Add-On: 15 Mold Panel: IgE

Alternaria alternata is one of the most common outdoor moulds and a potent aeroallergen. Specific IgE antibodies reflect Type I hypersensitivity; exposure to spores triggers mast-cell degranulation in sensitised individuals, leading to rhinitis, asthma exacerbation, and less commonly atopic dermatitis or allergic fungal rhinosinusitis.

Alternaria sensitisation is a recognised risk factor for severe asthma and is more prevalent in patients with poorly controlled respiratory allergy. Detection guides environmental control, inhalant avoidance, and allergen immunotherapy decisions.

Aspergillus fumigatus is ubiquitous in soil, decaying organic matter, and indoor water-damaged environments. IgE to Asp f signals sensitisation; in the absence of invasive disease, elevations are seen in allergic bronchopulmonary aspergillosis (ABPA), severe asthma with fungal sensitisation, and allergic fungal rhinosinusitis.

Aspergillus-specific IgE is essential in the diagnosis of ABPA and guides management of severe asthma with fungal sensitisation. It is interpreted alongside total IgE, eosinophil count, precipitins, and imaging, not in isolation.

Penicillium species are common indoor moulds, particularly in damp buildings. P. chrysogenum (formerly P. notatum) is the species from which penicillin was originally isolated, though the allergen is distinct from the drug. Specific IgE reflects sensitisation to airborne spores and hyphal fragments.

Penicillium sensitisation is associated with chronic rhinitis and asthma exacerbated by indoor damp. Clinical significance is determined by the history of exposure and respiratory symptoms; cross-reactivity with other moulds is common.

Cladosporium is one of the most abundant outdoor moulds worldwide and also found indoors in moisture-damaged materials. C. herbarum is the most allergenic species; specific IgE indicates Type I sensitisation to its spore and mycelial allergens.

Cladosporium sensitisation is common in allergic rhinitis and asthma, particularly in children and adolescents with atopy. It is a frequent sensitiser in damp or water-damaged homes.

Fusarium species are soil and plant pathogens found in water-damaged buildings and outdoor air. F. proliferatum is one of several Fusarium species implicated in respiratory allergy; specific IgE reflects sensitisation to inhaled spores.

Fusarium sensitisation is less common than Alternaria or Aspergillus but clinically relevant in occupational settings (agriculture, horticulture) and in patients with severe or refractory allergic rhinitis or asthma.

Stachybotrys chartarum, colloquially 'black mould,' grows on cellulose-rich materials in chronically damp indoor environments. It produces mycotoxins and allergens; specific IgE indicates Type I sensitisation. The clinical significance of Stachybotrys beyond IgE-mediated allergy remains debated.

Detection of Stachybotrys-specific IgE confirms sensitisation in patients with water-damaged building exposure and respiratory symptoms. Evidence for systemic toxicity from environmental exposure is limited, but sensitisation supports remediation and avoidance.

Chaetomium is a common indoor mould in water-damaged buildings, preferring cellulose substrates. C. globosum is the most prevalent species; specific IgE reflects sensitisation to its allergens.

Chaetomium sensitisation is a marker of indoor damp exposure and can contribute to allergic rhinitis and asthma. It is less commonly measured than Aspergillus or Penicillium but relevant in occupational or residential damp investigations.

Aureobasidium pullulans is a ubiquitous yeast-like fungus found on plant surfaces, in soil, and in indoor damp environments. Specific IgE indicates sensitisation; the fungus is a known cause of allergic respiratory symptoms in damp housing.

Sensitisation to Aureobasidium is common in patients with chronic rhinitis or asthma living in damp or mouldy environments. Cross-reactivity with other environmental moulds is frequent.

Epicoccum is a plant pathogen and saprophyte, common outdoors on dead plant material and indoors in damp conditions. E. purpurascens is the principal allergenic species; specific IgE denotes Type I sensitisation.

Epicoccum sensitisation is associated with seasonal allergic rhinitis and asthma, particularly in agricultural and horticultural workers and in patients exposed to outdoor and indoor mould.

Rhizopus stolonifer, the common bread mould, is a fast-growing fungus found on decaying fruit, vegetables, and baked goods. Specific IgE indicates sensitisation to inhaled or contact allergens from this ubiquitous organism.

Rhizopus sensitisation is less common than Aspergillus or Penicillium but clinically relevant in occupational settings (food handling, composting) and in patients with refractory allergic rhinitis or asthma.

Mucor species are ubiquitous environmental moulds found in soil, decaying vegetation, and spoiled food. M. racemosus is one allergenic species; specific IgE reflects Type I sensitisation.

Mucor sensitisation is uncommon but may be relevant in occupational or residential exposures involving organic decay or compost. It is grouped with other zygomycetes for allergy evaluation.

Botrytis cinerea, the grey mould, is a plant pathogen found on grapes, berries, and other fruits. It is common in agricultural settings and wine production. Specific IgE indicates sensitisation to its airborne spores and allergens.

Botrytis sensitisation is relevant in occupational exposures (viticulture, horticulture) and in patients with allergic rhinitis or asthma triggered by fruit handling or damp agricultural environments.

Trichoderma viride is a soil fungus and plant symbiont found in decaying wood and damp building materials. Specific IgE indicates Type I sensitisation to its allergens.

Trichoderma sensitisation is less frequently reported but may be relevant in indoor damp investigations and in agricultural or horticultural occupational exposures.

Curvularia species are dematiaceous moulds found in soil, plants, and indoor damp environments. C. lunata is one allergenic species; specific IgE denotes sensitisation to its spores.

Curvularia sensitisation is associated with allergic rhinitis and asthma in patients with damp indoor exposure. It is less commonly tested than Alternaria or Cladosporium but relevant in comprehensive mould panels.

Helminthosporium (also classified under Bipolaris) is a plant pathogen and allergen found outdoors and in damp indoor environments. H. halodes is one allergenic species; specific IgE reflects sensitisation.

Helminthosporium sensitisation is recognised in allergic rhinitis and asthma, particularly in agricultural workers and patients exposed to outdoor moulds. Cross-reactivity with other dematiaceous fungi is common.