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The heterogeneity of allergic phenotypes: genetic and environmental interactions

2001; Elsevier BV; Volume: 87; Issue: 6 Linguagem: Inglês

10.1016/s1081-1206(10)62341-1

1534-4436

С. Бонини, Guido Rasi, A Lazaro De La Torre, Mauro DʼAmato, Paolo Maria Matricardi,

Urticaria and Related Conditions

This article reinforces the reader's knowledge of the multifactorial nature of allergic diseases and of the heterogeneity of allergic phenotypes.Personal studies and an evidence-based approach is used to support the assumption that three major abnormalities concur in the pathophysiology of allergic diseases: 1) enhanced allergen recognition and specific immune response; 2) a T helper 2 cytokine profile that results in polyclonal immunoglobulin E activation and mast cell-eosinophilic inflammation; and 3) organ hyperreactivity.Examples of genetic and environmental factors that preferentially influence each of these distinct pathophysiologic abnormalities are provided.Data presented indicate that allergic diseases distribute along a wide spectrum depending on the preferential pathophysiologic abnormalities operating in the individual patient.Categorization of allergic patients into distinct clinical phenotypes might result in a more patient-oriented (rather than disease-oriented) approach, and hence, better management.