Introductory Chapter: Allergic Disease – New Developments in Diagnosis and Therapy

1. Introduction

In today’s world of the allergy epidemic, this book will discuss primarily the changes and developments in the diagnosis and treatment of well-known allergic diseases in light of recent literature. Today, with the developing of technology, diagnosing allergic diseases is much more than just skin-prick tests and specific IgE examinations. Many things now require diagnosis at the molecular level and more appropriate diagnosis and proper treatments [1, 2].

2. Aim

In our book and in this brief section, we gave priority to the topics, which we encounter very often in the allergy outpatient clinic and the current developments in this field.

3. New developments in diagnosis and therapy of allergic diseases

Nowadays, the basic knowledge of molecular allergy is increasing very rapidly. The molecular biological approach is most useful today in the study of food allergies and cross-reactive allergens [3, 4, 5]. In light of the innovations in the literature on molecular allergy, the reflection of this from laboratory tests to bedside clinical practices is becoming more important every day.

Also, an aerobiological approach and the contribution of aerobiology in the diagnosis and treatment of pollen allergy are one of the developing areas. An aerobiological approach will not only give a more accurate diagnosis but will also help detect and treat more accurately the actual pollen to which the person may be allergic [6].

Food allergies, which are increasing day by day, are like a new challenge to our civilization. While we were talking about food allergies that disappeared at an earlier age and were not so stubborn and difficult to treat until recently, we can talk about food allergies that are more resistant to treatment, disappear at a later age, and generally it appears as multiple food allergies [7, 8]. In the past, cow’s milk and egg food allergies were the most common and well-known types of food allergies that were relatively easy to treat. Again, apart from diet therapy, immunotherapy modalities that are tried by oral-sublingual route against various foods are very popular today. To reduce the frequency of food allergy development, early administration of some foods has also come to the fore today [9].

Again, the frequency of anaphylaxis, which is one of the serious problems in food allergies, and the chance of it appearing in the clinic is like the increase in the incidence of all other allergic diseases. Recently, there have been some changes in the definition of anaphylaxis, the diagnosis of which has always been controversial. Apart from hypotension, after exposure to certain/known allergens, the appearance of respiratory symptoms (e.g., laryngomalacia, and bronchospasm) was also accepted as anaphylaxis [10, 11]. Apart from the difficulties in diagnosing anaphylaxis, infant anaphylaxis is a difficult issue in its own right. As it is so difficult to evaluate and decide on anaphylaxis-related symptoms and signs in infants [12, 13], there has been no recent change in this treatment.

It is known that all allergic diseases occur through immune mediation. Again, although allergic diseases generally have a common immunopathogenesis, there may be minor variations specific to the individual disease. Allergen-specific immunotherapy is one of the most developed topics in allergy recently. Apart from the use of molecular allergy and aerobiological methods when planning immunotherapy [4], different methods have been developed as I mentioned above when talking about food allergy. In addition, application with other methods (oral, sublingual, epidermal, intralymphatic, etc.,) other than the classical method, the subcutaneous route, is partially becoming common in food as well as pollen allergies. Again, apart from orally administered liquid preparations, tablet-like and home allergen-specific immunotherapy applications are becoming widespread, especially for pollen and dust mite allergies [14, 15]. Various companies have preparations for this purpose, especially in European Union countries.

Besides allergen-specific immunotherapy, the use of mesenchymal stem/stromal cells is available today as trial treatments in many autoimmune, chronic diseases, even in COVID-19 other than allergic diseases. It has been first tried in mice, especially in atopic dermatitis, and its success has been reported [16]. It is very new to be tested for allergic diseases such as atopic dermatitis and chronic urticaria. Although this form of treatment looks promising, trials are new, and the chances of success are still low. But if it is successful, it may appear more frequently in the future as a radical and preventive treatment option [17].

4. Conclusion

I hope that the issues described in the light of the current information in this book will change the diagnostic and therapeutic approaches of allergists and lead to better and more accurate results for the patient.

I would be very glad that our book will be useful to all our readers…