ADVANCES IN THE DIAGNOSIS AND PERSONALIZED MANAGEMENT OF ALLERGIC DISEASES IN PEDIATRIC AND ADULT POPULATIONS

Abstract

Allergic diseases encompass a heterogeneous group of conditions whose clinical expression is shaped by age, genetic susceptibility, environmental exposure, immune pathways and comorbidities. Recent advances have moved allergy care beyond symptom- based classification toward integrated, mechanism-informed assessment. This narrative review summarizes developments in clinical phenotyping, skin-prick and serum-specific IgE testing, component-resolved diagnostics, selected functional assays, biomarkers and targeted treatment. Particular attention is given to age -related diagnostic challenges, severe asthma, allergic rhinitis, atopic dermatitis, food allergy and anaphylaxis. Molecular allergology can distinguish genuine sensitization from cross-reactivity and may improve risk assessment and selection for allergen immunotherapy, but test results must remain anchored to the clinical history. Biomarkers such as blood eosinophils, fractional exhaled nitric oxide and total IgE can support treatment selection in defined s ettings; none is sufficiently comprehensive to replace clinical evaluation. Biologics targeting IgE or type 2 inflammatory pathways have expanded options for patients with severe or treatment- refractory disease, while food oral immunotherapy and omalizumab offer selected patients additional risk-reduction strategies. Personalized care therefore requires shared decision- making, reassessment of treatment response, attention to access and adherence, and explicit safety planning. Important limitations remain, including variable biomarker performance, limited head-to-head trials, unequal availability of advanced diagnostics and uncertainty about long-term disease modification.