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.
Allergy. 2019 Dec;74(12):2293-2311. doi: 10.1111/all.13851. Epub 2019 Jun 4.
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.
过敏与临床免疫学专业已经进入精准医学时代，疾病分为不同的疾病亚组、明确的诊断和靶向治疗选择，包括生物制剂和小分子药物。本文综述了该学科的研究和患者护理的最新进展以及未来趋势。过敏疾病基础机制部分总结了现状，并定义了结构生物学、2 型炎症、免疫耐受、神经免疫机制、微生物组和饮食的作用、环境因素以及呼吸道病毒感染等方面的研究需求。在诊断挑战、临床试验、精准医学和过敏疾病的免疫监测部分，进一步详细讨论了哮喘、过敏性和非过敏性鼻炎以及药物超敏反应诊断和治疗新方法。第三部分突出了过敏疾病治疗的未满足需求和未来研究领域，涉及食物过敏、生物制剂、小分子药物以及气道疾病过敏原特异性免疫治疗的新治疗概念。在每个小节的最后都讨论了未知和未来的研究需求。
