Cardiac/Pulmonary Rehabilitation, ASST Pini/CTO, Milan, Italy.
Microbiology Department, Faculty of Medicine, Kuwait University, Kuwait.
Allergy. 2021 Apr;76(4):1041-1052. doi: 10.1111/all.14575. Epub 2020 Oct 19.
The introduction of personalized medicine (PM) has been a milestone in the history of medical therapy, because it has revolutionized the previous approach of treating the disease with that of treating the patient. It is known today that diseases can occur in different genetic variants, making specific treatments of proven efficacy necessary for a given endotype. Allergic diseases are particularly suitable for PM, because they meet the therapeutic success requirements, including a known molecular mechanism of the disease, a diagnostic tool for such disease, and a treatment blocking the mechanism. The stakes of PM in allergic patients are molecular diagnostics, to detect specific IgE to single-allergen molecules and to distinguish the causative molecules from those merely cross-reactive, pursuit of patient's treatable traits addressing genetic, phenotypic, and psychosocial features, and omics, such as proteomics, epi-genomics, metabolomics, and breathomics, to forecast patient's responsiveness to therapies, to detect biomarker and mediators, and to verify the disease control. This new approach has already improved the precision of allergy diagnosis and is likely to significantly increase, through the higher performance achieved with the personalized treatment, the effectiveness of allergen immunotherapy by enhancing its already known and unique characteristics of treatment that acts on the causes.
个性化医学（PM）的引入是医学治疗史上的一个里程碑，因为它彻底改变了以前的疾病治疗方法，转而采用治疗患者的方法。如今，人们已经认识到，疾病可能会出现不同的遗传变异，因此对于特定的表型需要采用经过验证的有效治疗方法。过敏疾病特别适合 PM，因为它们符合治疗成功的要求，包括疾病的已知分子机制、用于此类疾病的诊断工具以及阻断该机制的治疗方法。PM 在过敏患者中的重要性在于分子诊断，以检测针对单一过敏原分子的特异性 IgE，并区分致病分子与仅具有交叉反应性的分子，针对遗传、表型和社会心理特征的患者可治疗特征的研究，以及组学，如蛋白质组学、表观基因组学、代谢组学和呼吸组学，以预测患者对治疗的反应，检测生物标志物和介质，并验证疾病控制。这种新方法已经提高了过敏诊断的准确性，并有望通过个性化治疗的更高性能显著提高变应原免疫治疗的效果，增强其已知的、独特的针对病因的治疗特征。
