Editing Allergen (section)

== Fungal ==
In 1952 [[Basidiospore|basidiospores]] were described as being possible airborne allergens<ref>{{cite journal | vauthors = Gregory PH, Hirst JM | title = Possible role of basidiospores as air-borne allergens | journal = Nature | volume = 170 | issue = 4323 | pages = 414 | date = September 1952 | pmid = 12993181 | doi = 10.1038/170414a0 | s2cid = 4205965 | bibcode = 1952Natur.170..414G | doi-access = free }}</ref> and were linked to asthma in 1969.<ref>{{cite journal | vauthors = Herxheimer H, Hyde HA, Williams DA | title = Allergic asthma caused by basidiospores | journal = Lancet | volume = 2 | issue = 7612 | pages = 131–133 | date = July 1969 | pmid = 4183245 | doi = 10.1016/s0140-6736(69)92441-6 }}</ref> Basidiospores are the dominant airborne fungal allergens. Fungal allergies are associated with seasonal asthma.<ref>{{cite journal | vauthors = Hasnain SM, Wilson JD, Newhook FJ | title = Fungal allergy and respiratory disease | journal = The New Zealand Medical Journal | volume = 98 | issue = 778 | pages = 342–346 | date = May 1985 | pmid = 3858721 }}</ref><ref>{{cite journal | vauthors = Levetin E | title = Basidiospore identification | journal = Annals of Allergy | volume = 62 | issue = 4 | pages = 306–310 | date = April 1989 | pmid = 2705657 }}</ref> They are considered to be a major source of airborne allergens.<ref name="Horner-1991">{{cite journal | vauthors = Horner WE, Lopez M, Salvaggio JE, Lehrer SB | title = Basidiomycete allergy: identification and characterization of an important allergen from Calvatia cyathiformis | journal = International Archives of Allergy and Applied Immunology | volume = 94 | issue = 1–4 | pages = 359–361 | year = 1991 | pmid = 1937899 | doi = 10.1159/000235403 }}</ref> The basidiospore family include mushrooms, [[Rust (fungus)|rusts]], [[Smut fungi|smuts]], [[Polypore|brackets]], and [[puffballs]]. The airborne spores from mushrooms reach levels comparable to those of mold and pollens. The levels of mushroom respiratory allergy are as high as 30% of those with allergic disorder, but it is believed to be less than 1% of food allergies.<ref>{{cite journal | vauthors = Sprenger JD, Altman LC, O'Neil CE, Ayars GH, Butcher BT, Lehrer SB | title = Prevalence of basidiospore allergy in the Pacific Northwest | journal = The Journal of Allergy and Clinical Immunology | volume = 82 | issue = 6 | pages = 1076–1080 | date = December 1988 | pmid = 3204251 | doi = 10.1016/0091-6749(88)90146-7 }}</ref><ref>{{cite journal | vauthors = Koivikko A, Savolainen J | title = Mushroom allergy | journal = Allergy | volume = 43 | issue = 1 | pages = 1–10 | date = January 1988 | pmid = 3278649 | doi = 10.1111/j.1398-9995.1988.tb02037.x | doi-access = free }}</ref> Heavy rainfall (which increases fungal spore release) is associated with increased hospital admissions of children with asthma.<ref>{{cite journal | vauthors = Khot A, Burn R, Evans N, Lenney W, Storr J | title = Biometeorological triggers in childhood asthma | journal = Clinical Allergy | volume = 18 | issue = 4 | pages = 351–358 | date = July 1988 | pmid = 3416418 | doi = 10.1111/j.1365-2222.1988.tb02882.x | s2cid = 27600549 }}</ref> A study in New Zealand found that 22 percent of patients with respiratory allergic disorders tested positive for basidiospores allergies.<ref name="Hasnain-1985">{{cite journal | vauthors = Hasnain SM, Wilson JD, Newhook FJ, Segedin BP | title = Allergy to basidiospores: immunologic studies | journal = The New Zealand Medical Journal | volume = 98 | issue = 779 | pages = 393–396 | date = May 1985 | pmid = 3857522 }}</ref> Mushroom spore allergies can cause either immediate allergic symptomatology or delayed allergic reactions. Those with asthma are more likely to have immediate allergic reactions and those with [[allergic rhinitis]] are more likely to have delayed allergic responses.<ref>{{cite journal | vauthors = Santilli J, Rockwell WJ, Collins RP | title = The significance of the spores of the Basidiomycetes (mushrooms and their allies) in bronchial asthma and allergic rhinitis | journal = Annals of Allergy | volume = 55 | issue = 3 | pages = 469–471 | date = September 1985 | pmid = 4037433 }}</ref> A study found that 27% of patients were allergic to basidiomycete mycelia extracts and 32% were allergic to basidiospore extracts, thus demonstrating the high incidence of fungal sensitisation in individuals with suspected allergies.<ref>{{cite journal | vauthors = Lehrer SB, Lopez M, Butcher BT, Olson J, Reed M, Salvaggio JE | title = Basidiomycete mycelia and spore-allergen extracts: skin test reactivity in adults with symptoms of respiratory allergy | journal = The Journal of Allergy and Clinical Immunology | volume = 78 | issue = 3 Pt 1 | pages = 478–485 | date = September 1986 | pmid = 3760405 | doi = 10.1016/0091-6749(86)90036-9 | doi-access = free }}</ref> It has been found that out of basidiomycete caps, mycelia, and spore extracts, the spore extracts are the most reliable extract for diagnosing basidiomycete allergy.<ref>{{cite journal | vauthors = Weissman DN, Halmepuro L, Salvaggio JE, Lehrer SB | title = Antigenic/allergenic analysis of basidiomycete cap, mycelia, and spore extracts | journal = International Archives of Allergy and Applied Immunology | volume = 84 | issue = 1 | pages = 56–61 | year = 1987 | pmid = 3623711 | doi = 10.1159/000234398 }}</ref><ref>{{cite journal | vauthors = Liengswangwong V, Salvaggio JE, Lyon FL, Lehrer SB | title = Basidiospore allergens: determination of optimal extraction methods | journal = Clinical Allergy | volume = 17 | issue = 3 | pages = 191–198 | date = May 1987 | pmid = 3608137 | doi = 10.1111/j.1365-2222.1987.tb02003.x | s2cid = 45338948 }}</ref>

In Canada, 8% of children attending allergy clinics were found to be allergic to ''[[Ganoderma]]'', a basidiospore.<ref>{{cite journal | vauthors = Tarlo SM, Bell B, Srinivasan J, Dolovich J, Hargreave FE | title = Human sensitization to Ganoderma antigen | journal = The Journal of Allergy and Clinical Immunology | volume = 64 | issue = 1 | pages = 43–49 | date = July 1979 | pmid = 447950 | doi = 10.1016/0091-6749(79)90082-4 | doi-access = free }}</ref> ''[[Pleurotus ostreatus]]'',<ref>{{cite journal | vauthors = Lopez M, Butcher BT, Salvaggio JE, Olson JA, Reed MA, McCants ML, Lehrer SB | title = Basidiomycete allergy: what is the best source of antigen? | journal = International Archives of Allergy and Applied Immunology | volume = 77 | issue = 1–2 | pages = 169–170 | year = 1985 | pmid = 4008070 | doi = 10.1159/000233775 | doi-access = free }}</ref> ''[[Cladosporium]]'',<ref>{{cite journal | vauthors = Stephen E, Raftery AE, Dowding P | title = Forecasting spore concentrations: a time series approach | journal = International Journal of Biometeorology | volume = 34 | issue = 2 | pages = 87–89 | date = August 1990 | pmid = 2228299 | doi = 10.1007/BF01093452 | s2cid = 30836940 | bibcode = 1990IJBm...34...87S }}</ref> and ''[[Calvatia cyathiformis]]'' are significant airborne spores.<ref name="Horner-1991"/> Other significant fungal allergens include ''[[Aspergillus]]'' and ''[[Alternaria]]''-''[[Penicillium]]'' families.<ref>{{cite journal | vauthors = Dhillon M | title = Current status of mold immunotherapy | journal = Annals of Allergy | volume = 66 | issue = 5 | pages = 385–392 | date = May 1991 | pmid = 2035901 }}</ref> In India, ''[[Fomes pectinatus]]'' is a predominant air-borne allergen affecting up to 22% of patients with respiratory allergies.<ref>{{cite journal | vauthors = Gupta SK, Pereira BM, Singh AB | title = Fomes pectinatis: an aeroallergen in India | journal = Asian Pacific Journal of Allergy and Immunology | volume = 17 | issue = 1 | pages = 1–7 | date = March 1999 | pmid = 10403002 }}</ref> Some fungal air-borne allergens such as ''[[Coprinus comatus]]'' are associated with worsening of [[eczema]]tous skin lesions.<ref name="Fischer-1999">{{cite journal | vauthors = Fischer B, Yawalkar N, Brander KA, Pichler WJ, Helbling A | title = Coprinus comatus (shaggy cap) is a potential source of aeroallergen that may provoke atopic dermatitis | journal = The Journal of Allergy and Clinical Immunology | volume = 104 | issue = 4 Pt 1 | pages = 836–841 | date = October 1999 | pmid = 10518829 | doi = 10.1016/S0091-6749(99)70295-2 | doi-access = free }}</ref> Children who are born during Autumn months (during fungal spore season) are more likely to develop asthmatic symptoms later in life.<ref>{{cite journal | vauthors = Harley KG, Macher JM, Lipsett M, Duramad P, Holland NT, Prager SS, Ferber J, Bradman A, Eskenazi B, Tager IB | title = Fungi and pollen exposure in the first months of life and risk of early childhood wheezing | journal = Thorax | volume = 64 | issue = 4 | pages = 353–358 | date = April 2009 | pmid = 19240083 | pmc = 3882001 | doi = 10.1136/thx.2007.090241 }}</ref>

=== Treatment ===
Treatment includes [[over-the-counter medication]]s, [[antihistamines]], [[nasal decongestants]], [[allergy shots]], and [[alternative medicine]]. In the case of nasal symptoms, antihistamines are normally the first option. They may be taken together with [[pseudoephedrine]] to help relieve a stuffy nose and they can stop the itching and sneezing. Over-the-counter options include [[clemastine]]. However, these antihistamines may cause extreme drowsiness, therefore, people are advised to not operate heavy machinery or drive while taking this kind of medication. Other side effects include [[dry mouth]], [[blurred vision]], [[constipation]], [[Dysuria|difficulty with urination]], confusion, and [[lightheadedness]].<ref name="PDR">{{cite web|url=http://www.pdrhealth.com/disease/disease-mono.aspx?contentFileName=BHG01AL10.xml&contentName=Seasonal+allergies&contentId=134&sectionMonograph=ht4 |title=Seasonal Allergies | work = Physician's Desk Reference |access-date=9 April 2010| archive-url= https://web.archive.org/web/20100415194735/http://www.pdrhealth.com/disease/disease-mono.aspx?contentFileName=BHG01AL10.xml&contentName=Seasonal+allergies&contentId=134&sectionMonograph=ht4| archive-date= 15 April 2010 | url-status= live}}</ref> There is also a newer second generation of antihistamines that are generally classified as [[non-sedating antihistamines]] or anti-drowsy, which include [[cetirizine]], [[loratadine]], and [[fexofenadine]].<ref name="Hay Fever Pharmacy">{{cite web |url=http://www.hayfeverpharmacy.co.nz/products/antihistamine-tablets |title=Non-Sedating or Anti-Drowsy Antihistamine Tablets | work = Hayfever Pharmacy | location = New Zealand |access-date=9 April 2010 |archive-url=https://web.archive.org/web/20100411083410/http://www.hayfeverpharmacy.co.nz/products/antihistamine-tablets |archive-date=11 April 2010 |url-status=dead |df=dmy-all }}</ref>

An example of nasal decongestants is pseudoephedrine and its side-effects include [[insomnia]], [[anxiety (mood)|restlessness]], and difficulty urinating. Some other [[nasal spray]]s are available by prescription, including [[azelastine]] and [[ipratropium bromide]]. Some of their side-effects include drowsiness. For eye symptoms, it is important to first bathe the eyes with plain eyewash to reduce irritation. People should not wear [[contact lenses]] during episodes of [[conjunctivitis]].

[[Allergen immunotherapy]] treatment involves administering doses of allergens to accustom the body to induce specific long-term tolerance.<ref>Van Overtvelt L. et al. Immune mechanisms of allergen-specific sublingual immunotherapy. Revue française d'allergologie et d'immunologie clinique. 2006; 46: 713–720.</ref> Allergy immunotherapy can be administered orally (as [[sublingual tablets]] or sublingual drops), or by injections under the skin ([[Subcutaneous administration|subcutaneous]]).<ref>{{Cite web |date=2024-03-03 |title=Oral Immunotherapy (OIT) in Practice - FoodAllergy.org |url=https://www.foodallergy.org/resources/oral-immunotherapy-oit-practice |access-date=2024-03-03 |archive-url=https://web.archive.org/web/20240303043507/https://www.foodallergy.org/resources/oral-immunotherapy-oit-practice |archive-date=3 March 2024 }}</ref><ref>{{Cite web |title=Allergy Shots (Subcutaneous Immunotherapy) {{!}} Allergy Treatment |url=https://acaai.org/allergies/management-treatment/allergy-immunotherapy/allergy-shots/ |access-date=2024-03-03 | work = American College of Allergy, Asthma & Immunology (ACAAI) |language=en-US}}</ref> Immunotherapy contains a small amount of the substance that triggers the allergic reactions.<ref name="Mayo Clinic">{{cite web|url=http://www.mayoclinic.com/health/allergy-shots/MY01158 |title=Allergy shots | work = Mayo Clinic |access-date=9 April 2010| archive-url= https://web.archive.org/web/20100422142754/http://www.mayoclinic.com/health/allergy-shots/MY01158| archive-date= 22 April 2010 | url-status= live}}</ref>

Gradual introduction is also used for egg and milk allergies as a home-based therapy mainly for children.<ref name="Dietary Advancement Therapy Using M">{{cite journal | vauthors = Gallagher A, Cronin C, Heng TA, McKiernan A, Tobin C, Flores L, McGinley AM, Loughnane C, Velasco R, O'B Hourihane J, Trujillo J | title = Dietary Advancement Therapy Using Milk and Egg Ladders Among Children With a History of Anaphylaxis | journal = The Journal of Allergy and Clinical Immunology. In Practice | volume = 12 | issue = 8 | pages = 2135–2143 | date = August 2024 | pmid = 38729302 | doi = 10.1016/j.jaip.2024.04.057 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Chomyn A, Chan ES, Yeung J, Vander Leek TK, Williams BA, Soller L, Abrams EM, Mak R, Wong T | title = Canadian food ladders for dietary advancement in children with IgE-mediated allergy to milk and/or egg | journal = Allergy, Asthma, and Clinical Immunology | volume = 17 | issue = 1 | pages = 83 | date = August 2021 | pmid = 34353372 | pmc = 8340453 | doi = 10.1186/s13223-021-00583-w | doi-access = free }}</ref> Such methods cited in the UK involve the gradual introduction of the allergen in a cooked form where the protein allergenicity has been reduced to become less potent.<ref>{{cite journal | vauthors = Bloom KA, Huang FR, Bencharitiwong R, Bardina L, Ross A, Sampson HA, Nowak-Węgrzyn A | title = Effect of heat treatment on milk and egg proteins allergenicity | journal = Pediatric Allergy and Immunology | volume = 25 | issue = 8 | pages = 740–746 | date = December 2014 | pmid = 25251921 | doi = 10.1111/pai.12283 }}</ref><ref>{{cite journal | vauthors = Shin M, Han Y, Ahn K | title = The influence of the time and temperature of heat treatment on the allergenicity of egg white proteins | language = English | journal = Allergy, Asthma & Immunology Research | volume = 5 | issue = 2 | pages = 96–101 | date = March 2013 | pmid = 23450247 | pmc = 3579098 | doi = 10.4168/aair.2013.5.2.96 }}</ref><ref>{{cite journal | vauthors = Cronin C, McGinley AM, Flores L, McKiernan A, Velasco R, O'B Hourihane J, Trujillo J | title = Primary care as a setting for introducing milk using the milk ladder in children with IgE-mediated cow's milk protein allergy | journal = Clinical and Translational Allergy | volume = 13 | issue = 7 | pages = e12286 | date = July 2023 | pmid = 37488730 | pmc = 10351366 | doi = 10.1002/clt2.12286 }}</ref> By reintroducing the allergen from a fully cooked, usually baked, state, research suggests that a tolerance can emerge to certain egg and milk allergies under the supervision of a [[dietitian]] or specialist.<ref>{{cite journal | vauthors = Cotter S, Lad D, Byrne A, Hourihane JO | title = Home-based graded exposure to egg to treat egg allergy | journal = Clinical and Translational Allergy | volume = 11 | issue = 8 | pages = e12068 | date = October 2021 | pmid = 34667590 | pmc = 8506942 | doi = 10.1002/clt2.12068 }}</ref><ref>{{cite journal | vauthors = Venter C, Meyer R, Ebisawa M, Athanasopoulou P, Mack DP | title = Food allergen ladders: A need for standardization | journal = Pediatric Allergy and Immunology | volume = 33 | issue = 1 | pages = e13714 | date = January 2022 | pmid = 34882843 | doi = 10.1111/pai.13714 | veditors = Eigenmann PA }}</ref><ref name="Dietary Advancement Therapy Using M"/> The suitability of this treatment is debated between British and North American experts.<ref name="Dietary Advancement Therapy Using M"/>