Future research trends in understanding the mechanisms underlying allergic diseases for improved patient care.

Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria. Department of Respiratory Medicine & Allergology, Institute for Clinical Science, Skane University Hospital, Lund University, Lund, Sweden. Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic. Division of Immunology and Allergy, Food Allergy and Anaphylaxis Program, The Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada. Research Institute, The Hospital for Sick Children, Translational Medicine Program, Toronto, Ontario, Canada. Department of Immunology, The University of Toronto, Toronto, Ontario, Canada. Department of Otorhinolaryngology, Amsterdam University Medical Centres, Location AMC, Amsterdam, The Netherlands. Chair and Institute of Environmental Medicine, UNIKA-T, Technical University of Munich and Helmholtz Zentrum München, Augsburg, Germany. Christine Kühne Center for Allergy Research and Education, Davos, Switzerland. Sean N. Parker Center for Allergy & Asthma Research, Stanford University, Stanford, California. Department of Respiratory Medicine, Allergy and Clinical Immunology, Central Clinical School, Monash University, Melbourne, Victoria, Australia. Allergy, Asthma and Clinical Immunology Service, Alfred Health, Melbourne, Victoria, Australia. Departments of Medicine and Microbiology, APC Microbiome Ireland, National University of Ireland, Cork, Ireland. Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany. Allergy Unit, Regional University Hospital of Malaga, IBIMA-UMA-ARADyAL, Malaga, Spain. Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Department of Otolaryngology Head and Neck Surgery and Department of Allergy, Beijing Tongren Hospital, Beijing, China. Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Davos, Switzerland.

Allergy. 2019;(12):2293-2311

Abstract

The specialties of allergy and clinical immunology have entered the era of precision medicine with the stratification of diseases into distinct disease subsets, specific diagnoses, and targeted treatment options, including biologicals and small molecules. This article reviews recent developments in research and patient care and future trends in the discipline. The section on basic mechanisms of allergic diseases summarizes the current status and defines research needs in structural biology, type 2 inflammation, immune tolerance, neuroimmune mechanisms, role of the microbiome and diet, environmental factors, and respiratory viral infections. In the section on diagnostic challenges, clinical trials, precision medicine and immune monitoring of allergic diseases, asthma, allergic and nonallergic rhinitis, and new approaches to the diagnosis and treatment of drug hypersensitivity reactions are discussed in further detail. In the third section, unmet needs and future research areas for the treatment of allergic diseases are highlighted with topics on food allergy, biologics, small molecules, and novel therapeutic concepts in allergen-specific immunotherapy for airway disease. Unknowns and future research needs are discussed at the end of each subsection.

Methodological quality

Publication Type : Review

Metadata

MeSH terms : Research