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Environmental mycological studies on the causative agent of summer-type hypersensitivity pneumonitis

1988; Elsevier BV; Volume: 81; Issue: 2 Linguagem: Inglês

10.1016/0091-6749(88)90920-7

1097-6825

Kazuko Yoshida, Masayuki Ando, Tetsunori Sakata, Shukuro Araki,

Occupational exposure and asthma

Environmental mycological studies were carried out in 22 homes of patients with summer-type hypersensitivity pneumonitis and in 195 homes of control subjects.In 10 patients' homes, indiror sampling was performed by open-plate culture, house dust culture, and swab culture (group I), but in the other 12 patients' homes, sampling wus only by house dust culture (group 2).We isolated 302 strains of yeasts from the 22 patients' homes and 962 strains of yeasts from the homes of control subjects.The incidence qj' yeasts, except genera Trichosporon, was not significantly d@erent between homes of patients and control subjects when homes were assessed by three culture methods.T. cutaneum was isolated from seven of IO patients' homes in group I, and their colonizing places were revealed by the swab culture method.In group 2, the cells were isolated from four of 12 patients' homes.No T. cutaneum, however, i*'a.\isolated from the control subjects' homes.Among the isolated yeasts from patients' homes, 3 : strains were reactive to the patients' sera at I : 128 or higher in indirect fluorescent antiho& titers: 10 yeusts were T. cutaneum, isolated from 10 homes of 14 patients, but the other 13 t?easts were each a different species isolatedffom IO dtrerent homes.Furthermore, inhalation r~hallenge with the culture-filtrate antigen prepared from T. cutaneum was performed on the nine patients of six homes in group 1 and the two asymptomatic jamily members.Of the nine patients.sir were positive, one was probable, and two patients were negative.Neither of the two a,symptomrctu family members responded.These results suggest that T. cutaneum is a major causative agem of summer-type hypersensitivity pneumonitis.(J ALLERGY C'LIN IMMIJNOL I Y88:81:475-Y.I J Summer-type hypersensitivity pneumonitis is the most prevalent type of hypersensitivity pneumonitis in Japan.'It is characterized by symptoms that appear during the summer season; provocation of symptoms when the subject is at home, familial occurrence, and other manifestations similar to those of hypersensitivity pneumonitis of other types.Environmental factors, such as the muggy weather during early summer in Japan, and residence in old, wooden houses were considered causes, but the offending antigens remained undefined.In 1984, we demonstrated that Trichosporon cutuneum, an imperfect yeast, was a likely causative agent.'It was isolated from patients' homes, almost all of the patients' sera contained its antibodies, and some patients responded to inhalation challenge