To discuss new findings on how molecular diagnostics can enhance the identification and selection of appropriate allergens for targeted immunotherapy, as well as raise the safety of this therapy was the purpose of this study. Because specialized allergen immunotherapy targets particular allergens, identifying the disease-causing allergen is required for appropriate treatment prescription. When compared to diagnosis based on skin prick testing and/or specific IgE determination with commercial extracts in cases of complex sensitization to aeroallergens or hymenoptera venom allergy, the use of molecular diagnosis has demonstrated that it may lead to a change in indication and selection of allergens for immunotherapy in a large proportion of patients. In certain cases, modifications in immunotherapy prescription helped by molecular diagnostics have been shown to be cost-effective. Certain patterns of sensitivity to grass or olive pollen, as well as bee allergens, may identify patients who are more likely to have an unpleasant response during immunotherapy.

When combined with other techniques and patients’ clinical records, molecular diagnostics can assist physicians in better selecting the most appropriate individuals and allergens for specialized immunotherapy and, in certain circumstances, predicting the likelihood of adverse responses. The pattern of allergy sensitization might potentially predict the success of allergen immunotherapy, assuming that these immunotherapy products include enough allergens. Nonetheless, multiplex assays are still considered a third-level technique and should not be utilized as a screening tool in current practice.