Prevalence of basidiospore allergy in the Pacific Northwest

Mold spore-induced respiratory allergy has been incompletely studied, and only a limited number of Fungi Imperfecti are well established as aeroallergens. Basidiomycetes, a complex and common group of fungi, which include mushrooms, rusts, smuts, brackets, and puffballs, have not been well studied. Although basidiospores can be present in high atmospheric concentrations, little is known of their aeroallergen potential. To examine this question, we performed skin prick and RASTs in 33 adult residents of Washington State using a panel of 15 common inhalant allergents that included four Fungi Imperfecti and 15 basidiospore extracts. Thirty-one of 33 (94%) subjects had positive immediate reactions to two or more common inhalants. Nine of 33 (27%) subjects responded to at least one Fungi Imperfecti; reactions were most common to Aspergillus sp. (21%), and least common to Penicillium sp., which were positive in 6%. Positive responses to basidiospore extracts were observed in 10 of 33 (30%) subjects. The prevalence of basidiospore reactivity was similar to that of Fungi Imperfecti, ranging from 18% for Scleroderma sp. to 6% for four different spore extracts. These results demonstrate that a significant number of subjects with respiratory allergies have skin test reactivity to basidiospore extracts, suggesting that these spores could be important aeroallergens in the Pacific Northwest.