Latest Progresses in Allergic Diseases Biomarkers: Asthma and Atopic Dermatitis

Abstract

In the last years, the understanding of the pathologic mechanisms of asthma and atopic dermatitis, both characterized by allergic inflammation, has greatly improved. However, it is evident that both diseases present with high heterogeneity, which complicates the diagnosis and the therapeutic approach of the patients. Moreover, some of the currently available strategies to treat asthma and atopic dermatitis are still mostly controlling the symptoms, but not to lead towards full healing, thus having these two diseases labelled as unmet clinical needs by WHO. Therefore, the “one-size-fits-all” strategy is outdated for asthma and atopic dermatitis, and there is the need of better methods to clearly diagnose the disease and tailor the therapy according to the specific symptomatology. In this regard, the use of biomarkers has been advanced in order to characterize both diseases according to their clinical signs and to facilitate the subsequent treatment. Despite the advancements made in this regard, there is still need for better and more sensitive biomarkers and for less invasive sampling methodologies, with the aim to diagnose specifically each manifestation of asthma and atopic dermatitis and to provide the best treatment with the least suffering for the patients.

Glucocorticoids and COVID-19

“…Asthma can be classified in various types based on the different underlying pathologic mechanisms and immune cells involved. Therefore, the disease shows high degree of heterogeneity with the main types being the allergic and neutrophilic asthma [87] , [88] , [89] . The allergic type is the most common, and characterized by high serum levels of immunoglobulin E (IgE), infiltration of eosinophils into the lung, degranulation of mast cells, and release of inflammatory cytokines such as IL-4, IL-5, and IL-13 [86] , [90] .…”

How the Immune System Responds to Allergy Immunotherapy

“…Based on the prevalence of the two major types of effector T cells (Th2 and Th17) and helper ILCs (ILC2 and ILC3), endotypes of BA have been distinguished into “type 2” (or T2 high or eosinophilic) and “non-type 2” (or T2 low or non-eosinophilic) [ 24 , 78 , 79 ]. Mixed endotypes have also been described [ 80 ]. T2 high endotype is commonly induced by allergic inflammation sustained by type 2 immune response, characterized by the presence of tissue eosinophils [ 81 ].…”

Novel Serum Biomarkers for Patients with Allergic Asthma Phenotype

“…These EOS counts are the most studied and most widely used biomarker in clinical practice. Increased EOS counts are associated with a higher prevalence of exacerbations and a lower possibility of controlling the disease [9]. Increased total IgE levels are seen in patients with atopic diseases; therefore, they are considered a marker of atopy.…”