TY - JOUR
T1 - Nomenclature of allergic diseases and hypersensitivity reactions
T2 - Adapted to modern needs: An EAACI position paper
AU - Jutel, Marek
AU - Agache, Ioana
AU - Zemelka-Wiacek, Magdalena
AU - Akdis, Mübeccel
AU - Chivato, Tomás
AU - del Giacco, Stefano
AU - Gajdanowicz, Pawel
AU - Gracia, Ibon Eguiluz
AU - Klimek, Ludger
AU - Lauerma, Antti
AU - Ollert, Markus
AU - O'Mahony, Liam
AU - Schwarze, Jürgen
AU - Shamji, Mohamed H.
AU - Skypala, Isabel
AU - Palomares, Oscar
AU - Pfaar, Oliver
AU - Torres, Maria Jose
AU - Bernstein, Jonathan A.
AU - Cruz, Alvaro A.
AU - Durham, Stephen R.
AU - Galli, Stephen J.
AU - Gómez, R. Maximiliano
AU - Guttman-Yassky, Emma
AU - Haahtela, Tari
AU - Holgate, Stephen T.
AU - Izuhara, Kenji
AU - Kabashima, Kenji
AU - Larenas-Linnemann, Désirée E.
AU - von Mutius, Erica
AU - Nadeau, Kari C.
AU - Pawankar, Ruby
AU - Platts-Mills, Tomas A.E.
AU - Sicherer, Scott H.
AU - Park, Hae Sim
AU - Vieths, Stefan
AU - Wong, Gary
AU - Zhang, Luo
AU - Bilò, M. Beatrice
AU - Akdis, Cezmi A.
N1 - Publisher Copyright:
© 2023 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.
PY - 2023/11
Y1 - 2023/11
N2 - The exponential growth of precision diagnostic tools, including omic technologies, molecular diagnostics, sophisticated genetic and epigenetic editing, imaging and nano-technologies and patient access to extensive health care, has resulted in vast amounts of unbiased data enabling in-depth disease characterization. New disease endotypes have been identified for various allergic diseases and triggered the gradual transition from a disease description focused on symptoms to identifying biomarkers and intricate pathogenetic and metabolic pathways. Consequently, the current disease taxonomy has to be revised for better categorization. This European Academy of Allergy and Clinical Immunology Position Paper responds to this challenge and provides a modern nomenclature for allergic diseases, which respects the earlier classifications back to the early 20th century. Hypersensitivity reactions originally described by Gell and Coombs have been extended into nine different types comprising antibody- (I-III), cell-mediated (IVa-c), tissue-driven mechanisms (V-VI) and direct response to chemicals (VII). Types I-III are linked to classical and newly described clinical conditions. Type IVa-c are specified and detailed according to the current understanding of T1, T2 and T3 responses. Types V-VI involve epithelial barrier defects and metabolic-induced immune dysregulation, while direct cellular and inflammatory responses to chemicals are covered in type VII. It is notable that several combinations of mixed types may appear in the clinical setting. The clinical relevance of the current approach for allergy practice will be conferred in another article that will follow this year, aiming at showing the relevance in clinical practice where various endotypes can overlap and evolve over the lifetime.
AB - The exponential growth of precision diagnostic tools, including omic technologies, molecular diagnostics, sophisticated genetic and epigenetic editing, imaging and nano-technologies and patient access to extensive health care, has resulted in vast amounts of unbiased data enabling in-depth disease characterization. New disease endotypes have been identified for various allergic diseases and triggered the gradual transition from a disease description focused on symptoms to identifying biomarkers and intricate pathogenetic and metabolic pathways. Consequently, the current disease taxonomy has to be revised for better categorization. This European Academy of Allergy and Clinical Immunology Position Paper responds to this challenge and provides a modern nomenclature for allergic diseases, which respects the earlier classifications back to the early 20th century. Hypersensitivity reactions originally described by Gell and Coombs have been extended into nine different types comprising antibody- (I-III), cell-mediated (IVa-c), tissue-driven mechanisms (V-VI) and direct response to chemicals (VII). Types I-III are linked to classical and newly described clinical conditions. Type IVa-c are specified and detailed according to the current understanding of T1, T2 and T3 responses. Types V-VI involve epithelial barrier defects and metabolic-induced immune dysregulation, while direct cellular and inflammatory responses to chemicals are covered in type VII. It is notable that several combinations of mixed types may appear in the clinical setting. The clinical relevance of the current approach for allergy practice will be conferred in another article that will follow this year, aiming at showing the relevance in clinical practice where various endotypes can overlap and evolve over the lifetime.
KW - EAACI position paper
KW - allergic diseases
KW - hypersensitivity
KW - nomenclature
KW - pathophysiology and mechanism
UR - http://www.scopus.com/inward/record.url?scp=85173733789&partnerID=8YFLogxK
U2 - 10.1111/all.15889
DO - 10.1111/all.15889
M3 - Article
C2 - 37814905
AN - SCOPUS:85173733789
SN - 0105-4538
VL - 78
SP - 2851
EP - 2874
JO - Allergy: European Journal of Allergy and Clinical Immunology
JF - Allergy: European Journal of Allergy and Clinical Immunology
IS - 11
ER -