Allergy and Dermatophytes

Clinical Microbiology Reviews - Tập 18 Số 1 - Trang 30-43 - 2005
Judith A. Woodfolk1
1Asthma and Allergic Diseases Center, University of Virginia Health System, Charlottesville, Virginia.

Tóm tắt

SUMMARYTinea pedis (athlete's foot) and onychomycosis (infection of the toenails) caused by the dermatophyte fungusTrichophytonare highly prevalent in adults. SeveralTrichophytonallergens have been identified based on elicitation of immunoglobulin E antibody-mediated immediate-hypersensitivity (IH) responses. Evidence of an etiologic role forTrichophytonin asthma in some subjects with IH and chronic dermatophytosis is provided by bronchial reactivity toTrichophyton. Improvement of asthma after systemic antifungal treatment corroborates this link. A unique feature ofTrichophytonallergens is the ability of the same antigen to elicit delayed-type hypersensitivity (DTH) in individuals who lack IH reactivity. Delayed responses appear to confer protection, while IH responses do not, based on the association with acute versus chronic skin infection. The amino acid sequence identity ofTrichophytonallergens with diverse enzyme families supports a dual role for these proteins in fungal pathogenesis and allergic disease. Characterizing the immunologic properties ofTrichophytonallergens and defining immune mechanisms which drive dichotomous responses are pivotal to understanding the dermatophyte-allergy relationship. Recent studies have identified DTH-associated major T-cell epitopes which could facilitate the development of peptide vaccines. Characterization of additional molecular targets by using new techniques may aid not only in the eradication of infection but also in the resolution of allergic symptoms.

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