Today's science - tomorrow's practice: basic mechanisms of allergy and their clinical implications

Abstract

The current therapeutic perspective for the treatment of allergic disorders has shifted from mediators of allergy, such as histamine, to focus on cytokines and their interactions with cells involved in allergic inflammation. Although eosinophils are involved in the genesis of allergy in animal models, their role in human asthma has been questioned. On the other hand, immunoglobulin E (IgE) appears to play a key role in allergic reactions and is therefore the focus of therapeutic attention. Similarly, the relationship between allergic reactions and T-helper 1 (Th1) and Th2 cells has been the subject of intensive investigation. In addition to the inflammation that characterizes the allergic response, there are structural changes in the airways that may precede any obvious clinical disease. These structural changes, affecting the epithelial–mesenchymal trophic unit, may in part be genetically determined and will require treatment at the molecular biological level.