María Torres, President of the European Academy of Allergy and Clinical Immunology (EAACI) and Head of the Allergy Department at Malaga Regional University Hospital, Spain, detailed the scientific and clinical priorities for the 2026 EAACI Congress.
The overarching theme is 'Vision Zero in Allergy,' aiming to eliminate preventable deaths and severe exacerbations in patients with allergic conditions. A central focus is allergen immunotherapy (AIT), presented not just as a treatment but as a tool to alter the natural course of allergy. The program builds on previous years by integrating new data, updated therapeutic algorithms, and the increasing role of precision medicine and digital tools. It also addresses severe diseases, climate change impacts, and sustainable care models.
Congress sessions emphasize a shift in diagnostics, moving from simply identifying sensitization to defining clinically meaningful disease and treatment eligibility. Progress in in vitro testing for drug allergy, including cellular and immunoassays, aims to reduce high-risk drug provocation tests. For respiratory allergy, the role of nasal provocation testing to diagnose local allergic rhinitis is highlighted, distinguishing it from asymptomatic sensitization and identifying patients who will benefit from AIT.
Food allergy management is evolving from strict avoidance to active treatment strategies like oral immunotherapy (OIT) and biologics. The Congress is exploring low-dose OIT protocols for improved safety and efficacy, supported by real-world data on sustained unresponsiveness and quality of life. Biologics targeting Type 2 inflammation are also a focus, offering new possibilities for high-risk patients and those with multiple food allergies.
Promising biomarkers and functional assays discussed include the basophil activation test (BAT) for quantifying IgE-mediated reactivity and predicting severity. Omics sciences like transcriptomics and proteomics are opening avenues for identifying molecular endotypes and predicting treatment response. While standardized in vivo provocation protocols remain essential, the future lies in integrating clinical factors, functional assays, and biomarkers into decision-making pathways.
EAACI is also integrating drug allergy de-labelling pathways into routine care to improve antimicrobial stewardship. This involves risk stratification and AI-based decision-support tools to safely remove inaccurate allergy labels, enabling patients to receive first-line, narrow-spectrum antibiotics. This initiative aims to reduce healthcare costs, shorten hospital stays, and combat antimicrobial resistance.
The Congress addresses the challenge of matching biologic treatments to inflammatory endotypes rather than traditional disease labels. Research focuses on using omics sciences to characterize Type 2 and non-Type 2 inflammation and guide treatment selection. Strategies for prioritizing targets in patients with overlapping phenotypes and real-world evidence on biologic effectiveness are also presented.
The concept of epithelial barrier dysfunction as a driver linking skin, gut, and airway disease is influencing research. Studies are exploring how to restore barrier function to prevent allergen sensitization and allergic diseases. This paradigm shift may lead to earlier, more preventive, and integrated therapeutic interventions.
Digital tools and AI are seen as making immediate impacts in image-based diagnostics and structured symptom monitoring. AI algorithms can support more accurate interpretation of medical images, while digital platforms enhance longitudinal disease management and generate real-world data. Future potential lies in AI-driven diagnostic algorithms and prediction models for therapy response.
Under-recognised conditions like non-Type 2 asthma, non-immediate drug hypersensitivity reactions, food protein-induced enterocolitis syndrome, and allergic contact dermatitis are highlighted for needing greater attention due to unmet needs and limited therapeutic innovation.
For early-career professionals, critical skills include scientific excellence, rigorous methodology, critical thinking, networking, interdisciplinary collaboration, clear communication, self-demand, continuous improvement, and adaptability to integrate innovation into practice.