Precision medicine in patients with allergic diseases: Airway diseases and atopic dermatitis—PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology

TLDR

PRACTALL, a joint effort by EAACI and AAAAI, seeks to harmonize allergy practice and science, emphasizing precision medicine’s role in asthma, rhinitis, and atopic dermatitis while noting gaps in non‑type 2 endotype approaches and the need for consensus and biomarker development. The document aims to summarize current knowledge of major allergic disease endotypes and to validate biomarkers for pathway‑specific diagnostic tests. The authors compile and synthesize existing data on asthma, rhinitis, and atopic dermatitis endotypes through the PRACTALL collaboration platform. Progress has been achieved in profiling type 2 immune‑response asthma.

Abstract

In this consensus document we summarize the current knowledge on major asthma, rhinitis, and atopic dermatitis endotypes under the auspices of the PRACTALL collaboration platform. PRACTALL is an initiative of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology aiming to harmonize the European and American approaches to best allergy practice and science. Precision medicine is of broad relevance for the management of asthma, rhinitis, and atopic dermatitis in the context of a better selection of treatment responders, risk prediction, and design of disease-modifying strategies. Progress has been made in profiling the type 2 immune response-driven asthma. The endotype driven approach for non-type 2 immune response asthma, rhinitis, and atopic dermatitis is lagging behind. Validation and qualification of biomarkers are needed to facilitate their translation into pathway-specific diagnostic tests. Wide consensus between academia, governmental regulators, and industry for further development and application of precision medicine in management of allergic diseases is of utmost importance. Improved knowledge of disease pathogenesis together with defining validated and qualified biomarkers are key approaches to precision medicine.