Molecular Signatures and Functional Pathways of Human Monocytes and Macrophages in Allergy: An EAACI AllergoOncology Scoping Review

AllergoOncology explores the intersection of allergic diseases and cancer, focusing on shared immune mechanisms. While monocytes and macrophages are extensively studied in cancer, their roles in allergic diseases remain underexplored. To address this gap, we conducted a scoping review to systematically characterize the molecular landscape and related pathways of human monocytes and macrophages in allergy. An automated search of PubMed and Web of Science databases retrieved 4668 unique articles, which were manually curated based on predefined inclusion and exclusion criteria, yielding 138 eligible studies. From these, we identified 451 molecules associated with monocyte and macrophage responses across allergic disorders. Data analyses revealed a research bias towards blood-derived monocytes, underrepresentation of tissue-resident macrophages, and limited inclusion of miRNAs. Semantic similarity and pathway enrichment analyses highlighted a common molecular signature across major allergic disorders, with consistent enrichment in interleukin signaling and immune activation pathways. To enhance reproducibility and translational utility for researchers and clinicians, we developed ALO•HA, a web application for interactive data exploration. This overview of monocyte and macrophage molecular responses in human allergy underscores the need for integrative, human-focused approaches to better define their roles, and to guide future therapeutic strategies in allergic diseases and at the interface with oncology.