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Curvularia inaequalis is a fungal allergen extract derived from the mold species of the same name. It is utilized in clinical practice for both the diagnosis of mold-related hypersensitivity and as a therapeutic agent in allergen immunotherapy (AIT). In diagnostic applications, such as skin prick testing, the extract cross-links allergen-specific IgE on the surface of mast cells, leading to local degranulation and a wheal-and-flare reaction. For therapeutic use, the extract is administered in escalating doses to induce immunological tolerance, characterized by a shift from a Th2-biased allergic response to a Th1/Treg-mediated response, increased production of blocking antibodies (IgG4), and reduced recruitment of inflammatory cells to the respiratory mucosa. It is primarily indicated for patients with allergic rhinitis, conjunctivitis, or extrinsic asthma triggered by Curvularia exposure.
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