Biologic Therapies in Pediatric Allergic Diseases: Current Evidence and Future Perspectives

Pediatric allergic diseases, including asthma, atopic dermatitis, food allergy, chronic rhinosinusitis with nasal polyps, and eosinophilic gastrointestinal disorders, are increasing worldwide and impose a substantial burden on children, families, and healthcare systems. Advances in the understanding of type 2 inflammation and other immune pathways have supported the development of biologic therapies, including monoclonal antibodies targeting IgE, IL-4/IL-13, IL-5, and thymic stromal lymphopoietin. Although these agents have transformed the management of severe allergic conditions in adults, important questions remain regarding their use in children, including age-specific efficacy and safety, dosing across growth, long-term immune modulation during development, and criteria for patient selection. Growing approvals and off-label use have expanded treatment options, but pediatric-specific evidence continues to lag behind adult studies. Clinical trials and real-world data are beginning to clarify the efficacy and safety of biologics in selected pediatric populations, while studies of biomarkers, comparative effectiveness, and long-term outcomes remain limited. Further investigation is needed to define the optimal positioning of biologics across pediatric allergic diseases and to address uncertainties surrounding treatment duration, discontinuation, step-down strategies, and emerging therapeutic targets.This Research Topic aims to consolidate clinical, translational, and real-world evidence on biologic therapies for pediatric allergic diseases and to identify priorities for future research. It will examine the efficacy, safety, and clinical positioning of available and emerging biologics; address age-specific evidence gaps and biomarkers predictive of treatment response; and explore strategies for treatment initiation, continuation, discontinuation, and step-down. The Research Topic also seeks to support precise, evidence-based decision-making for clinicians managing severe or difficult-to-control allergic diseases in children and to inform the design of future pediatric trials.To gather further insights into biologic therapies for children with severe or difficult-to-control allergic diseases, this Research Topic will focus on pediatric asthma, atopic dermatitis, chronic rhinosinusitis with nasal polyps, food allergy, and eosinophilic gastrointestinal disorders, while also considering emerging indications and therapeutic targets. We welcome articles addressing, but not limited to, the following themes:•Mechanisms of action and immunological rationale for biologic therapies•Efficacy and safety outcomes from pediatric clinical trials•Evidence from registries and real-world studies•Biomarkers predictive of treatment response•Comparative effectiveness of different biologics•Patient selection and treatment initiation strategies•Long-term outcomes and safety in growing children•Treatment duration, discontinuation, and step-down strategies•Biologics in understudied pediatric age groups•Emerging biologic targets and immune pathways•Interactions between biologic therapies and allergen immunotherapy•Health-economic considerations and access to treatmentAppendix: We welcome Original Research, Reviews, Systematic Reviews, retrospective studies, Perspectives, and Clinical Trials. Topic editors: Francesco Catamerò, Gabriele Simonetti, Letizia Ciliberti Source: https://www.frontiersin.org/research-topics/85554/biologic-therapies-in-pediatric-allergic-diseases-current-evidence-and-future-perspectives