MODERN APPROACHES TO THE DIAGNOSIS AND THERAPY OF ALLERGIC DISEASES

Currently, great efforts are being made to optimize diagnostic and therapeutic standards in allergology. The introduction of biological drugs (omalizumab, mepolizumab, reslizumab, benralizumab, dupilumab) into clinical practice increases the need for biomarkers of allergic diseases that make it possible to adequately choose a treatment regimen, determine the duration of therapy with expensive biopreparations. The article discusses the possibilities of using biomarkers developed in recent years thanks to the so-called "omics" technologies in clinical practice. Biomarkers used for the diagnosis and treatment of bronchial asthma, atopic dermatitis, allergic rhinitis, food allergies, hypersensitivity to drugs, as well as for evaluating the effectiveness of allergen – specific immunotherapy are considered. The introduction of biomarkers into clinical practice has made it possible to carry out endotyping of some allergic diseases, which opens up prospects for new approaches to classification of these diseases, development of individual treatment targets and indications for administering personalized therapy. Endotyping of diseases is expected to be transferred to the category of diagnostic tests. However, it is necessary to overcome a number of problems before the treatment based on endotype determination will be introduced into everyday practice in allergic diseases and bronchial asthma. Currently, most of the research on the endotyping of diseases is carried out in severe forms of allergic diseases. It is beyond argument that the best ways to treat allergic diseases will be found in the near future, with a therapeutic approach focused on a specific patient, taking into account the patient's wishes, the presence of contraindications, the psychological characteristics of the patient, his expected adherence to therapy and possible side effects.