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.
Spring and Summer 2020 are unique in that the challenges of care for those suffering from pollen allergy coincide with the COVID-19 pandemic. Several considerations are important to allow optimal care of allergic rhinitis (AR) and asthma and hence prevention of coronavirus spread through sneezing, rhinorrhoea, and coughing. This compact overview of recommendations by the EUFOREA expert teams on allergic airway diseases and allergen-specific immunotherapy (AIT) is based on investigation of the current COVID-19 literature in association with the key words above and shared clinical experience of the experts involved. It deals with similarities and differences between AR and coronavirus infection, specific recommendations for allergic disease care in the COVID-19 era, including guidance on AIT.
- Publikační typ
- časopisecké články MeSH
- Klíčová slova
- Prof. Ulrich Wahn,
- MeSH
- desenzibilizace imunologická MeSH
- Publikační typ
- rozhovory MeSH
Allergen immunotherapy (AIT) is a proven therapeutic option for the treatment of allergic rhinitis and/or asthma. Many guidelines or national practice guidelines have been produced but the evidence-based method varies, many are complex and none propose care pathways. This paper reviews care pathways for AIT using strict criteria and provides simple recommendations that can be used by all stakeholders including healthcare professionals. The decision to prescribe AIT for the patient should be individualized and based on the relevance of the allergens, the persistence of symptoms despite appropriate medications according to guidelines as well as the availability of good-quality and efficacious extracts. Allergen extracts cannot be regarded as generics. Immunotherapy is selected by specialists for stratified patients. There are no currently available validated biomarkers that can predict AIT success. In adolescents and adults, AIT should be reserved for patients with moderate/severe rhinitis or for those with moderate asthma who, despite appropriate pharmacotherapy and adherence, continue to exhibit exacerbations that appear to be related to allergen exposure, except in some specific cases. Immunotherapy may be even more advantageous in patients with multimorbidity. In children, AIT may prevent asthma onset in patients with rhinitis. mHealth tools are promising for the stratification and follow-up of patients.
- MeSH
- alergeny aplikace a dávkování imunologie MeSH
- alergická rýma epidemiologie imunologie terapie MeSH
- analýza nákladů a výnosů MeSH
- biologické markery MeSH
- bronchiální astma epidemiologie imunologie terapie MeSH
- desenzibilizace imunologická * škodlivé účinky metody MeSH
- individualizovaná medicína metody MeSH
- klinické rozhodování MeSH
- komorbidita MeSH
- kritické cesty * MeSH
- lidé MeSH
- management nemoci MeSH
- náchylnost k nemoci MeSH
- osobní újma zaviněná nemocí MeSH
- postoj zdravotnického personálu MeSH
- směrnice pro lékařskou praxi jako téma MeSH
- výsledek terapie MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- MeSH
- alergeny * imunologie terapeutické užití MeSH
- alergie * imunologie terapie MeSH
- diagnostické techniky molekulární MeSH
- imunoglobulin E krev MeSH
- individualizovaná medicína MeSH
- lidé MeSH
- příprava léků MeSH
- sublinguální imunoterapie * metody MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- přehledy MeSH
- Geografické názvy
- Evropa MeSH
Allergy, ISSN 0105-4538 Volume 66, Supplementum 95, July 2011
65 stran : ilustrace ; 28 cm
- MeSH
- alergie terapie MeSH
- imunoglobulin E účinky léků MeSH
- imunoterapie metody MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
