Towards a Multi-omics Understanding of Anaphylaxis: Insights into Pathogenesis and Biomarker Identification.

Anaphylaxis is a severe, life-threatening hypersensitivity reaction that presents significant challenges in both clinical practice and scientific research. While individual omics studies have provided valuable insights into the genetic predisposition, immune dysregulation, and metabolic alterations associated with anaphylaxis, a comprehensive understanding of its full pathophysiology remains elusive. Multi-omics integration, which combines genomics, epigenomics, transcriptomics, proteomics, and metabolomics, has the potential to uncover novel mechanisms, biomarkers, and therapeutic targets. However, studies employing comprehensive multi-omics approaches in anaphylaxis are still limited. This review of 107 studies published between 2000 and 2024-including genomics (43), metagenomics (2), epigenomics (2), transcriptomics (20), proteomics (26), and metabolomics (14)-synthesizes findings from existing single-omics studies on human anaphylaxis, identifies key interconnections across omics layers, and underscores the critical need for large-scale, integrative research. Advancing this type of research is essential to advance our understanding of anaphylaxis, improve risk prediction, and enhance both diagnosis and treatment strategies.