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Nomenclature of allergic diseases and hypersensitivity reactions: Adapted to modern needs: An EAACI position paper.
Allergy 78, 2851-2874 (2023)
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.
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Publication type
Article: Journal article
Document type
Review
Keywords
Eaaci Position Paper ; Allergic Diseases ; Hypersensitivity ; Nomenclature ; Pathophysiology And Mechanism; T-cell; Immune-responses; Mast-cells; Chronic Rhinosinusitis; Revised Nomenclature; Atopic-dermatitis; Arthus Reaction; Gut Microbiota; Fc-receptors; Endotypes
ISSN (print) / ISBN
0105-4538
e-ISSN
1398-9995
Journal
Allergy
Quellenangaben
Volume: 78,
Issue: 11,
Pages: 2851-2874
Publisher
Wiley
Publishing Place
111 River St, Hoboken 07030-5774, Nj Usa
Non-patent literature
Publications
Reviewing status
Peer reviewed
Institute(s)
Institute of Asthma and Allergy Prevention (IAP)
Grants
We would like to thank Anna Globinska for the elaboration of all the figures in the Allergy style.