Introduction
Allergic diseases, including respiratory (allergic rhinitis and asthma)
and food allergy (FA), and drug hypersensitivity reactions (DHRs), have
shown an important increase in their prevalence over the last
decades.1-4 Severe rhinitis and asthma, and
potentially fatal anaphylaxis due to food and drug intake are a burden
because of their high impact in life-quality and cost for the health
system.5-7 Moreover, there is a great heterogeneity of
clinical symptoms, mechanisms, and specific gaps regarding
comorbidities, making diagnosis complex, with low sensitivity or
specificity, and treatments with low efficacy or no achievement of
disease control.8-11
Regarding the diagnostic approaches, the main goal is improving
sensitivity and specificity to diminish the false negative results,
which can be critical in severe reactions, and the false allergic
labelling of the patients, which is a main problem in
DHRs.12-16 A precise diagnosis will improve the
management of the patients by applying accurate treatments. There is a
need for new validated in vitro tests since, despite the
existence of several approaches, they pose limitations regarding the
real clinical relevance of positive results in cases of rhinitis,
asthma, and FA, and their low sensitivity in
DHRs.17-23
Concerning treatment, although the first line is the allergen/drug
avoidance, this is not always possible, especially FA, in which
accidental ingestion could happen due to the ubiquity of allergens and
hidden sources. Therefore, other managements that influence the
aetiology of the disease, as allergen specific immunotherapy (AIT), must
be applied. Although different formulas have been commercialised with
beneficial results in inducing tolerance to the patients24-27, AIT does not completely reduce the risk of
severe reactions and shows a lack of homogeneity between batches and
difficulties on the obtainment of the natural allergenic
extract.28,29 Thus, it has been suggested the need of
improving the efficacy of AIT using different
approaches.30
During the last years, applications of nanotechnology for diagnosis and
treatment in the field of immunology and allergy have increased and are
being referred as nanomedicine.31 We aim to present an
overview of different nanostructures used in biomedicine and their
potential suitability for in vitro diagnostic tests as well as
for their role in novel immunotherapy.