Development of allergic sensitization and its relevance to paediatric asthma

Purpose of review The purpose of this review is to summarize the recent evidence on the distinct atopic phenotypes and their relationship with childhood asthma. We start by considering definitions and phenotypic classification of atopy and then review evidence on its association with asthma in children. Recent findings It is now well recognized that both asthma and atopy are complex entities encompassing various different sub-groups that also differ in the way they interconnect. The lack of gold standards for diagnostic markers of atopy and asthma further adds to the existing complexity over diagnostic accuracy and definitions. Although recent statistical phenotyping studies contributed significantly to our understanding of these heterogeneous disorders, translating these findings into meaningful information and effective therapies requires further work on understanding underpinning biological mechanisms. Summary The disaggregation of allergic sensitization may help predict how the allergic disease is likely to progress. One of the important questions is how best to incorporate tests for the assessment of allergic sensitization into diagnostic algorithms for asthma, both in terms of confirming asthma diagnosis, and the assessment of future risk. Correspondence to Adnan Custovic, MD, PhD, Department of Paediatrics, Imperial College London, St Mary's Campus Medical School, Room 244, Norfolk Place, London W2 1PG, UK. Tel: +44 20 7594 3274; fax: +44 20 7594 3984; e-mail: a.custovic@imperial.ac.uk Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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