This review highlights some of the research advances in allergic
skin disease,
anaphylaxis, and
hypersensitivity reactions to foods, drugs, and insects that were reported primarily in the Journal in 2007. Advances in diagnosis include possible
biomarkers for
anaphylaxis, improved understanding of the relevance of food-specific serum
IgE tests, identification of possibly discriminatory T-cell responses for
drug allergy, and an elucidation of
irritant responses for
vaccine allergy diagnostic skin tests. Mechanistic studies are discerning T-cell and
cytokine responses central to eosinophilic gastroenteropathies and
food allergy, including the identification of multiple potential therapeutic targets. Regarding treatment, clinical studies of oral
immunotherapy and
allergen vaccination strategies show promise, whereas several clinical studies raise questions about whether oral
allergen avoidance reduces atopic risks and whether probiotics can prevent or treat atopic disease. The importance of skin barrier dysfunction has been highlighted in the pathogenesis of
atopic dermatitis (AD), particularly as it relates to
allergen sensitization and
eczema severity. Research has also continued to identify immunologic defects that contribute to the propensity of patients with AD to have viral and
bacterial infections. New therapeutic approaches to AD,
urticaria, and
angioedema have been reported, including use of sublingual immunotherapy,
anti-IgE, and a
kallikrein inhibitor.