There are conflicting data in the literature about the role of fungi in AD. The colonization of the skin with Malassezia species, the subsequent sensitization to this yeast, and positive patch tests with Malassezia extracts in patients with AD are not convincing proofs for the relevance of this yeast in the pathogenesis of AD; it could be a result of the skin barrier defect in these patients. On the other hand phylogenetically conserved allergen structures such as manganese superoxide dismutase (MnSOD) are present in fungi and in human cells. Interestingly, IgE- and T-cell-mediated reactivity against Malassezia was found in patients with extrinsic as in patients with intrinsic AE and occurs specifically in AE patients.56 In a subset of patients with AD sensitization to Malassezia, MnSOD should result in enhancing skin inflammation due to a molecular mimicry and cross-reactivity between fungal and human proteins.53 Therefore fungi are not causative for the development of AD but may aggravate the skin disease in some patients. New double-blind, placebo-controlled clinical trials with sufficient numbers of patients with well-characterized AD must clarify which patients with AD have a significant benefit from an antifungal therapy.

Food Allergies

Food Allergies

Peanuts can leave you breathless. Cat dander can lead to itchy eyes, a stuffy nose, coughing and sneezing. And most of us have suffered through those seasonal allergies with horrible pollen counts. Learn more...

Get My Free Ebook

Post a comment