Innate immunity in allergic diseases: Novel concepts

Dysregulation of type 2 immunity, which normally protects the host against large parasites, toxins, and venoms, leads to aberrant inflammatory responses underlying several allergic diseases. Recent advances have highlighted the important role of innate immune responses in the initiation and persistence of these disorders, identifying innate immune cells as key drivers as well as potential biomarkers and therapeutic targets. In this review, we summarize recent findings on the molecular mechanisms through which innate immune cells interact with adaptive immunity to promote the development and chronification of type 2-mediated diseases, including allergic rhinitis, chronic rhinosinusitis with nasal polyps, asthma, food allergy, eosinophilic esophagitis, and atopic dermatitis. We also discuss the emerging role of trained immunity and maladaptive trained immunity in either protecting against or promoting allergic disease development. A better understanding of innate immune pathways and their interplay with adaptive immunity may be crucial for the identification of novel biomarkers and therapeutic targets, fostering precision medicine approaches aimed at improving patients' quality of life while reducing the considerable socioeconomic burden of allergic diseases.