Identifying Domestic Aeroallergen Exposure in a Cystic Fibrosis Patient: A Case Study

Details

• Personal Author:
  Green, Brett J. ; Liu-Brennan D ; Sercombe JK ; Tovey ER
• Description:
  Cystic fibrosis patients often show sensitization to common indoor allergens, including fungi. Allergen exposure can exacerbate respiratory symptoms, including asthma. A 12 year old female patient with cystic fibrosis and asthma, and past ABPA, experienced asthma exacerbations at home. The patient tested positive by SPT to Der p 1, cat, and several fungal allergens. Airborne fungal exposure at home was suspected. 10M inhalable fraction air samplers were used in the home for 6 hours, staggered over a 24 hour period. Samples were cultured for fungal identification and viable counts. Samples were also immunostained for binding with the patient's serum IgE and with specific monoclonal antibodies (mAb), using the Halogen immunoassay (HIA). Viable counts reported 39 and 60 fungal CFUs in the bedroom and living room, respectively, from the 6-hour inhalable fraction air sample. Using HIA, 60 and 46 fungal conidia collected in the bedroom and living room, respectively, were seen to bind the patient's IgE. Similarly, IgE reactive hyphal counts were 6 and 8, whereas other antigenic particles were 176 and 214. Specific mAb HIAs showed 4056 (bedroom) and 3900 (living room) Fel d 1 particles, and 520 (bedroom) and 4660 (living room) Der p 1 particles. Using the HIA, we were able to determine what proportion of the airborne allergens in a home were contributed by fungal conidia and hyphae. In this case, the bulk of aeroallergen binding patient IgE was due to non-fungal sources. However, due to their viability, airborne fungal conidia may present greater potential allergen sources. [Description provided by NIOSH]
• Subjects:
  Air Pollutants, Occupational Asthma Asthma, Occupational Case Reports Environmental Monitoring Fibrosis Fungi Fungicide, Industrial Hypersensitivity Immune System Occupational Health Particulate Matter Respiratory Tract Diseases Safety

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• Keywords:
  Air-samplers Air-sampling Airborne-particles Allergens Allergies Bronchial-asthma Case-studies Fibrogenesis Fibrogenicity Fungicides Immunology Pulmonary-system-disorders Respiratory-system-disorders Sensitization

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• ISSN:
  0091-6749
• Document Type:
  Text
• Genre:
  Abstract or Summary ; Proceedings
• Place as Subject:
  OSHA Region 3 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  HELD - Health Effects Laboratory Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  17
• Issue:
  2
• NIOSHTIC Number:
  nn:20029987
• Citation:
  J Allergy Clin Immunol 2006 Feb; 117(2)(Suppl 1):S299
• Federal Fiscal Year:
  2006
• NORA Priority Area:
  Research Tools and Approaches: Exposure Assessment Methods
• Peer Reviewed:
  False
• Source Full Name:
  Journal of Allergy and Clinical Immunology
• Supplement:
  1
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:dd5f078c2192af1d86099646c483d6a41f4a20f69e3ffb1c6c02a2bb965e5f6e1878b9776914bf590fc9231b3bd82ed7f67a717c48d9041b5bb9e419987c694f
• Download URL:
  https://stacks.cdc.gov/view/cdc/190850/cdc_190850_DS1.pdf
• File Type:
  [PDF - 145.02 KB ]