Article -mycotoxins in the air of Stachy

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Respirable trichothecene mycotoxins can be demonstrated in the air of

Stachybotrys chartarum–contaminated buildings

C. Straus PhDa and C. PhDa

aFrom the Texas Tech University Health Sciences Center, Lubbock, Tex

Available online 1 September 2006.

To the Editor:

This correspondence is in response to the American Academy of Allergy,

Asthma and Immunology position paper recently published in the Journal and

entitled “The medical effects of mold exposure.”1 The authors imply that the

most important way that trichothecene mycotoxins could get into the human

body is via the inhalation of Stachybotrys chartarum (SC) conidia. We have

recently shown that the number of SC conidia in the air in a SC-infested

building is not a good predictor for the amount of macrocyclic trichothecene

mycotoxins (MTMs) in the air. This is because the MTMs can exist in the air

on fungal fragments free of conidia, so the number of SC conidia found in

the air should play only a small role in determining airborne MTM levels.2

This becomes very important because it has recently been shown that there

are 514 times more SC fungal fragments released by this organism than there

are SC conidia released.3 The authors also imply that the idea that the

presence of mycotoxins in a building should give rise to an array of

nonspecific complaints is “not consistent with what is known to occur when a

toxic dose is achieved.” This simply is not the case. Indeed, in a report

examining the introduction of this type of mycotoxin (a trichothecene) into

human beings, the opposite was observed. We know what kinds of symptoms are

observed when a simple trichothecene (a preparation of diacetoxyscirpenol,

also known as anguidine) is injected into humans. They are (among others)

nausea, vomiting, low blood pressure, drowsiness, ataxia, and mental

confusion.4 These symptoms are consistent with those reported by individuals

in SC-infested buildings.5 The authors also state, “…however, potential

levels of mycotoxins in nonagricultural air samples are too low to be

measured practically with this technology.” That may be true regarding the

discussed technology; however, we have measured MTMs in the air of

nonagricultural buildings.6 Finally, the authors stated, “Testing for

airborne mycotoxins in nonagricultural environments cannot be used to

diagnose mold exposure.” This is not the case. We have successfully

preformed airborne testing for MTMs in nonagricultural settings.6 In fact,

we have used an ELISA to measure MTMs in the serum of individuals from

SC-infested buildings.7 In conclusion, we feel that the following statements

are true. SC has been shown to grow in buildings where people are having

health problems.5 SC definitely produces MTMs in these situations.6 These

MTMs definitely get into the air in these buildings, where they can be

inhaled.6 They definitely are inhaled by people in these buildings.7 The

following, then, is the final question that remains to be answered: do the

MTMs get into human beings in concentrations sufficient to cause the health

problems observed in people in SC-contaminated buildings?

We found a number of other issues of contention in the authors' review.

However, because of space restrictions, we have limited our response to

these points.

References

1 R.K. Bush, J.M. Portnoy, A. Saxton, A.I. Terr and R.A. Wood, The medical

effects of mold exposure, J Allergy Clin Immunol 117 (2006), pp. 326–333.

SummaryPlus | Full Text + Links | PDF (146 K) | Abstract + References in

Scopus | Cited By in Scopus

2 T.L. Brasel, D.R. , S.C. and D.C. Straus, Detection of

airborne Stachybotrys chartarum macrocyclic trichothecene mycotoxins on

particulates smaller than conidia, Appl Environ Microbiol 71 (2005), pp.

114–122. Abstract-MEDLINE | Abstract-Compendex | Abstract-EMBASE |

Abstract-Elsevier BIOBASE | Abstract-GEOBASE | Order Document | Full Text

via CrossRef | Abstract + References in Scopus | Cited By in Scopus

3 S.-H. Cho, S.-C. Seo, D. Schmechel, S.A. Grinshpun and T. Reponen,

Aerodynamic characteristics and respiratory deposition of fungal fragments,

Atmos Environ 39 (2005), pp. 5454–5465. SummaryPlus | Full Text + Links |

PDF (291 K) | Abstract + References in Scopus | Cited By in Scopus

4 W.K. , M.A. Burgess, M. Valdivesio, R.B. Livingston, G.P. Bodey and

E.J. Freireich, Phase I clinical evaluation of anguidine, Cancer Treat Rep

62 (1978), pp. 1497–1502. Abstract-MEDLINE | Abstract-EMBASE | Order

Document | Abstract + References in Scopus | Cited By in Scopus

5 C.M. Scheel, W.C. Rosing and A.L. Farone, Possible sources of sick

building syndrome in a Tennessee middle school, Arch Environ Health 56

(2001), pp. 413–417. Abstract-EMBASE | Abstract-MEDLINE | Abstract-Elsevier

BIOBASE | Order Document | Abstract + References in Scopus | Cited By in

Scopus

6 T.L. Brasel, J.M. , C.G. Carriker, S.C. and D.C. Straus,

Detection of airborne Stachybotrys chartarum macrocyclic trichothecene

mycotoxins in the indoor environment, Appl Environ Microbiol 71 (2005), pp.

7376–7388. Abstract-Elsevier BIOBASE | Abstract-GEOBASE | Abstract-EMBASE |

Abstract-MEDLINE | Order Document | Full Text via CrossRef | Abstract +

References in Scopus | Cited By in Scopus

7 T.L. Brasel, A.W. , R.E. Demers, B.S. Fergusen, J. Fink and A.

Vojdani et al., Detection of trichothecene mycotoxins in sera from

individuals exposed to Stachybotrys chartarum in indoor environments, Arch

Environ Health 59 (2004), pp. 317–323. Abstract-MEDLINE | Abstract-Elsevier

BIOBASE | Abstract-EMBASE | Order Document | Abstract + References in

Scopus | Cited By in Scopus

Disclosure of potential conflict of interest: D. C. Straus and S. C.

state that they have received research support from Assured Indoor Air

Quality and served as expert witnesses in mold litigation and as experts for

the plaintiff in legal cases associated with mold exposure and the alleged

risks or injuries.

_____

From: [mailto: ]

On Behalf Of who

Sent: 17. september 2006 02:00

Subject: [] Re: ARTICLE :biomarkers of exposure to Stachybotrys

-Thank You, Im sorry, I should of stated the name of it but couldn't

recall it. it was the other one about indoor air detection.sorry if

you went to any trouble on this, thanks again. -- In

@ <mailto:%40> ,

" sylgja " <sylgja@...> wrote:

>

> 1: Environ Health Perspect. 2006 Aug;114(8):1221-6.

>

> Mycotoxin adducts on human serum albumin: biomarkers of exposure to

> Stachybotrys chartarum.

>

> Yike I, Distler AM, Ziady AG, Dearborn DG.

>

>

>

> Department of Pediatrics and Ann Swetland Center for

Environmental

> Health, Case Western Reserve University, Cleveland, Ohio 44106-

4948, USA.

>

>

>

> OBJECTIVE: Despite the growing body of evidence showing adverse

health

> effects from inhalation exposure to the trichothecene-producing mold

> Stachybotrys chartarum, controversy remains. Currently, there are no

> reliable assays suitable for clinical diagnosis of exposure. We

hypothesized

> that satratoxin G (SG) -albumin adducts may serve as biomarkers of

exposure

> to this fungus. DESIGN: We studied the formation of adducts of SG

with serum

> albumin in vitro using Western blots and mass spectrometry (MS) and

searched

> for similar adducts formed in vivo using human and animal serum.

RESULTS:

> Samples of purified human serum albumin that had been incubated with

> increasing concentrations of SG showed concentration-dependent

albumin bands

> in Western blots developed with anti-SG antibodies. MS analysis

found that

> as many as 10 toxin molecules can be bound in vitro to one albumin

molecule.

> The sequencing of albumin-adduct tryptic peptides and the analysis

of

> pronase/aminopeptidase digests demonstrated that lysyl, cysteinyl,

and

> histidyl residues are involved in the formation of these adducts.

Serum

> samples from three patients with documented exposure to S. chartarum

> similarly revealed lysine-, cysteine-, and histidine-SG adducts

after

> exhaustive digestion, affinity column enrichment, and MS analysis.

These

> adducts were also found in the sera from rats exposed to the spores

of S.

> chartarum in contrast to control human subjects and control animals.

> CONCLUSIONS: These data document the occurrence of SG-albumin

adducts in

> both in vitro experiments and in vivo human and animal exposures to

S.

> chartarum. Relevance to clinical practice: SG-amino acid adducts

may serve

> as reliable dosimeter biomarkers for detection of exposure to S.

chartarum.

>

>

>

> PMID: 16882529 [PubMed - in process]

>

>

>

>