Accordingly, the current understanding of precision medicine has developed and is continuously improving ( Table 1).Ĭomparisons between the traditional current approach and the precision medicine/stratified approachĭisease phenotypes cluster together relevant visible properties such as age at onset, triggers, comorbidities, physiological traits, remodeling, inflammation type (eosinophilic and non-eosinophilic), and treatment response ( 2, 3). Nonetheless, the treatments available today merely offer long-term relief of symptoms and do not cure the disease, making it increasingly clear that new approaches for the management of allergic diseases are required. The heterogeneous, dynamic combination of dysregulated immune response, chronic inflammation, tissue remodeling, and hyperresponsiveness in affected tissues defines the complexity of asthma, anaphylaxis, food allergy, allergic rhinitis, chronic rhinosinusitis (CRS), and atopic dermatitis (AD).Īt present, management guidelines for allergic diseases are based on evaluation of symptoms, target organ function, exacerbations, need for rescue medication, and limitation of quality of life, all the while reinforcing the importance of achieving disease control and reducing future risk ( 1). Introduction and general conceptsĪllergic diseases remain a worldwide problem, with almost one billion cases, causing significant morbidity and mortality and accounting for a considerable portion of health care expenditure. We describe here a precision medicine approach that stratifies patients based on disease mechanisms to optimize management of allergic diseases. Escalating health care costs together with questionable efficacy of the current management of allergic diseases facilitated the emergence of the endotype-driven approach. Polyomics, big data, and systems biology have demonstrated a profound complexity and dynamic variability in allergic disease between individuals, as well as between regions. The 100-year-old personalized allergen-specific management of allergic diseases has particularly contributed to early awareness in precision medicine. Precision medicine is becoming an overarching medical discipline that will require a better understanding of biomarkers, phenotypes, endotypes, genotypes, regiotypes, and theratypes of diseases. A rapidly developing paradigm for modern health care is a proactive and individualized response to patients’ symptoms, combining precision diagnosis and personalized treatment.
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