IMMUNOTHERAPY AND NEW TREATMENTS: Edited by Giovanni Passalacqua and Robert BushMolecular diagnosis and immunotherapySastre, Joaquína; Sastre-Ibañez, Marinab Author Information aAllergy Department Fundación Jiménez Díaz and CIBER de Enfermedades Respiratorias (CIBERES, Institute Carlos III, Ministry of Economy and Competitiveness) bHospital Clínico San Carlos, Madrid, Spain Correspondence to Joaquín Sastre, MD, PhD, Allergy Department, Fundación Jiménez Díaz, Av. Reyes Católicos 2, Madrid 28040, Spain. Tel: +34 91 5498225; fax: +34 91 5499498; e-mail: [email protected] Current Opinion in Allergy and Clinical Immunology: December 2016 - Volume 16 - Issue 6 - p 565-570 doi: 10.1097/ACI.0000000000000318 Buy Metrics Abstract Purpose of review To describe recent insights into how molecular diagnosis can improve indication and selection of suitable allergens for specific immunotherapy and increase the safety of this therapy. Recent findings As specific allergen immunotherapy targets specific allergens, identification of the disease-eliciting allergen is a prerequisite for accurate prescription of treatment. In areas of complex sensitization to aeroallergens or in cases of hymenoptera venom allergy, the use of molecular diagnosis has demonstrated that it may lead to a change in indication and selection of allergens for immunotherapy in a large proportion of patients when compared with diagnosis based on skin prick testing and/or specific IgE determination with commercial extracts. These changes in immunotherapy prescription aided by molecular diagnosis have been demonstrated to be cost-effective in some scenarios. Certain patterns of sensitization to grass or olive pollen and bee allergens may identify patients with higher risk of adverse reaction during immunotherapy. Summary Molecular diagnosis, when used with other tools and patients’ clinical records, can help clinicians better to select the most appropriate patients and allergens for specific immunotherapy and, in some cases, predict the risk of adverse reactions. The pattern of sensitization to allergens could potentially predict the efficacy of allergen immunotherapy provided that these immunotherapy products contain a sufficient amount of these allergens. Nevertheless, multiplex assay remains a third-level approach, not to be used as screening method in current practice. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.