Molecular allergology user’s guide. (Book)

Allergology is experiencing a technological revolution, which is transforming into a rapid clinical practice “evolution”. Our knowledge as “traditional” allergists, inherited since the first years of 1900, is progressively challenged by new concepts. Our tools, based on sometimes poorly standardized and highly variable allergenic preparations, become clearly defined and allow more analyses in depth. Similar to other areas of Medicine, these changes are facilitated by a new era of biosiences and technologies, including advanced molecular and structural biology. This process is part of a broader concept, coined “Precision Medicine” promoting personalized treatments based on a detailed patient’s disease phenotype. Thanks to this technological revolution, a growing number of allergenic molecules and their isoforms have been purified, sequenced, cloned, and produced in large quantities. They allowed to study the immunological reactivity of these molecules, their degree of cross-reactivity and to define complex IgE repertoires. New diagnostic methods have been made available for clinicians and improved therapeutic strategies will be further developed in the future.
The results of these studies are regularly published in medical journals with high impact factors. Up to now more than one thousand molecules from diverse allergen sources have been characterized; many others will be identified, purified and cloned in the future. Over 100 of these molecules have already been developed as diagnostic reagents for routine use in clinical practice. Many more will be introduced not far from today. Altogether, this knowledge has created a new branch establishing novel “allergomics” or “allergologic proteomics”. The main information on physico-chemical and biological features of allergenic molecules, their sources, abundance, regional distribution and nomenclature are accessible in several web-based databanks. Symposia and Congresses are nowadays providing and promoting exiting topics regarding Molecular Allergology.
However, this “scientific revolution” has not yet fully translated into an improved management of the allergic patient. The main reason for this “gap” between science and routine clinical practice is in part the complexity of the new subject, hampering instant utilization and interpretation of these new diagnostic tools by an average physician. Based on this scientific revolution in allergy practice, the medical education programs as well as the training programs for allergy specialists should be re-written and adapted accordingly.