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Cladosporium herbarum extract is a biologic allergen extract derived from the common environmental mold, *Cladosporium herbarum*. It is used in allergen immunotherapy (AIT) for the diagnosis and treatment of IgE-mediated allergic conditions such as allergic rhinitis, allergic conjunctivitis, and asthma in patients sensitized to this specific mold. [3, 4] The extract works by modulating the patient's immune response to the allergen. Through repeated administration of gradually increasing doses, it aims to induce immune tolerance, shifting the response from a Th2-dominated allergic profile to a more tolerant Th1 and regulatory T-cell (Treg) profile. This immunological change is characterized by a decrease in allergen-specific IgE antibodies and an increase in allergen-specific IgG4 antibodies, which are thought to function as "blocking antibodies" that prevent the activation of mast cells and basophils. [5] The treatment has been shown to be effective in reducing symptoms and medication needs. [4] However, due to the risk of side effects, including severe anaphylactic reactions, its use is often recommended for specialized clinics. [3, 4] Formulations are available for subcutaneous injection (SCIT) and intradermal or percutaneous use for skin testing. [2, 6] Known developers and manufacturers include Greer Laboratories, ALK-Abelló, Stallergenes Greer, and Allergopharma.
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