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Introduction: Atopic dermatitis (AD) is the most common chronic inflammatory skin disease. It is characterized by damaged epidermal barrier, skin dysbiosis and pruritus. It affects up to 20% of the population of developed countries. AD represents a heterogeneous condition belonging to the spectrum of atopic diseases. It occurs in the form of multiple phenotypes with varied pathogenesis requiring different therapeutic strategies. Aim of the study: To summarize the current state of knowledge on AD phenotypes and related therapeutic options. Methods and materials: A review of the literature available in PudMed and Google Scholar databases was conducted. The following keywords were used: "atopic dermatitis", "atopic dermatitis phenotypes", "atopic dermatitis current treatment". Results: There are many phenotypes of AD. However, due to the lack of a consistent classification system, identifying phenotypes is greatly hindered. It is possible to use the division of phenotypes into groups based on age, lesion topography, lesion morphology and patient ethnicity. Various drugs are available for the treatment of AD, but therapeutic strategies for specific phenotypes are sparse and insufficiently understood due to the problem of identifying phenotypes and the complexity of the endotypes behind them. Treatment of AD is not currently based on phenotype-specific targeted therapy. Conclusion: Development of personalized therapy for the treatment of AD requires additional research using uniform definitions of phenotypes and endotypes. It is necessary to create a classification system for AD phenotypes.

Resumen: Las bronquiectasias (BQ) son una enfermedad tanto heterogénea en su presentación como compleja en su naturaleza. Una variable única no es capaz de captar el impacto total que las BQ producen sobre el individuo. Algunos autores han observado la presencia de algunos fenotipos clínicos más homogéneos en su clínica, pronóstico o respuesta al tratamiento, como el paciente con infección bronquial crónica por P. aeruginosa, el paciente «exacerbador» o el overlap (BQ + enfermedad pulmonar obstructiva crónica [EPOC]). Otros autores han desarrollado escalas multidimensionales que tratan de clasificar la gravedad o el pronóstico, teniendo en cuenta diferentes aspectos de la enfermedad como la clínica, la función pulmonar, la extensión radiológica o el perfil microbiológico entre otros. Finalmente, se están desarrollando herramientas clínicas que van un paso más allá y valoran las BQ como una enfermedad compleja, teniendo en cuenta no solo su gravedad, sino también su actividad biológica y la forma que el paciente tiene de vivir la enfermedad (impacto). Para ello, además de las puntuaciones multidimensionales de gravedad, se han venido desarrollando diferentes cuestionarios de calidad de vida específicos o se han validado para esta enfermedad aquellos que eran utilizados en otras patologías respiratorias, fundamentalmente EPOC. Por otro lado, se siguen investigando biomarcadores biológicos válidos que se relacionen con outcomes de importancia en BQ. Abstract: Bronchiectasis is a disease that is both heterogeneous in form and complex in nature. The overall impact of bronchiectasis on the individual cannot be captured by a single variable. Some authors have observed the presence of some more homogeneous clinical phenotypes in terms of symptoms, prognosis or response to treatment in, for example, patients with chronic P. aeruginosa bronchial infection, exacerbators or patients with bronchiectasis and COPD overlap. Other authors have developed multidimensional scales that attempt to classify severity or prognosis, taking into account different aspects of the disease, such as symptoms, lung function, radiological extension, and microbiological profile, among others. Finally, clinical tools are being developed that go a step further and consider bronchiectasis as a complex disease, taking into account not only its severity, but also its biological activity and impact on the patient's way of life. To this end, multidimensional severity scores and different specific quality of life questionnaires have been developed, and those used in other respiratory pathologies, mainly COPD, have been validated for this disease. On another front, the search continues for valid biological biomarkers associated with outcomes of importance in bronchiectasis.

Severe bronchiolitis (i.e., bronchiolitis requiring hospitalization) during infancy is a heterogeneous condition associated with a high risk of developing childhood asthma. Yet, the exact mechanisms underlying the bronchiolitis-asthma link remain uncertain. Birth cohort studies have reported this association at the population level, including only small groups of patients with a history of bronchiolitis, and have attempted to identify the underlying biological mechanisms. Although this evidence has provided valuable insights, there are still unanswered questions regarding severe bronchiolitis-asthma pathogenesis. Recently, a few bronchiolitis cohort studies have attempted to answer these questions by applying unbiased analytical approaches to biological data. These cohort studies have identified novel bronchiolitis subtypes (i.e., endotypes) at high risk for asthma development, representing essential and enlightening evidence. For example, one distinct severe respiratory syncytial virus (RSV) bronchiolitis endotype is characterized by the presence of Moraxella catarrhalis and Streptococcus pneumoniae, higher levels of type I/II IFN expression, and changes in carbohydrate metabolism in nasal airway samples, and is associated with a high risk for childhood asthma development. Although these findings hold significance for the design of future studies that focus on childhood asthma prevention, they require validation. However, this scoping review puts the above findings into clinical context and emphasizes the significance of future research in this area aiming to offer new bronchiolitis treatments and contribute to asthma prevention., (Copyright © 2024 SEPAR. Published by Elsevier España, S.L.U. All rights reserved.)

Food allergy is a common event, especially in the pediatric population, affecting between 3-6% of children. There are various challenges in the care of patients with food allergy, but certainly the diversity of symptoms and the outcome of the disease are important aspects in the treatment of patients, in the development of care guidelines and in the knowledge of the Natural history of disease. The classification into phenotypes allows a better understanding of the evolution of food allergy. The endotype is a subtype of a phenotype defined by its pathophysiological characteristic. Genetic, epigenetic, and environmental characteristics interfere with the construction of the phenotype and its possible endotypes. Understanding the phenotypes and endotypes of food allergies brings with it two fundamental aspects: 1) the need to understand that the analysis of phenotypes and endotypes in food allergies will allow establishing prognoses and helping in intervention with specific therapies, and 2) the importance of understanding The characterization of local endotypes and phenotypes, and the dietary diversity of the different countries that make up Latin America brings with it a varied menu of foods that may pose a risk of allergy that needs to be studied.

The concepts of endotype and phenotype have been introduced in the past few years with the purpose of identifying the different variants of asthma in children and adults by the interaction of epigenetic factors, such as genotype, environmental factors, and not inherited factors. All these factors participate in the onset and progression of asthma, as well as environmental allergens, which are the cause of asthma in most children and teenagers. The latest onset may be induced by the characteristics of the environment, as happens in most adults (occupational asthma). In a review of a hundred medical records of children with and without a family history, and of a group of patients in whom high IgE levels were not detected, clear differences were observed in terms of the age of onset and other characteristics, although the sensitization to allergens was very similar in those three groups (Dermatophagoides mites).