common agents of sensitization, with 86.6% positive reactions.
Prevention And Therapy
Allergen immunotherapy
Immunotherapy is currently not recommended for patients allergic to molds, due to complexities of the allergens and patient co-allergies.
Prevention strategies
Avoidance is difficult to achieve due to the range of environments in which Stemphylium spp. can be found.
Cross-Reactivity
Cross-reactivity has been demonstrated to other molds. In a study carried out on 668 serum samples from patients which who had previously recorded at least one IgE positivity to fungal antigens, associations were observed between the patterns of IgE sensitization and fungal phylogenetic relationships. Using a panel of 17 fungal extracts including S. herbarum, some samples were only positive to one fungal species, whereas many were multi-sensitized. The results suggest that the associations are likely due to antigen cross-reactivity between fungal species, not uncommon in more closely related species. In another study, scientists were able to amplify an Alt a 1 analogue by polymerase chain reaction (PCR) from Stemphylium spp. and one Pleospora herbarum isolate. A 17–18 kDa S. botryosum allergen reacted to rabbit IgE raised against the Alternaria alternata antigen Alt a 1.
References
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