[On the role of Paecilomyces infection in the development of endogenous bronchial asthma].
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Biomedical subjects
Publications and source records attributed to A M Akhunova.
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2-week to 18 year follow-up data are analysed for 190 patients aged 3 to 70 years (91 females and 99 males) with bronchial asthma in Paecilomyses infection. Paecilomyces fungi play the role of a specific agent responsible for development of bacterial asthma. The bronchial spasm was provoked, on the one side, by hypersensitivity with participation of IgE defending the organism from the fulgi persisting in the blood and pulmonary tissue, on the other side, by biologically active substances produced by fungal cells, exogenic phospholipase A2, in particular. Clinical characteristics, course and outcome of bacterial asthma in Paecilomyces infection depend on the resistance of immune system to hematogenic fungal infection and immune reactions running in elimination of the agent.
Preincubation of blood, sputum, breast milk, and feces samples from patients in heparin-treated medium 199 for 18-24 h at ambient temperature to preserve viability of Paecilomyces tissue form when transferring the fungi from host to ambient temperature regimen results in transformation of the fungi into mycelium form in favorable conditions, which fact permits elevating the isolation rate of this fungus from 1.5 to 44-73 percent.
Primary or secondary infection of the lungs with fungi of the Paecilomyces family (P. variotii and P. viridis) gives rise to the development of infectious allergic bronchopulmonary paecilomycosis characterized by the presence of chronic allergic interstitial pneumonia and obstructive bronchitis, bronchial asthma, total and pulmonary eosinophilia, the presence of the tissue parasitic form of the fungus in sputum, blood, pulmonary tissue, the presence of allergen-specific IgE and/or IgG antibodies in patients' sera, immediate or double (20 min and 6 h) reaction of the skin to administration of allergen of Paecilomyces, by not infrequent combination of lung damage and impairment of other organs as well as by chronic relapses.
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The clinical and experimental studies showed that etiology and pathogenesis of allergic alveolitis in the inhabitants of the Samarkand Region stem from mycosepsis caused by Paecilomyces variotii Bainier, that is immunocomplex affection of the small and middle vessels and cell-mediated granulomatous inflammation of the tissues.
Among patients of an allergological center there appeared cases of respiratory and cutaneous allergy provoked by fungal infection Paecilomyces varioti Bainier. In the soil the fungi occurred in the mycelial form while in humans and animals the infection manifested in a parasitic hemotropic-tissue form. Pathogenesis of the disease is related to chronic sepsis-like state produced by the persistence of parasitizing hemotropic-tissue Chlamydiaceae-like fungi in blood and tissue cells, sensitization to them, impairments of small and medium size vessels by immunocomplex type, and delayed hypersensitivity in tissues.
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The lipolytic activity of extract of mycelium and cultural fluid of fungus Paecilomyces viridis and their protein fraction was investigated. The micelium of fungus Paecilomyces viridis is a weak producent of exogenic phospholipase A2, possessing the hemolytic activity. The optimum of zungal phospholipase A2 activity was within a range of pH 8.5-9.0 which coincides with the optimum of activity of phospholipase A2 from venoms of snakes and insects.
The fungus Paecilomyces variotii is known to develop as a saprotrophic mycelial form in the soil. When penetrating into the human organism or placing into a medium containing cultured cells it transforms into a parasitic flesh form. This form of the fungus was shown to undergo 3 morphological stages: endospore, juvenile (intermediate) form and mature sphaerula. The transformation of the mycelial form into parasitic one occurs in the biological media containing cells of the host, inside or outside the cell. The morphological structure of mycelium of P. variotii developed from the flesh parasitic form is different in aerobic and anaerobic conditions. In the former case, the spore production takes place by means of phialides, and in the latter case it occurs inside the mycelium.