IgE, blood eosinophils and FeNO are not enough for choosing a monoclonal therapy among the approved options in patients with type 2 severe asthma.

Type-2 inflammation is the most frequent endophenotype of asthma. Different biomarkers have been proposed to identify this inflammation because highly effective therapies have improved type-2 severe asthma control. We investigated the frequency of some biomarkers of type-2 inflammation (total IgE, sIgE, blood eosinophil, and FeNO) in the framework of severe asthma and assessed its ability to help us to choose the best biological therapy for each patient. Different scenarios (sensitivity analysis) were evaluated according to the biomarkers proposed for each biological therapy in 72 patients with type-2 severe asthma. Between 54.1% and 68% of patients could receive at least 2 different biological therapies and 34.7%-40.2% could receive any of the 3 types of therapies (anti-IgE, anti-eosinophil, anti-IL4). Biomarkers help to identify type-2 severe asthma but total IgE, sIgE, blood eosinophil, and FeNO are not enough to select 1 specific therapy. With the increasing arrival of new biological therapies, it is necessary to identify new biomarkers that allow us to improve our selection criteria for the best therapy for each patient or to construct a prediction rule.

Inducible urticaria: Case series and literature review.

Inducible urticaria is a heterogeneous group of skin disorders characterized by the appearance of wheals, pruritus and/or angioedema, sometimes accompanied by systemic symptoms caused by innocuous stimuli (cold, heat, pressure, etc.). This group of disorders compromises people's quality of life and most of the literature in this regard comes from case reports and case series since its epidemiology has been poorly studied and some cases are very rare. The aim of this review is to show an up-to-date overview of the available literature for various types of inducible urticarias, always beginning with an illustrative case and then describing their pathophysiological mechanisms, clinical manifestations, and treatment.

Urticaria inducible: serie de casos y revisión de la literatura

Las urticarias inducibles constituyen un grupo heterogéneo de trastornos cutáneos caracterizados por la aparición de habones, prurito o angioedema, que en ocasiones se acompañan de síntomas sistémicos causados por estímulos inocuos para la mayoría de la población, como el frío, el calor, la presión, etc., y que comprometen la calidad de vida de los pacientes. La mayor parte de la literatura médica pertinente proviene de reportes y series de casos, ya que su epidemiología se ha estudiado poco. El objetivo de esta revisión es ofrecer una visión actualizada de la información disponible sobre varios tipos de urticaria inducida, mediante la presentación de un caso clínico ilustrativo y la descripción de los mecanismos fisiopatológicos, las manifestaciones clínicas y el tratamiento de cada condición.

Inducible urticaria is a heterogeneous group of skin disorders characterized by the appearance of wheals, pruritus and/or angioedema, sometimes accompanied by systemic symptoms caused by innocuous stimuli (cold, heat, pressure, etc.). This group of disorders compromises people´s quality of life and most of the literature in this regard comes from case reports and case series since its epidemiology has been poorly studied and some cases are very rare. The aim of this review is to show an up-to-date overview of the available literature for various types of inducible urticarias, always beginning with an illustrative case and then describing their pathophysiological mechanisms, clinical manifestations, and treatment.