Precision medicine in the allergy clinic: the application of component resolved diagnosis

Expert Rev Clin Immunol. 2022 Feb;18(2):145-162. doi: 10.1080/1744666X.2022.2034501. Epub 2022 Feb 12.

Abstract

Introduction: A precise diagnosis is key for the optimal management of allergic diseases and asthma. In vivo or in vitro diagnostic methods that use allergen extracts often fail to identify the molecules eliciting the allergic reactions.

Areas covered: Component-resolved diagnosis (CRD) has solved most of the limitations of extract-based diagnostic procedures and is currently valuable tool for the precision diagnosis in the allergy clinic, for venom and food allergy, asthma, allergic rhinitis, and atopic dermatitis. Its implementation in daily practice facilitates: a) the distinction between genuine multiple sensitizations and cross-reactive sensitization in polysensitized patients; b) the prediction of a severe, systemic reaction in food or insect venom allergy; c) the optimal selection of allergen immunotherapy based on the patient sensitization profile. This paper describes its main advantages and disadvantages, cost-effectiveness and future perspectives.

Expert opinion: The diagnostic strategy based on CRD is part of the new concept of precision immunology, which aims to improve the management of allergic diseases.

Keywords: Allergen immunotherapy; allergic diseases; asthma; component resolved diagnosis; molecular allergens.

MeSH terms

  • Allergens
  • Desensitization, Immunologic / methods
  • Food Hypersensitivity* / diagnosis
  • Food Hypersensitivity* / therapy
  • Humans
  • Precision Medicine
  • Rhinitis, Allergic*

Substances

  • Allergens