Modern healthcare requires a proactive and individualized response to
diseases, combining precision diagnosis and personalized treatment.
Accordingly, the approach to patients with allergic diseases encompasses
novel developments in the area of personalized medicine, disease
phenotyping and endotyping and the development and application of
reliable biomarkers. A detailed clinical history and physical
examination followed by the detection of IgE immunoreactivity against
specific allergens still represents the state of the art. However,
nowadays, further emphasis focuses on the optimization of diagnostic and
therapeutic standards and a large number of studies have been
investigating the biomarkers of allergic diseases, including asthma,
atopic dermatitis, allergic rhinitis, food allergy, urticaria and
anaphylaxis. Various biomarkers have been developed by omics
technologies, some of which lead to a better classification of the
distinct phenotypes or endotypes. The introduction of biologicals to
clinical practice increases the need for biomarkers for patient
selection, prediction of outcomes and monitoring, to allow for an
adequate choice of the duration of these costly and long-lasting
therapies. Escalating healthcare costs together with questions on the
efficacy of the current management of allergic diseases requires further
development of a biomarker-driven approach. Here, we review biomarkers
in diagnosis and treatment of asthma, atopic dermatitis, allergic
rhinitis, viral infections, chronic rhinosinusitis, food allergy, drug
hypersensitivity and allergen-immunotherapy with a special emphasis on
specific IgE, microbiome and epithelial barrier. In addition, EAACI
guidelines on biologicals are discussed within the perspective of
biomarkers.