Cladosporium cladosporioides

Cladosporium cladosporioides on gypsum boardCladosporium cladosporioides on woodCladosporium cladosporioides on a ceiling tileCladosporium cladosporioides on EM agarCladosporium cladosporioides on RB agarCladosporium cladosporioides - Microscopy (EM Culture)

Basics

The Cladosporium genus is one of the most common environmental fungi to be isolated worldwide {813; 1056; 2770}. Of this genus, C. herbarum and C. cladosporioides are among the most frequently encountered species, both in outdoor and indoor environments; they are also the most common species reported as indoor contaminants  occasionally linked to health problems {3729; 1056}. The following information relates to the above two species unless otherwise stated.

Taxonomy

Kingdom Fungi Order Capnodiales
Phylum Ascomycota Family Davidiellaceae
Class Dothideomycetes Genus Cladosporium

The genus comprises over 40 officially named species {816; 3318} and 180 unnamed strains registered with the Universal Protein Resource international data bank {3318}.  Cladosporium herbarum is the type species, with over 30 registered varieties {3971}; C. cladosporioides has only one registered variety. 

Mycosphaerella tassiana is the teleomorph stage of Cladosporium herbarum; there is no known or published sexual stage for C. cladosporioides.  Other teleomorph genera associated with Cladosporium spp. are Capronia, Didmyellina, Loculistroma and Mycosphaerella.

Hormodendrum cladosporioides is an obsolete synonym for C. cladosporioides; C. graminum is an obsolete synonym of the species C. herbarum.

Habitat/Ecology

Cladosporium spp. are dematiaceous moulds, widely prevalent in outdoor air and on decaying organic material; these fungi are frequently found as contaminants on food. Some species are predominant in tropical and subtropical regions {2207; 814; 4289; 3729; 3283; 2770}.

This genus comprises common saprobic, phytopathogenic and human pathogenic species. The common saprobic members of Cladosporium are found in many different types of soil as well as on all types of senescing and dead plant matter; a few species are also known to grow on moist building materials. 

More details

Cladosporium herbarum is found in temperate, tropical and sub-tropical regions; it can even be found in polar regions. This fungus can colonise damaged leaves and stems and necrotise plant tissue within 2 months {989; 725} (725, 989).

On the other hand, Cladosporium cladosporioides is found in temperate or northern climates and less in sub-tropical regions.

Cladosporium sp. usually dominates the mould spore content of outdoor air {313; 1788; 638; 618; 2351; 2285; 1281; 2226; 2517; 2216}. This genus can represent as much as 70-80% of outdoor fungal counts {2569}; it is notably present in the summer and autumn {2759} .

Spore counts in excess of 125 000 CFU/m3 have been reported in peak seasons {1788}. An Iberian study reported that C. herbarum had the highest average daily concentrations (1 197 spores/m3) while C. cladosporioides had the highest single concentration (7 556 spores/m3) {2740}. An annual mean concentration of 200 CFU/m3 for (herbarum orcladosporioides ??) has been reported in Greece {1282}.

In one Egyptian study, total Cladosporium counts in air-dust particle samples collected on the roofs of selected houses reached up to 12.4 x 10³ CFU/g airborne dust {929};  these fungi were detected in 60% of cultured samples.
In another study, Cladosporium was also one of the most frequent isolates in aeroallergen samples collected from sandstorm dust {1841}.

Growth requirements

Cladosporium spp. grow optimally within a temperature range of 18-28 °C {725} ; however, for certain species, growth is also possible below 0°C {813}. Most Cladosporium species can grow at 30-35 °C, but do not grow above 35-37°C {412; 816}.

Available water (Aw) requirements are between 0.85 and 0.88 for both species described herein {989; 1202}. Both grow well on all general fungal media {813}.

C. cladosporioides is considered to be xerophilic, xerotolerant but also psychrophylic, as demonstrated by its ability to grow at freezing temperatures; it can grow at a slower pace at temperatures between -10°C and -3°C.

C. herbarum also has the ability to grow on frozen substratum; it is also xerophilic and xerotolerant {1202}.

Water activity : (C. cladosporioides)    Aw = 0.86-0.88   {2286}

Growth on building materials or indoor environment

Indoors, the common saprobic (saprophytic) members of Cladosporium are also frequently isolated from air, food stuffs, paint, moist window sills, textiles and other organic substrates {989; 2745; 813; 1056; 2770}. It is usually thought thatCladosporium spp. occur more often in the outdoor air rather than indoors, however in field studies this genus was widely found within homes in the USA (70% of examined dwellings) and in all homes examined in Canada, with an average count of 437-456 CFU/m3.  In fact, C. herbarum has been reported in dwellings sampled around the world {1202}.  However,Cladosporium is often in significantly lower concentrations indoors than outdoors.

More details

Cladosporium cladosporioides has been reported growing indoors on paper, pulp, paint, frescos and textiles (silk, cotton);C. herbarum has been found on rotting wood, rubber, leather, plastics, paper and pulp, paint and frescos {989}.Cladosporium sp. is considered an early colonizer, detectable at 2 weeks on untreated wet gypsum, observed both under controlled laboratory conditions and after water damage in buildings {587; 695}.

The occurrence of Cladosporium is often as high in indoor air as it is in outdoor air {2388} and, in some instances, can constitute the dominant genus in indoor air {2216}, both in terms of occurrence and concentration, up to 6 154 CFU/m3{2747}. A study of 68 homes in Southern California, found Cladosporium in all tested homes, with a mean viable spores concentration of 437/m3 {1824}.

A sampling of 49 houses in Santa Fe (Argentina) revealed a high presence of Cladosporium with a frequency of 58.9% and a mean count of 512 CFU/m3 (380 in the urban area, 676 in suburban areas) {1584}. Cladosporium species were also found in the indoor environment of households in Riyadh, in concentrations similar to that of several other moulds (up to 49 CFU/g house dust) {1756}.

Cladosporium sp. is widely distributed on leaf surfaces of deciduous trees {1281}. Consequently, indoor mould samples from houses located near deciduous forests often show high concentrations of C. herbarum, especially in the high season i.e. late summer and autumn, indicating that the spores will penetrate homes from the outdoor environment {715}; open windows is a factor associated with higher indoor concentrations of Cladosporium {2750}. Presence of large number of plants indoors can also influence the prevalence of Cladosporium. A study of the quality of indoor air of greenhouses and dwellings with house plants revealed that Cladosporium species were recovered between 90 to 97% of the time {1822; 2765}.

High concentrations of Cladosporium indoors during the low season, i.e. winter and early spring, almost always indicate moisture problems within the building {725}; the concentration of this fungi is significantly higher in an indoor environment with condensation {2750}. Airborne dust samples from 9 damp and 9 control residences were analyzed and revealed thatCladosporium was always found in damp houses in addition to being isolated in 7 control homes {764}. 
On moist window frames, it can be seen covering the entire painted area with a velvety olive-green layer. Visible growth can also be observed on wooden frames around thermo-glass, presumably due to dampness in the room and formation of condensation.

Interior paint work, paper or textiles stored under humid conditions are often discoloured by Cladosporium sp. {725}. In a controlled study on mould growth on wet gypsum wallboard in an indoor environment, Cladosporium sp. appeared as an early colonizer, being detected at 2 weeks on untreated gypsum {587}. Following hurricanes Katrina and Rita in 2005 on the Gulf Coast of Louisiana, thousands of homes were ultimately flooded and a characterization of airborne moulds revealed a frequency of Cladosporium spp. of 100% in outdoor samples and 80% in indoor air {695}. This fungus was also identified as a major contaminant in automobile air conditioning systems {2288}.

Air samples collected from a seven storey building undergoing renovations revealed that the frequency of Cladosporiumincreased from 5% before renovations to 39% during renovations as well as being the most common fungal genera {1750}. This fungus was also reported to be present in moderate concentrations (up to 500 CFU/m3) in crawl spaces {2104}.
A case study conducted during building renovations in Egypt found that Cladosporium sp. was the most frequent fungus in indoor air samples, with a prevalence of 80% {1790}.

Cladosporium has often been isolated from contaminated public buildings. A follow-up study performed after an extensive mould remediation in school buildings in Finland is a good example of this {199} whereby Cladosporium was systemically found in indoor air samples, before and after remediation of the damaged schools. The fungus was also found to be present in bathrooms of a university in Egypt {2193}.

The study of 72 mould-infected building material samples from 23 public buildings in Denmark found that Cladosporiumspecies was the sixth most frequently encountered fungus (prevalence 15%) {605}; both C. cladosporioides and C. herbarum specieswere identified. However, surface samples collected from both water-damaged and control Danish schools revealed almost no difference in terms of frequency of C. cladosporioides; this species was found in 8% and 7% respectively of damaged and control buildings {550}.

Since the minimum temperature requirement for growth is below 0 °C, Cladosporium may be found on refrigerated foods {813} or as a contaminant of dirty refrigerators, especially in the reservoir where condensation is collected {725}.

 

Laboratory section

Normal laboratory precautions should be exercised in handling cultures of this species within Biosafety Level 2 practices and containment facilities.

Colony, macroscopic morphology

Colonies of Cladosporium are rather slow-growing, reaching a diameter of 3 – 3.7 cm in 10 days when grown on malt extract agar (MEA) at 18-20 °C. The colonies are low, dense, becoming powdery or velvety due to abundant conidia, olivaceous-green to olivaceous-brown. The reverse of the colony is greenish-black. At low magnification, tree-like branching and smooth walls of the pigmented conidiophores can be observed.

On potato dextrose agar (PDA), the growth rate of Cladosporium is moderate at 25°C, and colony texture is also velvety to powdery. Similar to other dematiaceous fungi, the surface color is olivaceous green to black and the underside is black {715; 816}.

Microscopic morphology

Cladosporium spp. produce septate dark hyphae, erect and pigmented conidiophores, and conidia. While the conidiophores of C. cladosporioides are not geniculate, those of C. herbarum have a geniculate appearance. In addition, conidiophores of C. herbarum bear terminal and intercalary swellings.

Conidia of Cladosporium spp. in general are elliptical to cylindrical in shape, pale to dark brown in color and have dark hilae. Conidia are produced in branching chains that readily disarticulate. Conidial walls are smooth or occasionally echinulate.C. cladosporioides produces unicellular conidia. Conidia of C. herbarum are two- to four-celled {816}. Two characteristic forms of spores are produced in C. herbarum: lemon-shaped (3-5 mm) and torpedo-shaped, often with two or more cells (3-23 mm) {725}.

Specific metabolites

Organics compounds (including VOCs)

Cladosporium spp. produce a number of organic compounds, volatile organic compounds (VOCs) and enzymes; their complete profile is not known. They produce some metabolites with interesting bio-activities such as gibberellin, which acts as a plant hormone influencing various developmental processes {4306}, and ergosterol, a biological precursor to vitamin D2.   Research has shown that ergosterol may have anti-tumour properties {813; 700}.  Cladosporium cladosporioides is the best producer of gibberellin {4307}.

Mycotoxins

There are no reported mycotoxins produced by Cladosporium that would be deleterious to humans or animals. CertainCladosporium metabolites have a toxic effect, but none are recognized as true mycotoxins {989}.

More details

Certain toxic substances are biologically active against bacterial cells in vitro such as cladosporin. Emodin is not highly toxic despite having laxative properties in high concentrations.  

When contaminating grains or cereals, C. herbarum could be toxic for warm-blooded animals, although available data are insufficient. In overwintered grain, C. herbarum together with C. fagi may produce two substances, epicladosporic and fagicladosporic acids {4305}; these two metabolites could be associated with toxic reactions in animals fed these contaminated grains and contribute to aleukia.

Adverse health reactions

The ability to sporulate heavily along with easy dispersal and buoyant spores make C. herbarum one of the most important fungal airway allergens, which together with Alternaria, constitutes the main fungal cause of asthma and hay fever in the Western Hemisphere; however, this mould is generally considered non pathogenic (non-infectious) {2742; 813; 725}.

Irritation and inflammation

No specific irritation or inflammation symptoms have been attributed specifically to Cladosporium spp.

Experimental studies conducted on alveolar lavage cells show that C. cladosporioides, as well as many fungal spores, influence the inflammatory cytokines MIP-2 and KC involved in inflammation resulting from the inhalation of fungal spores in a time- and concentration-dependent manner {Shahan, 1998 4302 /id}.

Allergic reactions

Cladosporium sp. is both a common and important allergen, associated with type I allergies (hay fever and asthma) as well as some type III allergies (hypersensitivity pneumonitis) {481; 813; 2285}.

This fungus is recognized as a common inducer of allergic rhinitis and asthma in humans {2752}. Many studies have been conducted to establish the association between the presence of Cladosporium indoors or outdoors and sensitisation of exposed subjects: although results vary greatly from study to study, most do show such an association even when indoor concentrations of Cladosporium are low {445}.

Cladosporium is quite commonly found in homes of sensitized subjects even when not a dominant type {1589}. Sensitisation prevalence can be as high as 92% in mould-sensitised patients with seasonal allergies. Cladosporium sensitisation has been positively linked to allergic asthma {2762; 2667; 1814}. However in some instances, the presence of Cladosporiumdoes not appear to be correlated with symptoms of exposed occupants {1975; 2757; 2666}.

Along with others moulds, Cladosporium sp. has also been identified as being involved in the aetiology of chronic rhinosinusitis {1475} and found in nasal mucus of patients suffering from chronic rhinosinusitis {2227; 2678}. A strong association between IgE sensitization in eczematous patients and exposure to Cladosporium has been demonstrated {1580}.

More details

In investigating risk factors associated with bronchial hyper-responsiveness (BHR) linked to asthma and chronic obstructive lung disease, Chinn et al. {2744} identified house dust mite and Cladosporium sp. as factors increasing specific IgE response; Jaakkola et al. {2753} also observed a strong IgE response in asthmatics exposed to C. herbarum.

In a German study conducted in a population of 370 atopic or allergic school children, spore counts for Cladosporium andAspergillus were associated with an increased risk of allergic sensitization {445}.  A study of 105 asthma patients treated in Poland revealed that sensitization to Cladosporium was associated with severity of asthma, along with many others moulds {1585}. Results from a health based questionnaire also demonstrated an association between elevated mean concentration of some fungi, including Cladosporium, and respiratory health symptoms {1814}.  In an Australian study, doubling the exposure to Cladosporium also resulted in a 52% greater odds of having an attack of asthma {2762}.

Assessing the effect of building dampness in dwellings on the occurrence of asthma, Norback et al. {2667} found that immediate type allergy to Cladosporium or Alternaria was more prevalent in damp dwellings (9.3% vs. 3.9%) and was related to current asthma. In damp dwellings in Zagreb (Croatia), samples of wall scrapes were found to contain many fungal species: frequency of Cladosporium was 6%, although not one of the dominant species {1589} . In 22 homes of patients diagnosed with respiratory allergy to moulds, air sampling (431 indoor and 150 outdoor exposed plates) revealed that C. herbarumwas the most frequent species isolated and detected in 38.5% of indoor air samples (as compared to 62.6% in outdoor air), followed by Alternaria alternata (37.1%) and C. cladosporioides (34.1%) {624}.

In homes of more than 600 allergic patients (asthma : 72.6%; allergic rhinitis : 27.4%), C. herbarum was among the fungi detected, but with a very low frequency of 1.1% {162}. After exposing culture plates for 13 months in work-leisure-sleep environments of 130 allergy patients {1821}, investigators observed that of the 20 species detected, Cladosporium was the most often detected species, with a prevalence of 63%. The presence of this fungus in pillow swatches could also have implications for patients with respiratory diseases {2223}.

However, in a study designed to determine the association between respiratory tract symptoms and immediate skin reactions in 214 office workers, researchers were unable to find a link between the detection of Cladosporium and respiratory symptoms {2666}. Similarly, Asero and Botazzi found no significant association between the presence of  nasal polyposis in 68 patients and exposure to Cladosporium spores {1975}. Korhonen et al.  also reported that sensitisation to moulds, including Cladosporium spp., appeared to play only a minor role in the sensitisation of pre-school children with diagnosed asthma in a northern climate {2757}.

Sensitisation rates to Cladosporium vary depending on the studies. In individuals with allergic rhinitis or asthma, the highest frequency of positive skin test reactions to airborne fungal species was 57% to C. cladosporioides {1817} while skin prick tests to C. herbarum were positive in 92.3% of patients with seasonal allergic rhinitis who were hypersensitive to mould allergens {2764}.

In a clinical study of 99 children attending schools with moisture problems, Taskinen et al. reported positive reactions (skin-prick test) to C. herbarum in three attending moisture-problem schools(3/99), but none in the reference school (0/34) {720}.  In a group of asthmatic children in Sweden, Cladosporium-specific IgE antibodies were detected in 14% to 80% of tested subjects  {1399}. In a similar experiment performed with sera from patients with suspected mould allergy, a positive reaction to Cladosporium was found in approximately 17% of cases {1893}.  In a study by Gioulekass et al. {1788} investigating skin sensitivity (skin prick tests) to fungal spores from 5 different species, including Cladosporium, 7.4% of the 1311 patients tested had a positive reaction to this fungus.

There is also a significant sensitisation rate associated with Cladosporium in the work place. In maltworkers, 16% of tested subjects were serologically positive for Cladosporium herbarum {867} .  In industrial and home-type bakeries, the presence of this fungus was also related to a positive skin test (8.1% and 3.2% respectively) {2001} .

Allergic components and mechanism

At least 60 antigens derived from C. herbarum have been detected experimentally by counter-immuno-electrophoresis ;  of these, 36 fractions have IgE binding properties with sera from sensitised subjects {808; 2285}. Most of the allergens identified to date are intracellular proteins {2742}.

Some twelve fractions of C. herbarum have been studied and classified (Cla h 1-12); eight of these fractions are part of the official allergen list of the World Health Organisation and International Union of Immunological Societies {4287}.  One C. cladosporioides allergenic fraction has also been registered (Cla c 1).

More details

A member protein of the hydrophobin family, identified as a component of the cell wall of C. herbarum, acts as a rare but clinically relevant allergen in vitro and in vivo {2772}.

Hypersensitivity pneumonitis

A small number of confirmed cases of hypersensitivity pneumonitis (allergic alveolitis) due to Cladosporium sp. exposure has been reported, most of which were associated with humidifiers or very damp environments such as enclosed hot tub areas. 

More details

Five patients with hypersensitivity pneumonitis associated with home ultrasonic humidifiers (cold water) have been described {1407}; however, while Cladosporium was isolated from the humidifier’s water, the incidence of positive precipitating antibodies to this fungi in these patients was low.

In a study of 2 cases of Cladosporium species-related hypersensitivity pneumonitis (HP) in household environments, lymphocyte stimulating activity and antibody titre to these fungi (C. cladosporioides and C. herbarum) were found to be greatly increased in these 2 patients. These results are highly significant as it is sometimes difficult to diagnose cases of HP due to ubiquitous agents and because patients do not have an obvious history of antigen exposure. It is also important to state that high anti-Cladosporium antibody titre alone is not sufficient to diagnose Cladosporium-related HP{4308}. 

Toxic effects (mycotoxicosis)

No human or animal mycotoxicosis associated with Cladosporium sp. has been reported.

C. herbarum can produce an endotoxin able to cause mucosal damage in horses while mycelium extracts are toxic for chicken embryos {989}; this toxicity is not however considered a mycotoxicosis in the strict sense.  Cladosporiumcontaminated grain may be associated, in conjunction with other moulds, to certain cases of aleukia in farm animals {4305}.  

Infections and colonisations

Most environmental species of Cladosporium are not pathogenic. However, a few cases of Cladosporium opportunistic infections have been reported in skin lesions, keratitis, onychomycosis, sinusitis and pulmonary infections {1819; 415; 4304}.  The dematiaceous fungus Cladosporium cladosporioides is a widely distributed saprophyte that is reported to occasionally infect the lung, skin, eye and brain in humans {4301}.  Tropical infections known as chromoblastomycosis and tinea nigra occur in very specific settings and are beyond the scope of this document.

More details

Severely immunosuppressed individuals, such as those with haematologic malignancies, recipients of haematopoietic stem cell transplantation and patients receiving cytotoxic therapy for post-transplantation complications, remain a population at risk for fungal infections, including Cladosporium spp. {1792}.

Very few species have been associated with infections; among the common saprobic species, C. cladosporioides has been reported as a rare opportunist agent {3729}.   Two closely studied infections have been well documented in tropical or sub-tropical regions :  C. carrionii can be an agent of chromoblastomycosisand C. werneckii, an agent of tinea nigra.These two infectious agents are not known to grow in the indoor environment.

A few cases of superficial or subcutaneous phaeohyphomycosis due to Cladosporium cladosporioides have been reported in apparently healthy individuals {4290; 4295; 4303}. 

Virulence factors

No particular virulence factors have been reported for C. cladosporioides or C. herbarum.

Specific settings

Nosocomial infections

No nosocomial infections have been reported nor have any particular outbreaks due to exposure to Cladosporium been documented in the hospital setting. However, Cladosporium has been reported to grow on contaminated building materials and ventilation systems in hospitals {864; 313; 686; 386}. The risk for infection trough inhalation of Cladosporium airborne spores is not known.

More details

In a large tertiary Chicago hospital with extensive indoor renovation and extensive demolition, 74 duct dust samples were collected and analyzed for Aspergillus surveillance {313}; however, high concentrations of C. herbarum were also found (9.87 CFU/m3).  Likewise, eleven air filters from seven hospitals in the Eastern United States were selected on the basis of deposits on the filter media; Cladosporium sp.was a colonizing fungus in the air filters of three hospitals, indicating it was a major fungal contaminant {386}.  Aerobiological samples for fungal spores taken from the rooftop of a hospital in Netherlands revealed that Cladosporium was the major contaminant, its average contaminant being 12 858 CFU/m3(average, 109 CFU/m3) {864}.

Occupational diseases

No occupational infections have been reported: no particular outbreaks due to an exposure to Cladosporium sp.have been documented in the workplace.

However, this fungus has been reported in a few occupational settings where there are important quantities of airborne organic dust (cotton and wood industries, grain storage and bakeries) and in very damp environments (enclosed hot tub areas) {4310}; in such environments, at risk workers may develop mostly allergic sensitisation and respiratory reactions.

More details

In cotton samples provided from many areas of the world, Cladosporium was present in seven out of a total of 13 samples, and was the dominant species in four of them {700}. In one study, Cladosporium was also among the predominant fungi identified during normal sawmill activity {1581}.

In industrial and home-type bakeries, the occurrence of Cladosporium spp. was reported between 21.6% and 29.5%, {2001};  this fungus was the second most often isolated species, after Penicillium sp. and high concentration of this fungi was also reported in a rural bakery {2401}.  Cladosporium was also isolated from rice mill environments, at concentrations up to 44 CFU/m3 {1140}.

In rural areas, fungal species constitute a major component of environmental contaminants in facilities where animals are housed {2373; 1778; 2203; 2331}. In poultry feed mixtures, researchers found C. cladosporioides (frequency of 31%) although with  no association to mycotoxins {1778} . In assessing the exposure of farmers to airborne fungi in 3 different farms in Ohio, an aerobiological survey found that Cladosporium had the highest incidence, ranging from 8 to 31 x 103 spores/m3){1786}, with the highest concentrations found in dairy and grain farms. In Lithuania, C. cladosporioides and C. herbarum were isolated from several industrial environments, including a poultry house, a swinery, a feed storing house, a grain mill, a wooden panel production factory and organic waste recycling facilities {854}; these species usually represented 1.4 to 6.7% of all species isolated, except for a high frequency of C. cladosporioides of 17% in a grain mill isolate.

The results of air sampling at a library and archive storage facilities in Poland showed that C. herbarum and C. cladosporioides were found throughout the entire workplace , at concentrations ranging from 2.5 x 102 to 1.6 x 104 CFU/m3 {2774}.

Finally, it is interesting to note that Cladosporium sp. was one of the dominating genera of airborne micro-organisms found on board of the International Space Station {2767} .

Diagnostic tools

Cultures

C. herbarum and C. cladosporioides are not considered as infectious agents; cultures are generally not warranted.  Furthermore, the majority of clinical isolates of this genus represent colonisation of non-sterile body sites {4315}.  The saprobic Cladosporium spp. are among the most common dematiaceous contaminants found in clinical laboratories. Consequently, to confirm aetiology of a Cladosporium infection, one must complete a positive culture from a normally sterile site with histopathological evidence {4288}.

Histopathology

Very few infections have been reported: histological examinations do not reveal specific pathognomonic characteristics. Infected tissues may resemble other phaeohyphomycosis with dark (phaeoid) hyphae. In one case, a cutaneous biopsy showed a granulomatous infiltrate with numerous dark fungal elements scattered in the dermis as well as fungal elements within giant cells. Cultures of cutaneous biopsy fragments resulted in the growth of dark-green colonies of typicalCladosporium cladosporioides {4290}.

Immunodiagnosis

Cladosporium herbarum allergens and antigens are part of routine immunology panels.  
Allergen extracts are available for skin tests and RAST tests ; antigens for IgG testing may be useful to complete the diagnosis of HP {2019; 21}.

An accurate diagnosis of allergy to Cladosporium spp. can be made based on asthma symptoms which follow seasonal variations in Cladosporium spore counts and on the demonstration of IgE reactivity. For detection of IgE reactivity, the skin prick test using purified extract of C. herbarum is recommended as a primary screening test because it is rarely false-negative.  RAST tests can be negative in 20-30% of patients with positive allergy but are rarely false positive.

More details

Antigenic extracts of Cladosporium herbarum are available as single extracts or as pooled antigens for the IgE-RAST and IgG tests {3730}.  Extracts of C. cladosporioides (Hormodendrum cladosporioides) are available in a fungal mixture for skin testing {3284}. Cladosporium  allergens are part of the American Food and Drug Administration (FDA) surveillance program and part of the Biological Product Deviation Reports mould list {3285}.

The Cladosporium spp. allergen extracts listed by the FDA {3285} are as follows: 

  • GJ39 - Cladosporium cladosporioides
  • GJ40 - Cladosporium fulvum
  • GJ41 - Cladosporium herbarum
  • GJ42 - Cladosporium werneckii

The International Union of Immunological Societies (I.U.I.S.) and the World Health Organisation (W.H.O.) recognises 9 fractions as allergens :

Cladosporium cladosporioides (Cla c 9) 
C. herbarum (Cla h 2, Cla h 5, Cla h 6, Cla h 7, Cla h 8, Cla h 9, Cla h 10 ,Cla h 12).

Test IgE IgG Antigens Other
Skin Tests X      
RAST-IgE X      
RAST-IgG   X    
ELISA-ELIFA        
Immunodiffusion        
Immunofluorescence        
Complement fixation        
PCR        
Other        

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