Alternaria

Alternaria
Alternaria species (approximately 299) are abundant in the environment. They are normal agents of decay and decomposition of organic matter. 

Some Alterneria are plant pathogens infecting both fruit and vegetable commodities leading to agriculture spoilage. The spores are readily airborne and are present in soil and water and in the air, outdoors as well as indoors, and are found on building materials. 

Alternaria produce several mycotoxins: Tenuazonic acid (TA), Alter toxin I (ATX-I), Altenuene (ALT), Alternariol (AOH), Alternariol monomethyl ether (AME), and Tentoxin (TEN). (Centeno and Calvo, 2002; Logiieco et al, 2003). 

Carcinogenicity of Alternaria Mycotoxins 

Esophageal cancer has been associated with the consumption of contaminated grain containing AME and AOH produced by A. aitemata (Liu, 1992). Mutagenicity of A. alternata mycotoxins has been demonstrated in tissue mammalian cells and human esophageal epithelium in vitro (Zhang, 1991; Lehmann et al, 2006; Brugger et al, 2006). 

In addition, Tenuazonic acid following oral feeding caused dysplasia of the esophageal mucosa of mice (Yekeler et al, 2000). These reports suggest that additional research on potential carcinogenicity of Alternaria mycotoxins is warranted. 

Human Health and Alternaria 

Alternaria spp are opportunistic pathogens particularly in immunecompromised individuals causing infections as follows: onychomycosis, sinusitis, keratitis, osteomyelitis and visceral infections (Morrison et el, 1994; Vativarian et al, 1993). 

Phaeohyphomycosis has also been reported (Dubois et al, 2005). The most important risk factors are organ and bone marrow transplants and Cushing's (Pastor and Guarro, 2008). 

Skin infections and sinus colonization can occur in immunocompetent individuals (Vennewald et al, 1999; Manning et al, 1991; Di Silverio and Sacchi, 1986; Matson et al, 2010). 

Alternariosis of the skin has been reported in farmers and otitis media in agriculture workers (Spiewak, 1998; Wadhwani and Srivastava, 1984). 

Mold sensitivity in children with Alternaria moderate-severe asthma have been reported to have certain HLA (Human Leukocyte Antigen) alleles and genetic polymorphism in IL-4 RA single nucleotide (Knutsen et al 2010 a, b). These studies show that children with Alternaria sensitive asthma have a skewed TH2 response associated with an increased frequency of the IL-4RA ile75val polymorphism. 

The TH2 sensitivity was associated with a HLA-DR restriction and increased frequency of HLA-DRB1*13 and HLA-DQB1*03 alleles. A decreased frequency of HLA-DQB1*103 was present in Alternaria sensitive patients, suggesting that this gene may be protective against the development of Alternaria-sensitive severe asthma. 

In conclusion, Alternaria spp are present in both indoor and outdoor environments and are known to be present in WDB. 

Alternariosis occurs in both immunocompromised and immunocompetent individuals. Alternaria can colonize the sinuses leading to sinusitis. 

Finally, certain HLA genes render children, and probably adults, to be more sensitive to Alternaria causing moderate to severe asthma. 
Alternaria solani

Alternaria solani


References 

Brugger EM, Wagner J, Shucmacher DM, Koch K, Podlech J, et al. 2006. Mutagenicity of the mycotoxins alternariol in cultured mammalian cells. Toxicol Lett 164:221-30. 

Centen S, Calvo Ma. 2002. Mycotoxins produced by fungi isolate from wine cork stoppers. Pakistan J Nutr 1:267-9. 

Di Silverio A, Sacchi S 2986. Cutaneous alternariosis: a rate chromohyphomycosis. Report of a case. Mycopathologia 95:159-66. 

Dubois D, Pihet M, Clec'h CL, Croue A, Beguin H, et al. 2005. Cutaneous Phaeohyphomycosis due to Alternaria infecttoria. Mycopathol 160:117-23. 

Knutsen AP, Vijay HM, Kaiuki B, Santiago A, Graff r, Wofford JD. 2010a. Association of IL-4RA single nucleotide polymorphism, HLA-DR and HLA-DQ in children with Alternaria-sensitive moderate-severe asthma. Clin Mol Allergy 8:5-9. 

Knutsen AP, Vijay HM, Kumar V, Kariuki B, Santiago LA, Graff R, et al.m2010b. Mold-sensitivity in children with moder-severe asthma is associated with HLA-DR and HLA-DQ. Allergy May 10 [Epub ahead of print.

Liu GT, Qian YZ, Shang P, Dong WH, Qi YM, Guo HT. 1992. Etiological role of Alternaria alternata in hum esophageal cancer. Chin Med J. 105:394-400. 

Logrieco A, Bottalico A, Mule G, Moretti A, Perrone G. 2003. Epidemiology of fungi and their associated mycotoxins from some Mediterranean crops. European J Plant Pathol 109:645-67. 

Lehmann L, Wagner J, Metzler M. Estrogenic and clastogenic potential of the mycotoxin alternariol in cultured mammalian cells. Food chem Toxicol 44:398-408.

Manning, SC, Schaefer SD, Close LG, Vuitch f. 1991. Culture-positive allergic fungal sinusitis. Arch Otolaryngol Head Neck Surg 117:174-8.

Matson DR, Eudy JD, Matson SC. 2010. Cutaneous alternariosis in an adolescent patient. Pediatr Dermatol 27:98-100.

Morrison VA, Haake RJ, Seisdof DJ. Non-Candida fungal infections after bone marrow transplantation: Risk factors and outcome. Am J Med 96:497-503.

Okeler H, Bitmis K, Ozcelik N, Doymaz MZ, Calta M. 22002. Analysis of the toxic effects of Alternaria toxins on the esophagus of mice. Toxicol Pathol 29:492-7.

Pastor FJ, Buarro J. 2008. Alternaria infections: Laboratory diagnosis and relevant clinical features. Clin Micribiol Infect 14:734-46.

Spiewak R. 1998. Zoophilic and geophilic fungi as a cuase of skin disease in farmers. Ann Agric Environ Med 5:97-102.

Vativarian SE, Anaissie EJ, Bodey GP. 1993. Emerging fungal pathogens in immunocompromised patients: Classification, diagnosis and management. Clin Infect Dis 17:S487-91.

Vennewald I, Henker M, Klemm E, Seebacher C. 1999. Fungal colonization of the paranasal sinuses. Mycoses 42:33-6.

Wadhwani K, Srivastava AK. 1984. Fungi and otitis media of agricultural workers. Mycopathologia 88:155-9.

Williams C, Layton AM, Kerr K, Kibbler C, Baron RC. 2008. Cutaneous infection with an Alternaria sp in an immunocompetent host. Clin Exper Dermatol 33:440-2.

Zhang P. 1991. Studies on the activation of oncogenes by alternariol monomethyl either in human feta esophageal epithelium Zhonghua Bin Li Xue Za Zhi. 20:14-7.
Share by: