Ulocladium Allergy Shots: Why Alternaria SCIT Covers This Water-Damage Mold
Ulocladium chartarum has been formally reclassified as Alternaria chartarum — placing it within the Alternaria genus phylogenetically (Woudenberg 2013). Clinically, this means Ulocladium allergy IS Alternaria allergy: Ulo c 1, the major Ulocladium allergen, shares 89% sequence identity with Alt a 1 (Moreno A et al., Clin Exp Allergy 2016). No standalone Ulocladium SCIT extract exists.
About Curex’s SCIT program
Curex’s at-home allergy shots (SCIT) are coming soon and focus on the most common environmental allergens:
- • Pollens — tree, grass, weed & ragweed
- • Pet dander — cat & dog
- • Dust mites
- • Molds — Alternaria & mold mix
Ulocladiumis covered here for general education and may not be part of Curex’s current treatment set. Join the waitlist and our care team will help confirm your options.
Ulocladium Allergy Immunotherapy: How It Works
Allergy immunotherapy is the only long-term treatment that re-trains the immune system to stop overreacting to ulocladium — rather than just masking symptoms with antihistamines or steroids. By gradually exposing the body to controlled doses of ulocladium allergen, immunotherapy shifts the underlying allergic response and produces relief that often outlasts treatment by 7–10 years.
There are two evidence-based forms of ulocladium immunotherapy used today, both built on the same desensitization principle but delivered very differently.
of sustained relief after a complete immunotherapy course — the only allergy treatment with proven long-term effect after stopping.
Allergy Shots (SCIT)
Weekly injections of ulocladium extract in a clinic, escalating over 3–6 months until a maintenance dose is reached. Continued monthly for 3–5 years. Longest clinical track record for ulocladium allergy.
- Strongest evidence base for severe and polysensitized patients
- Covered by most insurance plans
- Requires 50–100+ in-person clinic visits across the full course
- Or at home with no clinic visits— Curex’s Virtual Shot Room model delivers the same SCIT program with live video supervision by trained Curex clinical staff for the first injection from each new vial or concentration and restarts after gaps or reactions.
Allergy Drops / Tablets (SLIT)
Daily drops or dissolvable tablets containing ulocladium extract, held under the tongue at home. Same desensitization principle, delivered without injections. WHO-recognized as an effective form of allergy immunotherapy since 2001.
- Taken at home — no weekly clinic trips, no needles
- Lower systemic reaction rate than allergy shots
- Curex offers prescription ulocladium immunotherapy drops with allergist oversight
The rest of this page goes deep on allergen-specific immunotherapy with shots — protocol, efficacy data, side effects, and cost. If you’d rather skip the clinic and treat ulocladium allergy with at-home drops, see how Curex sublingual immunotherapy compares below.
What is Ulocladium?
The biology, taxonomy, and clinical fingerprint of Ulocladium — the foundation of how SCIT targets it.
Ulocladium conidia — dark-pigmented, spherical 9–12 µm. Distinguished from Alternaria by narrower spore base. U. chartarum formally reclassified as Alternaria chartarum (Woudenberg JHC et al., Stud Mycol 2013).
- Scientific name
- Ulocladium chartarum (now Alternaria chartarum) / Ulocladium botrytis
- Family
- PleosporaceaePleosporales, Dothideomycetes, Ascomycota — same family as Alternaria
- Type
- Indoor water-damage indicator mold — taxonomically reclassified within Alternaria
- Native to
- Cosmopolitan; found on water-damaged gypsum, paper, textiles, painted surfaces, and house dust
- Allergen proteins
- Ulo c 1 (major) — ortholog of Alt a 1 with 89% sequence identity; confirmed IgE cross-reactivity (Moreno A et al., Clin Exp Allergy 2016)Ulo c 2 — reacts with 40–58% of mold-allergic patient sera (Moreno A et al., 2016)Ulo c 6 — reacts with 40–58% of mold-allergic patient sera (Moreno A et al., 2016)
- Particle size
- Conidia roughly spherical 9–12 µm diameter, dark-pigmented; distinguished from Alternaria by narrower bases
- Avoidance difficulty
- Moderate
How Ulocladium Allergy Presents
Symptoms by body system — useful for distinguishing Ulocladium sensitivity from overlapping allergies and infections.
Respiratory
- Perennial allergic rhinitis in patients sensitized to Ulo c 1 (Alt a 1 ortholog) via water-damaged-building exposure
- Asthma exacerbation linked to indoor Ulocladium / Alternaria cross-reactive sensitization
- Symptoms functionally indistinguishable from Alternaria allergy given 89% allergen identity
- Water-damage-indicator presentation: symptoms worsening after known building moisture events
Ocular
- Allergic conjunctivitis correlating with documented indoor mold exposure in affected buildings
- Bilateral itching and tearing in sensitized patients with Ulocladium exposure history
- Periorbital edema during acute mold-exposure flares in sensitized patients
Dermal
- Eczema flares in atopic patients with Ulocladium / Alternaria cross-reactive sensitization
- Rare opportunistic cutaneous infections in immunocompromised patients — not IgE-mediated
- Skin prick test reactions with U. botrytis extract in sensitized patients
Systemic
- Symptom burden from Ulocladium sensitization functionally mirrors Alternaria allergy — including potential asthma severity given shared Alt a 1 / Ulo c 1 allergen
- Fatigue and systemic symptoms in chronically exposed water-damaged-building occupants
- Indoor air quality deterioration from Ulocladium co-occurring with Stachybotrys and Chaetomium as chronic moisture indicator
When I see a positive Ulocladium test, I think Alternaria. These are the same family, the same order, and Ulocladium chartarum has now been formally reclassified into the Alternaria genus. The allergen Ulo c 1 is essentially Alt a 1 at 89% sequence identity. If my patient's rAlt a 1 is positive, we treat with Alternaria SCIT — there is no separate Ulocladium shot to prescribe, and we do not need one.
Where Ulocladium Triggers Year-Round
Ulocladium is a perennial trigger — exposure is constant for sensitized patients. Geographic intensity still varies by climate.
12-Month Intensity
Year-roundYear-round indoor exposure in water-damaged buildings; slight seasonal amplification when outdoor humidity peaks in summer· Perennial in affected buildings; also found in house dust year-round
US Exposure Map
0 high-intensity statesExposure intensity by state (text version)
- ME:
- Low
- VT:
- Low
- NH:
- Low
- WA:
- Low
- MT:
- Low
- ND:
- Low
- MN:
- Low
- WI:
- Low
- MI:
- Low
- NY:
- Low
- MA:
- Low
- OR:
- Low
- ID:
- Low
- WY:
- Low
- SD:
- Low
- IA:
- Low
- IL:
- Low
- IN:
- Low
- OH:
- Low
- PA:
- Low
- NJ:
- Low
- CT:
- Low
- RI:
- Low
- CA:
- Low
- NV:
- Low
- UT:
- Low
- CO:
- Low
- NE:
- Low
- MO:
- Low
- KY:
- Low
- WV:
- Low
- VA:
- Low
- MD:
- Low
- DE:
- Low
- AZ:
- Low
- NM:
- Low
- KS:
- Low
- AR:
- Low
- TN:
- Low
- NC:
- Low
- SC:
- Low
- OK:
- Low
- LA:
- Low
- MS:
- Low
- AL:
- Low
- GA:
- Low
- TX:
- Low
- FL:
- Low
- AK:
- Low
- HI:
- Low
What Ulocladium Cross-Reacts With
Patients sensitized to one allergen often react to others sharing similar proteins. This map shows the documented molecular overlaps.
Ulocladium's most important cross-reactivity — and the clinically definitive one — is with Alternaria alternata via the 89% Alt a 1 / Ulo c 1 allergen identity. This is not mere cross-reactivity; it is near-complete ortholog conservation.
Ulo c 1 / Alt a 1 ortholog: 89% sequence identity; confirmed IgE cross-reactivity; same Pleosporaceae family; U. chartarum formally reclassified as Alternaria chartarum (Woudenberg 2013; Moreno 2016)
Close Pleosporaceae cousin; Stm b allergen also an Alt a 1 ortholog with ~88% sequence identity — same Pleosporaceae family
Pan-fungal enolase (Ulo c 6 ortholog / Cla h 6) and mannitol dehydrogenase overlap shared with Alternaria
Pleosporales-adjacent shared IgE-binding bands in atopic mold panels
Pleosporaceae cross-reactivity in mold-sensitized patients; Epicoccum-Curvularia-Alternaria triangle includes Ulocladium via Alt a 1 / Ulo c 1
Is SCIT Right for Your Ulocladium Allergy?
If you tested positive to Ulocladium, this five-question assessment identifies the most practical next step — which in most cases is confirming Alt a 1 sensitization and evaluating for Alternaria SCIT.
Have you been tested for rAlt a 1 (Alternaria component) alongside Ulocladium IgE?
The Ulocladium SCIT Protocol
Ulocladium SCIT as a standalone treatment does not exist. When rAlt a 1 positivity is confirmed and Alternaria SCIT is prescribed, that protocol plausibly cross-covers Ulocladium via the 89% Ulo c 1 / Alt a 1 sequence identity.
The practical Ulocladium treatment is Alternaria SCIT confirmed on rAlt a 1 component testing. The same mold-SCIT rules apply: mold-only vials separate from pollen extracts (protease degradation rule per AAAAI/ACAAI Practice Parameter). With Curex at-home SCIT the serum is sterile-compounded, a prescribed epinephrine auto-injector is confirmed on-hand before your first dose, and the first injection from each new vial or concentration is supervised live in the Virtual Shot Room by trained Curex clinical staff, with gradual week-by-week escalation thereafter. Non-standardized US extracts — Alt a 1 content varies by manufacturer. European standardized extracts used in the Kuna 2011 and Tabar 2019 RCTs have better quantification.
Alternaria SCIT maintenance with mold-only vials. Expected benefit timeline: 38.7% combined score reduction at year 2, 63.5% at year 3 per Kuna 2011 JACI. Whether Ulocladium-specific reactivity is separately tracked is not established — clinical success is assessed by overall mold-season symptom control.
Alternaria SCIT durability data (Kuna 2011, Tabar 2019) applies. Ulocladium-specific durability data does not exist independently — clinical success is tracked as Alternaria-protocol outcomes.
Extract Concentration Ladder
You progress through each vial during build-up. Concentration increases ~10x per step.
What the Research Shows for Ulocladium SCIT
No standalone Ulocladium SCIT trial has been conducted. The efficacy reference is Alternaria SCIT — which plausibly covers Ulocladium via the 89% Ulo c 1 / Alt a 1 allergen identity.
- Alternaria SCIT combined symptom-medication score reduction (year 3) — coverage estimate for Ulocladium64%Kuna P et al., JACI 2011, N=111 — Alternaria SCIT as the plausible treatment given 89% Ulo c 1 / Alt a 1 identity
- Alternaria SCIT year 1 benefit with purified Alt a 145%Tabar AI et al., JACI 2019 — first DBPC RCT with purified native Alt a 1 extract
No RCT exists for Ulocladium-specific SCIT. The 89% sequence identity between Ulo c 1 and Alt a 1 provides the biological basis for expecting Alternaria SCIT to cover Ulocladium sensitization — but this extrapolation has not been directly tested in a head-to-head trial. Alternaria SCIT remains the only mold-immunotherapy approach with robust DBPC-RCT evidence, and it is the practical clinical answer for rAlt a 1-positive patients with positive Ulocladium IgE.
Ready to skip the surprise bills?
At-home allergy shots (SCIT) are designed by board-certified allergists. See the listed SCIT plan rate in our pricing record and request a quote for eligibility, initiation and total care costs.
- MD-ledBoard-certified allergists
- QuoteTotal care estimate
- 50K+Patients treated
- HSA/FSAEligible
Ulocladium SCIT Side Effects
Ulocladium's treatment is Alternaria SCIT — the side-effect profile is identical to Alternaria mold extract immunotherapy, including the requirement for mold-only vials separate from pollen extracts.
Local reactions
4 documented| Reaction | Rate | Severity |
|---|---|---|
Injection-site swelling and erythema (Alternaria extract) Expected with mold extracts; same as Alternaria SCIT profile | Rate 30–50% | Mild |
Large local reaction (>5 cm) May require dose adjustment; report to allergist | Rate 10–20% | Moderate |
Injection-site pruritus | Rate 20–40% | Mild |
Delayed local swelling | Rate 5–15% | Mild |
Systemic reactions
4 documented| Reaction | Rate | Severity |
|---|---|---|
Rhinitis or mild asthma flare | Rate 0.5–2% of injections | Mild |
Generalized urticaria | Rate 0.1–0.5% of injections | Moderate |
Bronchospasm | Rate 0.05–0.1% of injections | Moderate |
Anaphylaxis the first injection from each new vial or concentration supervised live in the Virtual Shot Room by trained Curex clinical staff, with a prescribed epinephrine auto-injector confirmed on hand | Rate <0.01% of injections | Severe |
In the Kuna 2011 JACI trial of Alternaria SCIT, no severe systemic reactions requiring epinephrine occurred at the target maintenance dose. With Curex at-home mold SCIT a prescribed epinephrine auto-injector is confirmed on-hand before the first dose and the first injection from each new vial or concentration is supervised live in the Virtual Shot Room by trained Curex clinical staff — the safeguards that make at-home administration safe across the build-up window.
SCIT vs Alternatives for Ulocladium
Ulocladium-sensitized patients' treatment options mirror Alternaria allergy management — because Ulocladium IS taxonomically Alternaria and the primary allergen Ulo c 1 IS the Alt a 1 ortholog.
| Criterion | At-home Alternaria SCIT (Curex)Best | SLIT Drops | Remediation | Medications |
|---|---|---|---|---|
| Effectiveness | 63.5% score reduction (Kuna 2011) — plausibly covers Ulocladium via 89% allergen identity | Limited data for Alternaria; Pozzan 2010 shows promise | Removes indoor Ulocladium source | Symptom control only |
| 5-yr cost | $3,500–$15,000 total | Available from various providers as off-label sublingual drops (not Curex's product — Curex delivers at-home SCIT shots, not drops) | Variable — professional cost | $500–$2,000/year |
| Duration | 3–5 years maintenance | 3–5 years typical | One-time + ongoing moisture control | Indefinite |
| Convenience | Weekly then monthly clinic visits | Daily at-home drops | Professional service | Daily |
| Safety | 30-min observation required; mold-only vials | Low systemic risk | No injection risk | Generally safe |
| Lasting effect | 7–12+ years post-treatment | Data suggest durable benefit | Sustained with moisture control | No disease modification |
At-home Alternaria SCIT (Curex)Best
SLIT Drops
Remediation
Medications
Alternaria SCIT is the evidence-based immunotherapy for confirmed rAlt a 1-positive patients, plausibly covering Ulocladium via the 89% allergen identity. Curex delivers that Alternaria SCIT at home with pricing confirmed in a current program quote — sterile-compounded mold-only serum, a prescribed epinephrine auto-injector confirmed on-hand, and the first injection from each new vial or concentration supervised live in the Virtual Shot Room by trained Curex clinical staff — so patients who cannot access weekly clinic injections still get the evidence-based mold immunotherapy rather than a weaker substitute.
What Ulocladium SCIT Actually Costs
Alternaria SCIT is covered by most major US insurers under standard allergy-immunotherapy benefits when prescribed by a board-certified allergist with documented Alt a 1 positivity and inadequate symptom control on pharmacotherapy. Ulocladium IgE testing (ImmunoCAP m204) is a diagnostic test that may be covered under standard lab benefits. Curex at-home IgE testing identifies specific ulocladium sensitization before allergist consultations, eliminating the need for an initial skin-test visit.
Cost range varies by deductible, co-insurance, and clinic.
Verify these codes with your insurer to confirm coverage.
See the listed Environmental Allergy Shots Plan rate, commercial terms dated 2026-10-12; consultations are included without copay. Confirm availability, eligibility, other included services, testing, any in-person care, insurance responsibility and billing cadence in your written quote before enrolling.
Join the waitlistStop guessing about your ulocladium allergy. Get a plan.
Take Curex’s 3-minute allergy quiz. A board-certified allergist will review your symptoms and recommend the right immunotherapy path for you — shots or drops.
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Ulocladium SCIT — Frequently Asked
Quick answers to the questions patients ask most before starting treatment.
DNA-based phylogenetic studies conducted in the 2000s and early 2010s revolutionized mold taxonomy by revealing that morphology-based classification had grouped unrelated species together and split related ones. For Ulocladium, Woudenberg JHC et al. (Studies in Mycology 2013;75:171-212) used multi-locus molecular data to demonstrate that Ulocladium chartarum falls within the Alternaria clade — making it formally Alternaria chartarum. This is not a minor renaming: it reflects genuine evolutionary relatedness, which is why the major allergen Ulo c 1 has 89% sequence identity with Alt a 1 (the major Alternaria allergen). Other Ulocladium species, including U. botrytis, retain the Ulocladium name while the chartarum species has been moved. For clinical allergy practice, this reclassification means that Ulocladium chartarum allergy and Alternaria allergy are the same immunological problem at the molecular level.
The 89% sequence identity provides a strong biological basis to expect cross-coverage, but no head-to-head randomized trial has directly tested whether Alternaria SCIT reduces reactivity to Ulocladium specifically. The mechanism is straightforward: if your IgE antibodies are directed primarily against the Ulo c 1 / Alt a 1 shared epitopes (which 89% identity makes highly likely), then Alternaria SCIT's induction of blocking antibodies and immune tolerance toward Alt a 1 should similarly reduce reactivity to Ulo c 1. However, 11% sequence divergence means some Ulo c 1-specific epitopes may exist outside the shared region. In practice, allergists proceed on the reasonable assumption of cross-coverage and monitor clinical response. No allergist should prescribe a separate Ulocladium extract — it does not exist commercially.
A positive Ulocladium whole-extract IgE with negative whole-extract Alternaria IgE is an unusual pattern that warrants component-resolved testing. The key test is rAlt a 1 (ImmunoCAP m229). Given the 89% Ulo c 1 / Alt a 1 identity, a positive rAlt a 1 alongside positive Ulocladium IgE would confirm that this is alt a 1-driven sensitization regardless of the whole-extract Alternaria result. Whole-extract SPT and IgE concordance is imperfect — batch-to-batch variability in non-standardized US extracts means a positive on one assay and negative on another can reflect extract quality differences rather than true differential sensitization. Your allergist can use the component testing results to determine whether Alternaria SCIT is the appropriate treatment and whether water-damage remediation should precede immunotherapy.
Ulo c 2 and Ulo c 6 are the second and third characterized Ulocladium allergens, each reacting with 40–58% of mold-allergic patient sera in the Moreno 2016 study. Ulo c 6 is the ortholog of Alt a 6 (enolase) — a pan-fungal allergen shared with Cladosporium, Aspergillus, and other molds. A patient positive to Ulo c 6 but negative to Ulo c 1 and rAlt a 1 may actually be primarily sensitized to Cladosporium via the shared enolase pathway — an important diagnostic distinction. Ulo c 2 has less characterized cross-reactivity. In practice, rAlt a 1 component testing is the most clinically useful first test when managing Ulocladium-positive IgE panels. If Alt a 1 is negative, the picture becomes more complex and an experienced mold-allergy specialist should interpret the full panel in the context of exposure history.
Yes — Ulocladium and its now-reclassified Alternaria chartarum form are found in house dust, particularly in homes with water-damage history. Salo PM et al. (JACI 2006) found Alternaria-related allergens in 25.5% of US bedroom dust samples in NHANES 2005–2006 data. Because Ulocladium chartarum is now Alternaria chartarum, studies of Alternaria in house dust implicitly include Ulocladium. It grows on gypsum drywall backing, paper, textiles, and painted surfaces in water-damaged buildings — all common components of house dust in affected homes. Perennial indoor Ulocladium exposure differs from the seasonal outdoor Alternaria pattern in that indoor exposure is year-round, potentially driving perennial rhinitis rather than the classic late-summer seasonal pattern of outdoor Alternaria-driven allergy.
Both Ulocladium and Stachybotrys are indoor water-damage indicator molds, but they have very different profiles. Stachybotrys requires extremely high moisture (water activity above 0.94 — serious flooding or sustained water intrusion), grows slowly, and produces slimy spores that do not readily become airborne. Ulocladium grows at slightly lower moisture requirements and produces spores that are more readily dispersed than Stachybotrys but less so than outdoor dry-spored molds. Importantly, Ulocladium has characterized allergens (Ulo c 1, 2, 6) and a clinical immunotherapy pathway via Alternaria SCIT, while Stachybotrys has a single incompletely characterized allergen (Sta c 3) and zero SCIT evidence. The practical implication: if your water-damage building has both molds, the Ulocladium sensitization may be more clinically treatable with SCIT than the Stachybotrys component.
This content is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. Content reviewed by board-certified allergists at Curex.
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