ABSTRACT
Fungal allergy is a worldwide public health burden, and problems associated with a reliable allergy diagnosis are far from being solved. Especially, the lack of high-quality standardized fungal extracts contributes to the underdiagnosis of fungal allergy. Compared to the manufacturing processes of extracts from other allergen sources, the processes used to manufacture extracts from fungi show the highest variability. The reasons for the high variability are manifold as the starting material, the growth conditions, the protein extraction methods, and the storage conditions all have an influence on the presence and quantity of individual allergens. Despite the vast variety of studies that have analyzed the impact of the different production steps on the allergenicity of fungal allergen extracts, much remains unknown. This review points to the need for further research in the field of fungal allergology, for standardization and for generally accepted guidelines on the preparation of fungal allergen extracts. In particular, the standardization of fungal extracts has been and will continue to be difficult, but it will be crucial for improving allergy diagnosis and therapy.
ABSTRACT
BACKGROUND: Any reliable allergy diagnosis depends on the quality of the testing material. In the case of fungal allergy, fungal extracts, typically used as test solutions, exhibit considerable differences in their allergenicity. Better knowledge of fungal allergen expression would enable the production of diagnostic fungal extracts of higher quality and, thus, improve the specificity and sensitivity of fungal allergy diagnosis. OBJECTIVE: Our study aimed to find optimal cultivation conditions for the highest expression of fungal allergens. METHODS: Fungal species (Alternaria alternata, Ulocladium chartarum, Aspergillus fumigatus, Cladosporium herbarum, and Paecilomyces variotii) were cultivated under different conditions, and extracts were prepared from fungal material. To detect the expression of the homologous major allergens Alt a 1 and Ulo c 1 and of different fungal enolases, Western blots with allergen-specific antibodies were carried out. RESULTS: Western blots performed with antibodies directed against Alt a 1 and enolases showed that the expression of fungal allergens is highly species-dependent. Even allergens of closely related fungal species and highly conserved, cross-reactive allergens display different expression patterns. CONCLUSION: This study exhibits the impact of different environmental conditions on the expression of the fungal allergens Alt a 1, Ulo c 1, and different fungal enolases. Furthermore, it broadens the knowledge regarding the expression pattern of the major fungal allergens Alt a 1 and Ulo c 1. Information obtained in this study will help to optimize fungal cultivation to produce diagnostic fungal extracts of high quality and, therefore, improve diagnostic specificity and sensitivity.
