Personalized medicine for allergy treatment: Allergen immunotherapy still a unique and unmatched model

Cristoforo Incorvaia (1) , Mona Al‐ahmad (2, 3) , Ignacio Ansotegui (4) , Stefania Arasi (5) , Claus Bachert (6, 7, 8) , Catherine Bos (9) , Jean Bousquet (10, 11) , Andrzéj Bozek (12) , Davide Caimmi (13, 14) , Moises Calderón (15) , Thomas Casale (16) , Adnan Custovic (17) , Frédéric de Blay (18) , Pascal Demoly (14, 13, 19) , Philippe Devillier (20, 21) , Alain Didier (22, 23) , Alessandro Fiocchi (5) , Adam Fox (24) , Philippe Gevaert (6) , Maximiliano Gomez , Enrico Heffler (25, 26) , Natalia Ilina (27) , Carla Irani (28) , Marek Jutel (29) , Efstrathios Karagiannis (9) , Ludger Klimek (30) , Piotr Kuna (31) , Robin O'Hehir (32) , Oxana Kurbacheva (33) , Paolo Matricardi (34) , Mario Morais‐almeida (35) , Ralph Mosges (36, 37) , Natalija Novak (38) , Yoshitaka Okamoto (39) , Petr Panzner (40) , Nikolaos Papadopoulos (17, 41) , Hae‐sim Park (42) , Giovanni Passalacqua (43) , Ruby Pawankar (44) , Oliver Pfaar (45) , Peter Schmid‐grendelmeier (46) , Silvia Scurati (9) , Miguel Tortajada‐girbés (47, 48) , Carmen Vidal (49) , J. Christian Virchow (50) , Ulrich Wahn (34) , Margitta Worm (34) , Petra Zieglmayer , Giorgio Canonica (25, 26)

1 ASST Pini-CTO
2 Kuwait University
3 Al-Rashed Allergy Center [Kuwait City]
4 Hospital Quirónsalud Bizkaia [Bilbao]
5 IRCCS Ospedale Pediatrico Bambino Gesù = Bambino Gesù Children’s Hospital
6 Ghent University Hospital
7 Karolinska Institutet [Stockholm]
8 Karolinska University Hospital [Stockholm]
9 Stallergenes - Stallergenes SA
10 CHU Montpellier
11 MACVIA-LR - Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon
12 SUM - Medical University of Silesia
13 Hôpital Arnaud de Villeneuve [CHRU Montpellier]
14 IDESP - Institut Desbrest de santé publique
15 Imperial College London
16 USF - University of South Florida [Tampa]
17 University of Manchester [Manchester]
18 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
19 EPAR - Epidemiology of Allergic and Respiratory Diseases Department [iPlesp]
20 Hôpital Foch [Suresnes]
21 Université Paris-Saclay
22 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
23 UT3 - Université Toulouse III - Paul Sabatier
24 Guy's and St Thomas' Hospitals
25 Humanitas Clinical and Research Center [Rozzano, Milan, Italy]
26 Hunimed - Humanitas University [Milan]
27 Federal Institute of Immunology of Russia [Moscou]
28 USJ - Université Saint-Joseph de Beyrouth
29 Wrocław Medical University
30 Center for Rhinology and Allergology = Zentrum für Rhinologie und Allergologie
31 MUL - Medical University of Łódź
32 Monash University [Melbourne]
33 Federal Medical-Biological Agency of Russia
34 Charité - UniversitätsMedizin = Charité - University Hospital [Berlin]
35 Hospital CUF Descobertas
36 University of Cologne
37 Clinical Research International Ltd.
38 University Hospital Bonn
39 Chiba University Hospital
40 UK - Univerzita Karlova [Praha, Česká republika] = Charles University [Prague, Czech Republic]
41 NKUA - National and Kapodistrian University of Athens
42 Ajou University School of Medicine
43 UniGe - Università degli studi di Genova = University of Genoa
44 Nippon Medical School [Tokyo, Japon]
45 Philipps Universität Marburg = Philipps University of Marburg
46 University hospital of Zurich [Zurich]
47 Dr Peset University Hospital
48 UV - Universitat de València
49 CHUS - Complejo Hospitalario Universitario de Santiago de Compostela [Saint-Jacques-de-Compostelle, Espagne]
50 University of Rostock

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.

Mots clés: treatable traits; personalized medicine; omics; molecular diagnosis; allergen immunotherapy; treatable traits

Domaines: Allergologie

Cristoforo Incorvaia, Mona Al‐ahmad, Ignacio Ansotegui, Stefania Arasi, Claus Bachert, et al.. Personalized medicine for allergy treatment: Allergen immunotherapy still a unique and unmatched model. Allergy, 2021, 76 (4), pp.1041-1052. ⟨10.1111/all.14575⟩. ⟨hal-03613250⟩