Recent advances in biomarkers for efficacy assessment in allergen-specific immunotherapy

Allergen-specific immunotherapy (AIT) is a disease-modifying therapeutic approach that addresses the fundamental etiology of allergic diseases by inducing immune tolerance through modulation of the immune system. Nevertheless, assessing AIT efficacy necessitates long-term treatment, underscoring the need for reliable predictive biomarkers. This review summarizes the recent advances in biomarker research for predicting the effectiveness of AIT, including immunoglobulins, cellular parameters, functional cytokine assays, and provocation tests. This study aims to predict the efficacy of AIT treatment early by classifying and evaluating biomarkers. Combining immunoglobulins, such as sIgE and tIgE, and their ratios, along with cytokine levels (e.g., IL-10, IL-35), could be used to predict clinical efficacy and to construct a composite prediction scoring system for improved accuracy. Monitoring of changes in sIgE, sIgG4, sIgG2, cellular markers, and cellular functions (e.g., BAT, ECP, cytokines) should be implemented to assess patient adherence and guide therapy, as they are closely associated with clinical outcomes. Although multiple biomarkers show promising potential, a standardized, unified panel of biological parameters has not yet been established. Future research should integrate multi-omics technologies, combine provocation tests with clinical evaluations, and develop accurate predictive models and more reliable, stable biomarkers for the evaluation of AIT efficacy.