Routine lipid profiles in allergic disease: a mini review

Allergic diseases are traditionally interpreted through epithelial barrier dysfunction, type 2 immune activation, and downstream inflammatory mediators, whereas routine serum lipid measures have usually been considered markers of cardiometabolic risk. However, emerging clinical and mechanistic evidence suggests that high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides (TG) may provide additional information about systemic inflammatory and metabolic contexts in allergic diseases. This review synthesizes current evidence on routine lipid profiles across asthma, atopic dermatitis, and allergic rhinitis, with emphasis on their clinical associations, disease-specific differences, and potential immune mechanisms. Asthma currently provides the strongest case for clinical relevance, with lipid abnormalities linked to disease burden, metabolic complexity, and heterogeneous clinical outcomes. In atopic dermatitis, circulating lipid measures appear less central than epidermal barrier lipid abnormalities, although they may still reflect selected metabolic or cardiovascular risk contexts. In allergic rhinitis, clinical associations remain inconsistent, but mechanistic studies suggest that lipoprotein function, particularly HDL-related regulation of eosinophils, antigen-presenting cells, and type 2 innate lymphoid cells, may be biologically relevant. Overall, this review presents routine lipid profiles as accessible contextual markers that may help connect systemic metabolism with allergic immune regulation, refine clinical stratification, and generate hypotheses about lipid-immune crosstalk. Future studies integrating routine lipid panels with functional lipoprotein assays, tissue-level immunology, and longitudinal outcome data are needed to determine whether these measures can become useful tools in allergic disease management.