The Role of Aeroallergen Sensitization Testing in Asthma Management

Asthma is a global disease affecting almost 400 million people. Simultaneously, the overall burden of allergies is increasing. Although allergies are frequent and commonly recognized triggers of asthma severity and exacerbations, the majority of patients with asthma are not investigated for their underlying aeroallergen sensitizations, despite the potentially preventable consequences and therapeutic options. This review summarizes the current state of aeroallergen sensitization testing for people with asthma. We describe who should be tested and why, how testing can be used to optimize asthma management, list barriers to implementation of effective asthma management strategies, and make recommendations for improving asthma/allergy management by aeroallergen testing. Establishing a diagnosis of asthma and determining whether there is an allergic component is fundamental to an effective treatment plan. Moreover, moving from severity-based to phenotype-based asthma care can improve the care of asthma and allergic diseases. Timely diagnosis of aeroallergen sensitizations forms the basis for individualized treatment plans, which may include allergen remediation strategies when appropriate, and allergen immunotherapy, the only immunomodulating therapy for allergic asthma. Finally, the advent of biologics will expand the number of patients who can benefit from treatment, with decreased symptoms and disease remission a possibility for the first time.