Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Review Int Arch Allergy Immunol 2008;145:58–86 DOI: 10.1159/000107578 The Spectrum of Fungal Allergy Birgit Simon-Nobbe Ursula Denk Verena Pöll Raphaela Rid Michael Breitenbach Department of Cell Biology, University of Salzburg, Salzburg, Austria dates back to the 19th century, major improvements in the diagnosis and therapy of mold allergy have been hampered by the fact that fungal extracts are highly variable in their protein composition due to strain variabilities, batch-to- batch variations, and by the fact that extracts may be pre- pared from spores and/or mycelial cells. Nonetheless, about 150 individual fungal allergens from approximately 80 mold genera have been identified in the last 20 years. First clinical studies with recombinant mold allergens have demonstrat- ed their potency in clinical diagnosis. This review aims to give an overview of the biology of molds and diseases caused by molds in humans, as well as a detailed summary of the latest results on recombinant fungal allergens. Copyright © 2007 S. Karger AG, Basel Introduction Fungi are eukaryotic, non-chlorophyllous and hetero- trophic organisms that depend on external nutrients and therefore live as saprophytes, parasites or symbionts of animals and plants under nearly all environmental con- ditions. The phenotype of molds ranges from a unicellu- lar to a dimorphic or filamentous appearance. Out of over 100,000 fungal species reported, a few hundred occur as opportunists and about 100 are known to elicit mycoses in man and animals [1] . More than 80 mold genera have Key Words Allergy  Cross-reactivity  Epitope  Fungi  IgE  Mold  Recombinant allergen Abstract Fungi can be found throughout the world. They may live as saprophytes, parasites or symbionts of animals and plants in indoor as well as outdoor environment. For decades, fungi belonging to the ascomycota as well as to the basidiomy- cota have been known to cause a broad panel of human dis- orders. In contrast to pollen, fungal spores and/or mycelial cells may not only cause type I allergy, the most prevalent disease caused by molds, but also a large number of other illnesses, including allergic bronchopulmonary mycoses, al- lergic sinusitis, hypersensitivity pneumonitis and atopic der- matitis; and, again in contrast to pollen-derived allergies, fungal allergies are frequently linked with allergic asthma. Sensitization to molds has been reported in up to 80% of asthmatic patients. Although research on fungal allergies Published online: August 20, 2007 Correspondence to: Dr. Birgit Simon-Nobbe Department of Cell Biology, Division Genetics University of Salzburg, Hellbrunnerstrasse 34 AT–5020 Salzburg (Austria) Tel. +43 662 8044 5791, Fax +43 662 8044 144, E-Mail birgit.simon@sbg.ac.at © 2007 S. Karger AG, Basel 1018–2438/07/1451–0058$23.50/0 Accessible online at: www.karger.com/iaa ABPA = Allergic bronchopulmonary aspergillosis; ABPM = allergic bronchopulmonary mycosis; AD = atopic dermatitis; GST = glutathi- one-S-transferase; HSP = heat shock protein; MnSOD = manganese- dependent superoxide dismutase; RAST = radioallergosorbent test; SPT = skin prick test.