Allergy to fungi – allergic reactions of an immediate-type allergic reaction and delayed-type hypersensitivity, which develop with fungal infections when the saprophytic fungi are in the body.
Etiology and pathogenesis
Infection occurs when in the zone of spread of fungi, through professional contact in agriculture, production of antibiotics, and during communicatioin with sick people and animals. Parasitization requires a number of favorable conditions: structural features of the skin and sweating, dysfunction of the endocrine glands, hypovitaminosis, long-term antibiotictherapy, which alters the composition of normal microflora, reduced immunity, especially cellular, immunosuppressive therapy.
The interrelationships of various species of fungi and microorganism depend not so much on the properties of the pathogen, but on there activity of the host and may have the following character: the development of immunity after suffering superficial infections; the formation of allergies inhealthy carriers with saprophytic or mild forms of fungal infections; the appearance of hyperergic reactions in respiratory fungal allergies, some forms of skin lesions, food allergies; decrease in reactivity up to anergy in visceral mycoses.
The immunological response is formed by 10-14 daysfrom the moment of invasion of the fungus into the tissue. During these periods, individuals exposed to infection get positive skin tests with fungal allergens. The site of invasion is infiltrated with neutrophils, macrophages, lymphocytes, plasma cells. It is assumed that neutrophils represent the “firstline of defense”, creating a granulocyte shaft around the site of the fungal invasion. Persons with hereditary defects of neutrophils and the NW component of the system complement required for phagocytosis are susceptible to fungal infections. T lymphocytes are an important factor in maintaining antifungal immunity. Therefore, a high frequency and generalization of fungal infections are observed in patients with immunological insufficiency of the T-system: in case of thymus aplasia, Wiskott-Aldrich syndrome, ataxia-telangiectasia. Fungal infections are also susceptible to persons with secondary immunological insufficiency: lymphomas, lymphogranulomatosis, and leukemia, as well as elderly people against the background of a physiological decrease in the level of immunological protection.
The development and nature of the reaction are determined by their ingestion in the body, a feature of tissue reactivity, the general state of immunity. There are various options for the reaction to invasion. So, allergy to fungi in saprophytization in a healthy body is characterized by latent sensitization. Fungi are often found in the throat, gastrointestinal tract, vagina. This type of allergy occurs when a person is infected with candida and detected in 90% of the adult population. The skintest with candida antigen is used as an indicator of cellular immunity.
Allergy with surface fungal infections – keratomycosis (ringworm, trichophytosis) – is manifested by frequent latent sensitization to the pathogen; if the stratum corneum is damaged, antibodies against the pathogen are determined.
Allergy with the defeat of the deep layers of thedermis and subcutaneous tissue (lermatpmicoses) is characterized by latent sensitization or the appearance of secondary allergic elements (ringworms) of erythematous, eczematous and urticarial types with localization close to the primary site of infection or at distant from the skin areas. The generalization of the elements is accompanied by a general reaction: fever, headache, malaise. Provocative factors are the following: skin maceration, sweating.
Allergy to fungi with respiratory fungal infections is manifested by bronchial asthma attacks, fibrosing alveolitis, allergic bronchopulmonary aspergillosis. Allergic tissue reaction has a diffuse or granulomatous character. With this type of allergy to fungi, antifungal antibodies belonging to immunoglobulin E and eosinophilia are detected in the blood of patients, skin tests with fungal allergens are positive and belong to the immediate or delayed type. The disease can occur in an acute form with the development of symptoms during the sporulation period or take a chronic course.
Allergy to fungi in food allergies is associated with increased growth of fungi, mainly Candida, in the gastrointestinal tract. The growth of colonies is constantly found in smears from the mucous membrane of the mouth, pharynx, in the feces. This type of allergy occurs when intestinal dysbiosis, as a complication of long-term antibiotic therapy. In addition, allergies to fungi of this variety are often caused by eating foods made with the addition of yeast-like fresh bread, beer, wine, cheese. Across-allergic reaction to cheese is possible in individuals who have previously used penicillin or have been in contact with this antibiotic.
Allergy is possible against the background of inhibition of immunity in case of damage to the skin and mucous membranes, especially rubbing surfaces (intertrigo), nail rollers (paronychia), oralmucosa (thrush), lips (cheilitis). vagina and visceral (systemic) mycoses. It is most often caused by candida and actinomycetes, affecting the cardiovascularand nervous systems, lungs, liver, kidneys and leading to the development of sepsis.
Depending on the peculiarities of allergy, antifungal antibiotics are used, a combination of desensitizing and immunostimulating therapies is possible: vaccine therapy, transfer factor, decaris.