1,455
Views
155
CrossRef citations to date
0
Altmetric
Review Article

Health Effects of Mycotoxins: A Toxicological Overview

, M.D., M.S. & , M.D.
Pages 217-234 | Received 29 Sep 2003, Accepted 19 Nov 2003, Published online: 05 Nov 2004

References

  • Kendrick B. Chapter 1, kingdoms and classification. The Fifth Kingdom2nd ed. Mycologue, Waterloo, OntarioCanada 1992; 1–6
  • Solomon W R, Platts‐Mills T AE. Chapter 19, aerobiology of inhalant allergens. Allergy‐Principles and Practice4th ed, E Middleton, C E Reed, E F Ellis, N F Adkinson, J W Yunginger, W W Busse. Mosby, St. Louis 1993; 469–528
  • Jelinek C F, Pohland A E, Wood G E. Review of mycotoxin contamination worldwide occurrence of mycotoxins in foods and feeds—an update. J Assoc Anal Chem 1989; 72(2)223–230
  • Kendrick B. Chapter 21, mycotoxins in food and feed. The Fifth Kingdom2nd ed. Mycologue, Waterloo, OntarioCanada 1992; 316–331
  • FDA: FDA/CFSAN Food Compliance Program. Mycotoxins in Imported Foods. Center for Food Safety Applied Nutrition Food Compliance Program, Issued January 20, 1999
  • Ueno Y. The toxicology of mycotoxins. CRC Crit Rev Toxicol 1985; 14(2)99–132
  • Hadidane R, Roger‐Regnault C, Bouattour H, Ellouze F, Bacha H, Creppy E E, Dirheimer G. Correlation between elementary mycotoxin contamination and specific diseases. Human Toxicol 1985; 4(5)491–510
  • MMWR. Pulmonary hemorrhage/hemosiderosis among infants—Cleveland, Ohio, 1993–1996. Morb Mort Wkly Rep 1997; 46: 33–35
  • Zavaleta E G, Fernandez B B, Grove M K, Kaye M D. Saint Anthony's fire (ergotamine induced leg ischemia) a case report and review of the literature. Angiology 2001; 52(5)349–356
  • Williams S R. Chapter 102, Ergotamines. Medical Toxicology3rd ed, R C Dart. Lippincott, Williams & Wilkins, Baltomore 2004
  • Dennings D W. Aflatoxin and human disease. Adv Drug React Ac Pois Rev 1987; 6(4)175–209
  • Forgacs J, Carll W T. Mycotoxicoses: toxic fungi in tobaccos. Science 1966; 152(729)1634–1635
  • Riley R T, Kemppainen B W, Norred W P. Penetration of aflatoxins through isolated epidermis. J Toxicol Environ Health 1985; 15(6)769–777
  • Ryan N J, Hogan G R, Hayes A W, Ungar P D, Siraj M Y. Aflatoxin B1: its role in the etiology of Reye's syndrome. Pediatrics 1979; 64(1)71–75
  • Hsieh D PH, Wong J J. Metabolism and toxicity of aflatoxins. Adv Exp Med Biol 1982; 136(B)847–863
  • Smela M E, Currier S S, Bailey E A, Essigmann J N. The chemistry and biology of aflatoxin B1: from mutational spectrometry to carcinogenesis. Carcinogenesis 2001; 22(4)535–545
  • Patten R C. Aflatoxins and disease. Am J Trop Med Hyg 1981; 30(2)422–425
  • Willis R M, Mulvihill J J, Hoofnagle J H. Attempted suicide with purified aflatoxin. Lancet 1980; 1(8179)1198–1199
  • Pohland A E, Trucksess M W. Mycotoxin method evaluation. Methods Mol Biol 2001; 157(1)3–10
  • Gilbert J. Recent advances in analytical methods for mycotoxins. Food Addit Contam 1993; 10(1)37–48
  • Wilkenson A P, Denning D W, Morgan M. An ELISA method for the rapid and simple determination of aflatoxin in human serum. Food Addit Contam 1988; 5(4)609–619
  • FDA: Food and Drug Administration Office of Regulatory Affairs Compliance Policy Guides (CPG) Section 683.100 Action Levels for Aflatoxins as in Animal Feeds (CPG 7126.33), FDA Issued 11/21/79, revised 8/28/94
  • Verardi G, Rosner H. Some reflections on establishing a community legislation on mycotoxins. Nat Toxins 1995; 3(4)337–340
  • Stoloff L, Van Egmond H P, Park D L. Rationales for the establishment of limits and regulations for mycotoxins. Food Addit Contam 1991; 8(2)213–222
  • Krogh P, Axelsen N H, Elling F, Gyrd‐Hansen N, Hald B, Hyldgaard‐Jensen J, Larsen A E, Madsen A, Mortensen H P, Moller T, Peterson O K, Ravnkov U, Rostgaard M, Aalund O. Experimental porcine nephropathy. Changes of renal function and structure induced by ochratoxin A‐contaminated feed. Acta Pathol Microbiol Scand, A 1974; 0(Suppl. 246)1–21
  • Kumagai S. Effects of plasma ochratoxin toxin and luminal pH on the jejunal absorption of ochratoxin A in rats. Food Chem Toxicol 1988; 26(9)753–758
  • Chang F C, Chu F S. The fate of ochratoxin A in rats. Food Cosmet Toxicol 1977; 15(3)199–204
  • Fukui Y, Hoshino K, Kameyma Y, Yasui T, Toda C, Nagano H. Placental transfer of ochratoxin A and its cytotoxic effect on the mouse embryonic brain. Food Chem Toxicol 1987; 25(1)17–24
  • Kuiper‐Goodman T, Scott P M. Risk assessment of the mycotoxin ochratoxin A. Biomed Environ Sci 1989; 2(3)179–248
  • Creppy E E, Roschenthaler R, Dirheimer G. Inhibition of protein synthesis in mice by ochratoxin A and its prevention by phenylalanine. Food Chem Toxicol 1984; 22(11)883–886
  • Omar R F, Rahimtula A D. Role of cytrochrome P‐450 and in ochratoxin A‐stimulated lipid peroxidation. J Biochem Toxicol 1991; 6(3)203–209
  • Chu F S. Studies on ochratoxins. CRC Crit Rev Toxicol 1974; 2(4)499–524
  • Domijan A M, Paraica M, Fuchs R, Lucic A, Radic B, Balija M, Bosanac I, Grgicevic D. Ochratoxin A in blood on healthy population in Zagreb. Arh Hig Rada Toksikol 1999; 50(3)263–271
  • Chu F S. Recent progress on analytical techniques for mycotoxins in feedstuffs. J Anim Sci 1992; 70(12)3950–3963
  • Food and Agriculture Organization of the United Nations and World Health OrganizationJoint FAO/WHO Expert Committee on Food Additives 56th MeetingGenevaFebruary2001
  • WHO Environmental Health Criteria 105. Selected Mycotoxins: Ochratoxins, Trichothecenes, Ergot. World Health Organization, Geneva 1990
  • Kemppainen B W, Riley R T. Penetration of [H]T‐2 toxin through excised human and guinea pig skin during exposure to [H]T‐2 toxin adsorbed to corn dust. Food Chem Toxicol 1984; 22(11)893–896
  • Barel S, Yagen B, Biler M. Pharmacokinetics of the trichothecenes mycotoxin verrucarol in dogs. J Pharm Sci 1990; 79(6)548–551
  • Beasley V R, Swanson S P, Corley R A, Buck W B, Koritz G D, Burmeister H R. Pharmacokinetics of the trichothecene mycotoxin, T‐2 toxin, in swine and cattle. Toxicon 1986; 24(1)13–23
  • Ueno Y. Mode of action of trichothecenes. Ann Nutr Aliment 1977; 31(4–6)885–900
  • Khachatourians G G. Metabolic effects of trichothecene T2 toxin. Can J Physiol Pharm 1989; 68(7)1004–1008
  • Yoshizawa T, Sakamoto T, Kuwamura K. Structure of deepoxytrichothecene metabolites from 3‐hydroxy HT‐1 toxin and T‐2 tetraol in rats. Appl Environ Microbiol 1985; 50(3)67–69
  • Madhyastha S, Marquardt R R, Abramson D. Structure‐activity relationship and interactions among trichothecene mycotoxins assessed by yeast bioassay. Toxicon 1994; 32(9)1147–1152
  • Bergmann F, Soffer D, Yagen B. Cerebral toxicity of the trichothecene toxin T‐2, of the products of its hydrolysis and of some related toxins. Toxicon 1988; 26(10)923–930
  • Sudakin D L. Trichothecenes in the environment: relevance to human health. Toxicol Lett 2003; 143(2)97–107
  • Smith R D, Udseth H R, Wright B W. Rapid and high resolution capillary supercritical fluid chromatography and SFC/MS of trichothecene mycotoxins. J Chromatogr Sci 1985; 23(5)192–199
  • Rood H D, Swanson S P, Buck W B. Rapid screening procedure for the detection of trichothecenes in plasma and urine. J Chromatogr 1986; 378(2)375–383
  • Pestka J J. Enhanced surveillance of foodborne mycotoxins by immunochemical assay. J Assoc Off Anal Chem 1988; 71(6)1075–1081
  • Frank H K. Citrinin. Z Ernahrwiss 1992; 31(3)164–177
  • Castegnaro M, Michelon J, DeMeo M, Laget M. Destruction of ochratoxin A and citrinin using sodium hypochlorite. IARC Sci Publ 1991; 113: 9–16
  • International Agency for Research of Cancer. IARC monographs on the evaluation of the carcinogenic risk of chemicals to humans. Patulin. IARC 1984; 40: 83–98
  • FDA: Office of Plant and Dairy Food and Beverages, Center for Food Safety and Applied Nutrition. Patulin in Apple Juice, Apple Juice Concentrates and Apple Juice Products. U.S. Food and Drug Administration. June 15, 2000
  • Thiel P G, Marasas W FO, Sydenham E W, Shepherd G S, Gelderblom W CA. The implications of naturally occurring levels of fumonisins in corn in human and animal health. Mycopathologia 1992; 117(1)3–9
  • Wang J S, Groopman J D. DNA damage by mycotoxins. Mutat Res 1999; 424(1–2)167–181
  • Wentzel C A, Gelderblom W, Marasas W, Vleggaar R, Thiel P G, Cawood M E. Fumonisins: isolation, chemical characterization and biological effects. Mycopathologia 1992; 117(1)11–16
  • Kellerman T S, Maras W F, Thiel P G, Gelderblom W C, Cawood M E. Leukoencephalomalacia in two horses induced by oral dosing of fumonisin B1. Onderstepoort J Vet Res 1990; 57(4)269–275
  • Chu F S, Li G Y. Simultaneous occurrence of fumonisin B1 and other mycotoxins in moldy corn collected from the People's Republic of China in regions with high incidences of esophageal cancer. Appl Environ Microbiol 1994; 60(3)847–852
  • Emanuel D A, Wenzel F J, Lawton B R. Pulmonary mycotoxicosis. Chest 1975; 67(3)293–297
  • MMWR. Update: pulmonary hemorrhage/hemosiderosis among infants—Cleveland, Ohio, 1993–1996. Morb Mort Wkly Rep 2000; 49: 180–184
  • Nikulin M, Reijula K, Jarvis B B, Veijalainen P, Hintikka E L. Effects of intranasal exposure to spores of Stachybotrys atra in mice. Fundam Appl Toxicol 1997; 35(2)182–188
  • Rao C Y, Burge H A, Brain J D. The time courses of responses to intratracheally instilled toxic Stachybotrys chartarum spores in rats. Mycopathologia 2000; 149(1)27–34
  • Hodgson M J, Morey P, Leung W Y, Morrow L, Miller D, Jarvis B B, Robbins H, Halsey J F, Storey E. Building‐associated pulmonary disease from exposure to Stachybotrys chartarum and Aspergillus versicolor. J Occup Environ Med 1998; 40(3)241–249
  • Knapp J F, Michael J G, Hegenbarth M A, Jones P E, Black P G. Case records of the Children's Mercy Hospital, case 02‐1999: a 1‐month‐old infant with respiratory distress and shock. Pediatr Emerg Care 1999; 15(4)288–293
  • Flappan S M, Portnoy J, Jones P, Barnes C. Infant pulmonary hemorrhage in a suburban home with water damage and mold (Stachybotrys atra). Environ Health Perspect 1999; 107(11)927–930
  • Novotny W E, Dixit A. Pulmonary hemorrhage in an infant following 2 weeks of fungal exposure. Arch Pediatr Adolesc Med 2000; 154(3)271–275
  • Tripi P A, Modlin S, Sorenson W G, Dearborn D G. Acute pulmonary hemorrhage in an infant during induction of general anesthesia. Paediatr Anaesth 2000; 10(1)92–94
  • Elidemir O, Colasurdo G N, Rossmann S N, Fan L L. Isolation of Stachybotrys from the lung of a child with pulmonary hemosiderosis. Pediatrics 1999; 104(4 Part 1)964–966
  • Trout D, Bernstein J, Martinez K, Biangini R, Wallingford K. Bioaerosol lung damage in a worker with repeated exposure to fungi in a water‐damaged building. Environ Health Perspect 2001; 109(6)641–644
  • Croft W A, Jarvis B B, Yatawara C S. Airborne outbreaks of trichothecene toxicosis. Atmos Environ 1986; 20(3)549–552
  • Baldo J V, Ahmad L, Ruff R. Neuropsychological performance of patients following mold exposure. Appl Neuropsychol 2002; 9(4)193–202
  • Hudnell H K, Otto D A, House D E, Molhave L. Exposure of humans to a volatile organic mixture II. Sensory. Arch Environ Health 1992; 47(1)31–38
  • Otto D A, Hudnell H K, House D E. Exposure of humans to a organic mixture. I. Behavioral assessment. Arch Environ Health 1992; 47(1)23–30
  • Dalton P. Upper airway irritation, odor perception and health risk due to chemicals. Toxicol Lett 2003; 140–141: 239–248
  • Liu X, Luo X, Hu W. Studies on the epidemiology and etiology of moldy sugarcane poisoning in China. Biomed Environ Sci 1992; 5(2)161–177
  • Ludolph A C, He F, Spencer P S, Hammerstad J, Sabri M. 3‐Nitropropionic acid exogenous animal neurotoxin and possible human striatal toxin. Can J Neurol Sci 1991; 18(4)492–498
  • Lalitha Rao B, Husain A. Presence of cyclopiazonic acid and kodo millet (Paspalum scrobiculitum) causing kodua poisoning and its production by associated fungi. Mycopathologia 1985; 89(3)177–180
  • Sobotka T J, Brodie R E, Spaid S L. Neurobehavioral studies of tremorgenic mycotoxins verruculogen and penitrem A. Pharmacology 1978; 16(5)287–294
  • Breton P, Bizot J‐C, Buee J, DeLamanche I. Brain neurotoxicity of penitrem A: electrophysiological, behavioral and histopathological study. Toxicon 1998; 36(4)645–655
  • Monatana E, Etzel R A, Allan T, Horgan T E, Dearborn D G. Environmental risk factors associated with pediatric idiopathic pulmonary hemorrhage and hemosiderosis in a Cleveland community. Pediatrics 1997; 99(1)117–124
  • Les‐Haley P R. Commentary on neuropsycological performance of patients following mold exposure. Sci Rev Mental Health Prac, In press
  • Eichner R D, Mullbacher A. Hypothesis: fungal toxins are involved in aspergillosis and AIDS. Aust J Exp Biol Med Sci 1984; 62(part 4)479–484
  • Drobotko V G. Stachybotryotoxicosis. A new disease of horses and humans. Am Rev Sov Med 1945; 2: 238–242
  • Giambrone J J, Ewert D L, Wyatt R D, Eidson C S. Effect of aflatoxin on the humoral and cell‐mediated immune system of the chicken. Am J Vet Res 1978; 39(2)305–308
  • Corrier D E. Mycotoxicoses: mechanisms of immunosuppression. Vet Immunol Immunopathol 1991; 30(1)73–87
  • Pier A C, Richard J L, Cysewski S J. Implications of mycotoxins in animal disease. J Am Vet Med Assoc 1980; 176(8)719–724
  • LaFarge‐Frayssinet C, Decloitre F, Moussnets, Martin M, Freyssinet C. Induction of DNA single strand breaks by T2 toxin, a trichothecene metabolite of Fusarium. Mutat Res 1981; 88(2)115–123
  • Dales R, Miller D, White J, Dulberg C, Lazarovits A I. Influence of residential fungal contamination on peripheral blood lymphocyte population in children. Arch Environ Health 1998; 53(3)190–195
  • Johanning E, Biagini R, Hull D L, Morey P, Jarvis B. Landsbergis. Health and immunology study following exposure to toxigenic fungi (Stachybotrys chartarum) in a water‐damaged office environment. Int Arch Occup Environ Health 1996; 68(4)206–218
  • Bondy G S, Pestka J J. Immunomodulation by fungal toxins. J Toxicol Environ Health, Crit Rev 2000; 3(2)109–143
  • Wogan G N. Aflatoxin carcinogenesis: interspecies potency differences and relevance for human risk assessment. Prog Clin Biol Res 1992; 374: 123–137
  • Peraica M, Radic B, Lucic A, Pavlovic M. Toxic effects of mycotoxins in humans. Bull World Health Organ 1999; 77(9)754–766, World Health Organization
  • Yu M C, Yuan J N, Govindarajan S, Ross R K. Epidemiology of hepatocellular carcinoma. Can J Gastroenterol 2000; 14(8)703–709
  • Hussanin S P, Harris C C. Molecular epidemiology and carcinogenesis: endogenous and exogenous carcinogens. Mutat Res 2000; 462(2–3)311–322
  • Chao T C, Maxwell S M, Wong S Y. An outbreak of aflatoxicosis and boric acid poisoning in Malaysia: a clinical pathological study. J Pathol 1991; 164(3)225–233
  • Dvrorackova I, Kusak E, Vesely D, Vesela J, Nesnidal P. Aflatoxin and encephalopathy with fatty degeneration of viscera (Reye). Ann Nutr Aliment 1977; 31(4–6)977–990
  • Hayes R B, Van Nieuwenhuize J P, Raatgiver J W, ten Kate F JW. Aflatoxin exposures in the industrial setting: epidemiological study of mortality. Food Chem Toxicol 1984; 22(1)39–43
  • Olsen J H, Dragsted L, Autrup H. Cancer risk in occupational exposure to aflatoxins in Denmark. Br J Cancer 1998; 58(3)392–396
  • Dvrorackova I. Aflatoxin and inhalation and alveolar cell carcinoma. Br Med J 1976; 1(6011)691
  • Pohland A E. Mycotoxins in review. Food Addit Contam 1993; 10(1)17–28
  • Withanage G S, Murata H, Koyama T, Ishiwata I. Agonistic and antagonistic effects of Zearalenone, an estrogenic mycotoxin, on SKN, HHUA, and Hep G2 human cancer cell lines. Vet Hum Toxicol 2001; 43(1)6–10
  • Dees C, Foster J S, Ahamed S, Wimalasena J. Dietary estrogens stimulate human breast cells to enter the cell cycle. Environ Health Perspect 1997; 105(suppl. 3)633–636
  • Korpinen E, Kallela K, Ylimaki A. Estrogenic activity of Fusarium gramineam on rats in experimental conditions. Nord Vet Med 1972; 24(2)62–66
  • Yoshizawa T, Yamashita A, Luo U. Fumonisin occurrence in corn from high and low risk areas for human esophageal cancer in China. Appl Environ Microbiol 1994; 60(5)1626–1629
  • Nam K S, Jo Y S, Kim Y H, Hyun J W, Kim H W. Cytotoxic activities of acetoxyscirpenediol and ergosterol peroxide from Paecilomyces tenuipenus. Life Sci 2001; 69(2)229–237
  • Juranic Z, Stojiljkovic M P, Bocarov‐Stancica, Kilibarda V, Milovanovic S R, Juranic I, Bijelogrlic S, Vuletic N, Radulovic S. T‐2 toxin affects proliferation of three different neoplastic cell lines. J Exp Clin Cancer Res 1998; 17(1)33–40
  • Hardin B D, Kelman B J, Saxon A. Adverse human health effects associated with molds in the indoor environment. ACOEM Evidence‐Based Statement. American College of Occupational and Environmental Medicine, Arlington Heights, IL October 27, 2002
  • DiPaolo N, Guarnieri A, Loi F, Sacchi G, Mangiarotti A M, DiPaolo M. Acute renal failure from inhalation of mycotoxins. Nephron 1993; 64(4)621–625
  • Mantle P G. Interruption of early pregnancy in mice by oral administration of agroclavine and sclerotia of Claviceps fusiformis (loveless). J Reprod Fertil 1969; 18(1)81–88
  • Mantle P G, Finn G CA. Investigations of the mold of action of D‐6‐methyl‐8‐cyanomethylergoline in suppressing pregnancy in the mouse. J Reprod Fertil 1971; 24(3)441–444
  • Greatorex J C, Mantle P G. Effect of rye ergot on the pregnant sheep. J Reprod Fertil 1974; 37(1)33–41
  • Weaver G A, Kurtz H J, Bates F Y, Chi M S, Behrens J C, Robison T S. Acute and chronic toxicity of T‐2 mycotoxin in swine. Vet Rec 1978; 103(24)531–535
  • Bhat R V, Shetty P H, Amruth R P, Sudershan R V. A food borne disease outbreak due to the consumption of moldy sorghum and maize containing fumonisin mycotoxins. Clin Toxicol 1997; 35(3)249–255
  • McPartland J M, Vilgays R J, Cubeta M A. Mushroom poisoning. Am Fam Phys 1997; 55(5)1791–1809
  • Broussard C N, Aggarwal A, Lacey S R, Post A B, Granilich T, Henderson J M, Younossi Z M. Mushroom poisoning—from diarrhea to liver transplantation. Am J Gastroenterol 2001; 96(11)3195–3198
  • Kuhn D M, Ghannoum M A. Indoor mold, toxigenic fungi and Stachybotrys chartarum: infectious disease perspective. Clin Microbiol Rev 2003; 16(1)144–172
  • Lacey J, Lacey M E. Microorganisms in the air of cotton mills. Ann Occup Hyg 1987; 31(1)1–19
  • Malmberg P, Rask‐Anderson A, Rosenhall L. Exposure to microorganisms associated with allergic alveolitis and febrile reactions to mild dust in farmers. Chest 1993; 103(4)1202–1209
  • Wilkins C K, Larsen S T, Hammer M, Poulson O M, Welkoff P, Nielsen G D. Respiratory effects in mice exposed to airborne emissions from Stachybotrys chartarum and implications for risk assessment. Pharmacol Toxicol 1998; 83(3)112–119
  • Fischer G, Dott W. Quality assurance and good laboratory practice in the mycological laboratory‐compilation of basic techniques for the identification of fungi. Int J Hyg Environ Health 2002; 205(6)433–442
  • Selim M I, Juchems A N, Popendorf W. Assessing airborne aflatoxin B1 during/on farm grain handling activities. AIHAJ 1997; 59(4)252–256
  • Fung F, Clark R, Williams S. Stachybotrys, a mycotoxin producing fungus of increasing toxicologic importance. Clin Toxicol 1998; 36(1–2)79–86
  • Miller R V, Martinez‐Miller C, Bolin V. A novel risk assessment model for the evaluation of fungal exposure in indoor environments. Mycotoxin and Phytotoxins in Perspective at the Turn of the Millennium, W J De Koe, R A Samson, H P van Egmond, J Gilbert, M Sabino. IUPAC and AOAC. 2001; 123–131
  • Sorenson W G, Frazer D G, Jarvis B B, Simpson J, Robinson V A. Trichothecene mycotoxins in aerosolized conidia of Stachybotrys atra. Appl Environ Microbiol 1987; 53(6)1470–1475
  • Registry of Toxic Chemical Substance (RTECS): Mycotoxin T‐2RTECS Number: YD0100000Department of Health and Human Service, National Institute of Occupational Safety and Health Publication, March 1996
  • USAMRIID's Medical Management of Biological Casualties Handbook4th ed. US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD 2001, appendix I
  • Fung F, Hughson W G. Health effects of indoor fungal bioaerosol exposure. Appl Occup Environ Hyg 2003; 18(7)535–544
  • Guyatt G H, Haynes R B, Jaeschke R Z, Cook D J, Green L, Naylor C D, Wilson M C, Richardson W S. for the Evidence‐Based Medicine Working Group. Users' Guides to the Medical Literature: XXV. Evidence‐based medicine: Principles for applying the Users' Guides to patient care. JAMA 2000; 284(10)1290–1296
  • McClusky O E. Black mold and human illness. Report of Council on Scientific Affairs CSA Report 1‐I‐02. Texas Medical Association. September, 2002
  • Chapman J A. Stachybotrys chartarum (chartarum = atra = altarnans) and other problems caused by allergenic fungi. Allergy Asthma Proc 2003; 24(1)1–7

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.