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Friday, May 6, 2016

Toward precision medicine and health: Opportunities and challenges in allergic diseases

“Precision medicine” is a term that’s quickly gaining currency across all the different fields of medicine.  Specifically referring to the customization of healthcare in the context of each patient’s unique characteristics, including genetic and other biometric information, precision medicine seems to be on the cutting edge of healthcare.  But as Galli writes in this month’s issue, allergists have long prided themselves on a high degree of precision by testing for specific allergens and immunizing accordingly (J Allergy Clin Immunol 2016; 137(5): 1289-1300).  But now, with newer insights into genes and even the microbiome, we can take this precision medicine to another level.  Mining data from what is called the Information Commons – which includes the set of genetic and environmental factors predisposing to and/or exacerbating disease in individual patients – may help to devise approaches to more precisely and effectively diagnose and treat allergic disorders, or even to prevent these diseases.

The overarching goal is to move away from the “trial and failure” approach, where providers try therapeutics from the first-line down to the third- or fourth-line agents just to see if the approach works, towards a targeted selection of a treatment that is most likely to work.  Of course, all of this is easier said than done.  There is a lot of information about allergic disease that remains unknown and prevents us from applying precision medicine.  And even in diseases where a lot of data are available, we have yet to organize these data in a way that can move from the abstract towards a specific precise approach for a single patient.

7 comments:

  1. My name is Dr. Jacqueline W. Muller and I am a board certified medical doctor practicing in New York City. I treat many patients with environmental allergies and read your article (above) with great interest. The treatment for environmental allergies which has improved my patients' quality of life most dramatically is without a doubt custom sublingual immunotherapy. Sublingual immunotherapy drops are drops placed under a person's tongue in the convenience of his/her own home. This is a natural way (no medication) to desensitize a person with environmental allergies. Once desensitized, that person has less inflammation in his/her body which makes them less symptomatic and therefore more comfortable and less reliant on medication. This is an example in which we customize a patient's treatment once we have identified that individual's specific allergens; this type of targeted therapy is ideal. Sublingual immunotherapy has truly been life changing for these patients. For more information on this and other forms of allergy treatment please visit: www.allergytreatmentny.com

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