PRECISION MEDICINEPrecision medicine in atopic diseasesCianferoni, Antonellaa; Annesi-Maesano, Isabellab Author Information aAllergy and Immunology Division, Department of Pediatric, Perelman School of Medicine, University of Pennsylvania, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA bEpidemiology of Allergic and Respiratory Diseases Department, IPLESP, INSERM and Sorbonne University, Medical School Saint-Antoine, Paris, France Correspondence to Antonella Cianferoni, Allergy and Immunology Division, Department of Pediatric, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA. E-mail: [email protected] Current Opinion in Allergy and Clinical Immunology: December 2019 - Volume 19 - Issue 6 - p 654-664 doi: 10.1097/ACI.0000000000000591 Buy Metrics Abstract Purpose of review To analyze the status of precision medicine in atopic diseases. Recent findings Atopic diseases are increasingly recognized as heterogeneous in nature and they can be quite different in severity, response to therapy, triggers, genetic back ground, ancestral risk and type of inflammation. This significant variability in the landscape of atopic diseases is not reflected in the common treatment guidelines that follow ‘one fits all’ approach for their management. Such an approach is largely based on minimal ‘phenotype’ elements, such as severity of disease and response to therapy and does not reflect the information accumulate in the last 20 years about particular pathogenic pathways (endotypes) leading to disease (phenotypes) based on biomolecular analysis of the single individuals. Accumulating data have defined asthma allergic rhinitis, food allergy based on their endotypes and clinically relevant phenotypes. In general, atopic diseases can be largely classified as high or low Th2 inflammatory status, which may explain the severity and response to therapy. Summary Precision medicine is aiming to use known endotype phenotype to guide specific individualized treatment. The work aimed in deep characterization of diseases to guide the disease management is crucial in light of the availability of ever more precise treatment able to target specific pathways. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.