From the Guidelines
A mold allergen panel typically includes tests for common mold species such as Alternaria alternata, Aspergillus fumigatus, Cladosporium herbarum, and Penicillium notatum. The selection of these components is based on a careful history of relevant symptoms, knowledge of possible environmental exposures, and correlation with positive test results for specific IgE antibodies 1. The panel is conducted through blood tests or skin prick tests where small amounts of mold extracts are placed on the skin to observe reactions.
Key Components of a Mold Allergen Panel
- Alternaria alternata
- Aspergillus fumigatus
- Cladosporium herbarum
- Penicillium notatum Results are typically available within a few days for blood tests or immediately for skin tests. This testing is important for individuals experiencing symptoms like sneezing, runny nose, itchy eyes, or asthma exacerbations when exposed to damp or moldy environments. Identifying specific mold allergies helps healthcare providers develop targeted treatment plans, which may include avoidance strategies, medications like antihistamines or nasal corticosteroids, or in some cases, immunotherapy to build tolerance to the allergens. It is also important to note that the allergen content of most mold extracts is variable, and proteolytic enzymes present in some mold extracts could digest other antigens when combined in a mixture 1. Therefore, separation of extracts with high proteolytic enzyme activities, such as mold/fungi, from other extracts, such as pollens, is recommended 1.
From the Research
Mold Allergen Panel Components
The components included in a mold allergen panel can vary, but based on the provided studies, the following molds are commonly tested:
- Alternaria alternata 2, 3, 4, 5, 6
- Aspergillus fumigatus 2, 3, 4, 5, 6
- Penicillium chrysogenum 3, 5, 6
- Cladosporium herbarum 2, 3, 5
- Candida 2, 4
- Helminthosporium 4
- Aspergillus versicolor 3, 6
- Curvularia 4
- Acremonium spp., Aspergillus penicillioides, Aspergillus restrictus, Chaetomium spp., Phialophora spp., Stachybotrys chartarum, Tritirachium (Engyodontium) album, and Trichoderma spp. may also be associated with indoor mold pollution, but their inclusion in a mold allergen panel is not explicitly stated in the provided studies 5
Testing Methods
The studies mention various testing methods, including:
- Skin prick test (SPT) 3, 5
- Intradermal skin test 2
- ImmunoCAP system 2, 4
- Radioimmunoassay version of CAP 2
- In-vitro allergy screening (UniCap 100/Phadia) 5
- In-house dot-blot assay 6
Sensitization Rates
The studies report varying sensitization rates to different mold species, with Alternaria alternata and Aspergillus fumigatus being the most common sensitizers 2, 3, 4, 5, 6. The sensitization rates to individual mold species are: