In the last decades, significant progresses have been reached in the management of atopic diseases in childhood. Several approaches have been proposed in patients affected by moderate-to-severe atopic diseases. Severe asthma and atopic dermatitis are poorly known with different underlying phenotypes and endotypes, and they may require further cares with biological therapies. Omalizumab, anti-IgE monoclonal antibody, is effective and safe in patients with atopic diseases, especially uncontrolled asthma and chronic urticaria. Anti-IL-5 drugs including mepolizumab, reslizumab and benralizumab are effective in resistant eosinophilic asthma. In patients with uncontrolled atopic dermatitis, dupilumab is of benefit. Allergen-specific immunotherapy (AIT) represents the only treatment attaining immunologic tolerance and sustaining improvement in symptoms. Both subcutaneous and sublingual immunotherapies are characterized by a short-term and a long-term efficacy, as demonstrated by a reduced immunologic reactivity after discontinuation. Component-resolved diagnosis has been found an essential diagnostic tool potentially able to increase the efficacy of AIT in polysensitized children, establishing a precise AIT prescription for patient genuinely sensitized to allergens. The future care of allergic diseases in childhood requires an individualized approach to achieve a patient-tailored therapy for difficult-to-treat atopic diseases.

中文翻译：

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过敏原特异性免疫疗法、新药和生物制品：来自难以治疗的过敏儿童的希望

在过去的几十年里，儿童特应性疾病的管理取得了重大进展。已经在受中度至重度特应性疾病影响的患者中提出了几种方法。重度哮喘和特应性皮炎由于不同的潜在表型和内型而知之甚少，它们可能需要进一步的生物疗法护理。Omalizumab 是一种抗 IgE 单克隆抗体，对患有特应性疾病，尤其是未控制的哮喘和慢性荨麻疹的患者有效且安全。包括美泊利单抗、瑞利珠单抗和贝那利珠单抗在内的抗 IL-5 药物对抵抗性嗜酸性粒细胞哮喘有效。对于未控制的特应性皮炎患者，dupilumab 是有益的。变应原特异性免疫疗法 (AIT) 是唯一获得免疫耐受性和持续改善症状的治疗方法。皮下和舌下免疫疗法的特点是短期和长期疗效，如停药后免疫反应性降低所证明的那样。已发现成分解析诊断是一种重要的诊断工具，可能能够提高 AIT 在多敏儿童中的疗效，为真正对过敏原敏感的患者制定精确的 AIT 处方。儿童过敏性疾病的未来护理需要采取个性化的方法，以针对难以治疗的特应性疾病实现患者量身定制的治疗。已发现成分解析诊断是一种重要的诊断工具，可能能够提高 AIT 在多敏儿童中的疗效，为真正对过敏原敏感的患者制定精确的 AIT 处方。儿童过敏性疾病的未来护理需要采取个性化的方法，以针对难以治疗的特应性疾病实现患者量身定制的治疗。已发现成分解析诊断是一种重要的诊断工具，可能能够提高 AIT 在多敏儿童中的疗效，为真正对过敏原敏感的患者制定精确的 AIT 处方。儿童过敏性疾病的未来护理需要采取个性化的方法，以针对难以治疗的特应性疾病实现患者量身定制的治疗。