Artificial intelligence (AI) is significantly transforming the specialty of allergy by offering novel tools for diagnosis, risk prediction, disease monitoring, and personalized care. This narrative review comprehensively explores key advances in the application of AI techniques-expert systems, machine learning, deep learning, and natural language processing-across various allergic diseases such as asthma, anaphylaxis, atopic dermatitis, food allergy, allergic rhinitis, eosinophilic esophagitis, and drug hypersensitivity reactions. Despite these advancements, several challenges persist, including model interpretability, external validation, and ethical and regulatory barriers. Nonetheless, AI holds strong potential to enhance diagnostic efficiency, therapeutic precision, and patient outcomes. This review presents an updated perspective on the state of the art of AI in allergy, highlighting both its achievements and ongoing challenges.

Asthma is a heterogeneous inflammatory disorder involving multiple immune pathways, frequently presenting alongside comorbidities such as chronic rhinosinusitis with nasal polyps (CRSwNP). Although biologic therapies such as dupilumab have shown clinical efficacy, the molecular mechanisms underlying variable treatment responses remain poorly understood. This study aimed to characterize transcriptomic patterns that distinguish asthmatic patients from healthy controls and to evaluate transcriptomic changes induced by dupilumab. Whole-blood RNA-seq was performed in 66 samples, 18 patients (G0) with severe asthma before and after 6 months of dupilumab treatment compared with 30 non-asthmatic controls. Differentially expressed genes (DEGs) were identified and validated by quantitative PCR (qPCR). Clinical responses were assessed using the FEV1, Exacerbations, Oral corticosteroids, Symptoms (FEOS) score and the Sino-Nasal Outcome Test-22 (SNOT-22). A total of 1124 DEGs were identified, distinguishing asthmatic patients from controls. Notably, ABCC1, CYP4F12, FBN1, IKZF2, and RAB44 were differentially expressed across all patients’ subgroups and are proposed as putative general disease biomarkers. Unsupervised machine learning analysis of pre- vs. post-dupilumab transcriptomic profiles identified two distinct patient subgroups within G0, here termed G1 and G2. When comparing baseline vs. post-treatment samples in the overall cohort (G0), only 12 DEGs were identified. In contrast, stratified analysis revealed 1288 DEGs in G1 and 354 DEGs in G2, suggesting divergent molecular response to treatment. Additionally, baseline expression of DIXDC1 was identified as a predictor of CRSwNP non-super-responders. By applying unsupervised machine learning to transcriptomic profiles, this exploratory study identifies two distinct endotypes with divergent molecular mechanisms of response to dupilumab, supporting a precision medicine approach to biologic therapy in severe asthma.

Allergic rhinitis (AR) and asthma caused by cat dander have a highly variable prevalence across countries, which can reach 30% of the population in some regions. Cat allergens are widely distributed in the environment, making exposure nearly unavoidable, even in non-cat-owning households. Eight cat allergens have been identified, with Fel d 1 and Fel d 4 being particularly associated with the development and severity of asthma. Symptoms can range from mild nasal and eye symptoms to severe asthma exacerbations, with many patients experiencing polysensitization to other allergens. Management usually begins with allergen avoidance and pharmacotherapy, but these approaches are often insufficient. Allergen immunotherapy (AIT), both sublingual (SLIT) and subcutaneous (SCIT), offers a disease-modifying strategy, though allergen potency, composition, standardization issues, and low prescription rates limit its use. AIT formulations that include allergens beyond Fel d 1, such as Fel d 4, show promise in improving cat-induced asthma and rhinitis outcomes. Additionally, novel approaches for antigen presentation or combination therapies with monoclonal antibodies may enhance the effectiveness and safety of AIT. To increase treatment success, personalized care using component-resolved diagnostics to identify sensitization profiles and better education for both physicians and patients are essential in the broader adoption of cat AIT.

Recent advances in biological therapies, small molecules and allergen-specific immunotherapy are reshaping the management of immunoallergic diseases, progressively shifting therapeutic goals from short-term disease control toward the possibility of achieving sustained clinical remission. Despite increasing evidence across multiple conditions, a universally accepted and disease-transversal definition of clinical remission (CR) remains lacking. In this review we propose a comprehensive framework for defining clinical remission across a broad spectrum of immune-mediated diseases traditionally managed in Allergy and Clinical Immunology practice, including asthma, allergic rhinitis, chronic rhinosinusitis with nasal polyps, chronic urticaria, atopic dermatitis, mastocytosis, food allergy, and eosinophilic esophagitis. Clinical remission is defined as a sustained state of absence of clinically relevant disease manifestations, independently of underlying biological activity; suppression of inflammatory pathways and normalization of biomarkers define biological remission, which may coexist with, but is not required for, clinical remission.We introduce the 3D-CR model, a pragmatic, disease-adaptable framework integrating 3 complementary domains — clinical, biological, and functional — to characterize remission states as complete, partial, or absent. Building on this model, we propose the Allergic Disease Remission Score (ADReS) as a modular tool designed to support standardized assessment, longitudinal follow-up, and cross-disease comparison in clinical trials and real-world settings. These tools are intended as conceptual and research instruments rather than prescriptive algorithms for individual therapeutic decision-making.Finally, we outline a World Allergy Organization call to action advocating for a harmonized global approach to defining, measuring, and implementing clinical remission as a meaningful treatment target. Establishing standardized remission endpoints has the potential to improve patient outcomes, facilitate precision medicine strategies, enhance comparability across studies, and reduce heterogeneity in clinical research and practice worldwide.

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory condition associated with functional impairment and a relevant socioeconomic burden. While direct healthcare costs have been partially described in Spain, indirect costs related to loss of work productivity remain insufficiently characterized. This study aimed to estimate the indirect costs associated with CRSwNP in Spain from a societal perspective, focusing on productivity losses due to absenteeism and presenteeism. A cost-of-illness analysis with a one-year time horizon and a societal perspective was conducted in working-age adults (18–64 years) with CRSwNP in Spain. Disease prevalence (0.8

Introduction and Objectives:Accurate diagnosis of IgE-mediated diseases requires identifying relevant allergens to guide appropriate clinical management and reduce healthcare costs (1). The ImmunoCAP Phadiatop (Thermo Fisher Scientific) is an in vitro assay detecting that detects IgE antibodies against a balanced mixture of common inhalant allergens, serving as a first-level screening tool for sensitization in patients with suspected airway allergies, and guiding subsequent management. This study aimed to evaluate test results, the impact on clinical decision-making, and its role in managing allergic conditions. Materials and Methods:A real-world retrospective observational study was conducted in a tertiary hospital allergy department (June 2021-June 2023). Data were collected using the Modulab Laboratory Information System (Werfen, Spain) and stored in a dissociated database. The Ethics Committee of Salamanca approved the study protocol. Phadiatop values above 0.35 PAU/l were considered positive. In case of repeated samples, the first was selected. Variables analyzed included test results, patient demographics, requesting departments, and allergy referrals, a well-balanced mixture of common inhalant allergens with regional adaptation. The allergen groups included were comprise: house dust mites, (e.g., Dermatophagoides pteronyssinus, D. farinae), pollens, from grasses (e.g., timothy, ryegrass), trees (e.g., birch, olive), and weeds (e.g., mugwort, plantain, ragweed), molds (e.g., Alternaria, Cladosporium, Aspergillus, Penicillium), and animal dander (e.g., cat, dog). Results:The study included 596 patients (median age 46, 64.1% female). Of these, 12.6% were under 18 years old. Most patients (95.8%) were referred from primary care, with 83.1% of them from urban areas. A total of 37.9% of patients had a positive result (median IgE 7.81 PAU/l). Most positive patients resided in urban areas (82.3%), were aged <18 years of age (p = 0.001), and were male (p < 0.001). Patients aged >59 (26.3%) presented mainly negative results (82.2%). Of the positive cases, 31.4% were referred to an allergist, with higher Phadiatop values increasing associated with increased referrals (p = 0.001). Conclusions:Phadiatop was mainly utilized in primary care. One-third of patients tested positive; of those, only one-third were referred to allergists, with higher Phadiatop values increasing associated with higher referral rates. Positivity was higher in males and younger people.

BACKGROUND AND OBJECTIVES:Defining a patient´s allergic profile by identifying the allergens that cause symptoms is essential for the design of specific, tailored immunotherapy, ensuring greater effectiveness in cases of polyallergy. Objective: This observational, multicenter study aimed to demonstrate the heterogeneity of the Spanish population with respiratory allergy by analyzing specific immunoglobulin E (sIgE) patterns for aeroallergens and exploring the relationship between sensitization and clinical symptoms. PATIENTS AND METHODS:A total of 474 patients with respiratory allergy from different regions of Spain were recruited based on their case histories and skin prick test data for aeroallergens. Serum samples were analyzed using ImmunoCAPTM assays to determine sIgE levels for 33 allergenic sources and 43 molecular allergens. RESULTS:Ninety percent of patients were polysensitized. Pollen was the most common cause of sensitization, followed by mites. Interestingly, polysensitization was significantly associated with the severity of rhinitis symptoms. The molecular diagnosis revealed Phl p 1 as the most prevalent pollen sensitizer. Sensitization to mites was mainly driven by Der p 2. Fel d 1 and Alt a 1 were the most frequently recognized allergens among patients sensitized to animal epithelia and molds, respectively. Moreover, sensitization to mite and animal epithelia allergens was significantly associated with more severe asthma symptoms. CONCLUSIONS:Our findings show a high prevalence of polysensitization and highlight the importance of molecular diagnosis for improving diagnostic accuracy and designing immunotherapy tailored to patients in the region.

Artificial intelligence (AI) offers new opportunities to improve asthma management across the care process. This review synthesizes evidence on AI applications in diagnosis, classification, monitoring, and treatment. We conducted a narrative review based on a PubMed search (1995-2025). Eligible studies included peer-reviewed reports on AI applied to diagnosis, monitoring, prediction, and treatment of asthma. Outcomes of interest included diagnostic accuracy, risk prediction, adherence, and clinical decision support. Of 943 records screened, 32 studies met the inclusion criteria. Diagnostic tools integrating clinical data and data from objective tests performed best: deep neural networks combining spirometry and bronchial challenge tests achieved up to 98% accuracy, and automated pulmonary function test interpretation outperformed specialists in consistency and accuracy. Acoustic analyses of cough and respiratory sounds demonstrated sensitivity and specificity above 90%, supporting remote monitoring. In prediction of exacerbations, the electronic health record combining peak expiratory flow and symptom data achieved areas under the curve of up to 0.85. Unsupervised clustering approaches provided clinically meaningful asthma phenotypes. Evidence on treatment optimization remains scarce. AI has the potential to enhance diagnostic accuracy, phenotyping, and monitoring in asthma. However, most studies remain proof-of-concept, with limited external validation and little evidence of clinical impact. Future research should prioritize pragmatic trials, responder stratification, and real-world implementation to confirm clinical and cost-effectiveness.

Aspirin-exacerbated respiratory disease (AERD) is characterized by chronic rhinosinusitis with nasal polyps (CRSwNP), asthma, and hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs). Although high-dose aspirin therapy after desensitization (ATAD) and surgery are effective, adverse effects and high dropout rates limit its use. The emergence of biologics for asthma and/or CRSwNP entails rethinking the management of AERD. There is no consensus on choosing between ATAD and biologics. This systematic review evaluates current evidence on the role of biologics in the management of AERD, focusing on their potential to induce NSAID tolerance and proposing a management algorithm. A systematic literature search was conducted across PubMed, Embase, and Scopus up to March 2025. Studies were selected based on predefined criteria, excluding editorials, reviews, case reports, guidelines, and publications not in English. Data were extracted from clinical trials, real-world studies, and retrospective analyses. The various inflammatory pathways targeted by biologics included immunoglobulin E (omalizumab), subunit alpha of the interleukin 4 receptor (IL-4Ra) (dupilumab), IL-5/IL-5Ra (mepolizumab, benralizumab), and thymic stromal lymphopoietin (tezepelumab). These drugs have demonstrated efficacy in improving asthma and CRSwNP in AERD. The most consistent evidence seems to favor omalizumab and dupilumab for enhancing tolerance to NSAIDs. Although evidence remains inconclusive, the combination of ATAD and biologics may offer additive benefits in selected patients. Biologics represent a promising alternative in the management of AERD, particularly for patients with poor tolerance to aspirin. Further prospective, controlled studies are needed to define optimal treatment algorithms and identify biomarkers predictive of therapeutic response.

BACKGROUND AND OBJECTIVE:Although mepolizumab has demonstrated efficacy and effectiveness in the treatment of severe asthma, it is unknown whether the characteristics of patients starting this biologic have changed over the years and whether this impacts their response to mepolizumab. METHODS:TYREX was a multicenter, retrospective, observational study conducted in 24 asthma units across Spain to compare baseline clinical and demographic characteristics, and 12-month response to mepolizumab in two cohorts defined by the date of biologic initiation (cohort 1: 2017-2019 vs cohort 2: 2022-2024). RESULTS:Among the 446 patients included in the TYREX study, 191 were classified in cohort 1 and 108 in cohort 2. Cohort 1 had higher baseline exacerbation rates (3.45 vs. 2.40/year; p = 0.0002) and higher blood eosinophils (806 vs. 607 cells/μL; p = 0.0175). Twelve months after mepolizumab initiation, annual exacerbation rate were reduced to 0.46 in cohort 1 and to 0.51 in cohort 2, ACT scores increased from 14.23 to 21.84 vs. from 15.43 to 21.06; daily oral corticosteroid dependent patients dropped from 33.51% to 9.04% vs. from 12.96% to 2.78%; and clinical remission was achieved in 37.5% vs. 38.5% of patients after 12 months with mepolizumab. In multivariable analysis for 4-domain clinical remission (n = 108), higher baseline ppFEV1 increased the odds of remission while maintenance OCS use decreased them (Figure. 3). In the 3-domain remission model (n = 198), CRSwNP and higher baseline blood eosinophil count increased the odds of remission, whereas maintenance OCS use decreased them (Figure. 3). CONCLUSION:The decrease over time in severity and blood eosinophilia in asthma patients starting mepolizumab has not shown any impact on the clinical response to the drug.

BACKGROUND:Amoxicillin (AX) is the most frequently prescribed β-lactam antibiotic in the USA and Europe and a leading cause of drug-induced hypersensitivity. Although cross-reactivity between aminopenicillins and ureidopenicillins can be considered unlikely based on side-chain dissimilarity, clinical data remain limited. OBJECTIVE:To prospectively evaluate cross-reactivity to piperacillin-tazobactam (PPZ-TZB) in patients with confirmed AX hypersensitivity. METHODS:We conducted a prospective study of 49 patients with confirmed AX hypersensitivity. Diagnosis was established through clinical history, skin testing (ST), specific IgE testing, and drug provocation testing (DPT), where indicated. All patients were systematically tested with PPZ-TZB by ST, followed by DPT in those with negative results. RESULTS:Among 49 patients with confirmed AX hypersensitivity (mean age, 47.5 years; 61.2% female), 31 (63.3%) experienced immediate reactions and 18 (36.5%) experienced non-immediate reactions. Anaphylaxis was the most common presentation (49.9%). AX hypersensitivity was confirmed by positive ST result in 32 patients (65.3%), specific IgE in 3 (6.1%), DPT in 12 (24.5%), and clinical history in 2 (4.1%). All patients had negative results for penicillin major and minor determinants. PPZ-TZB hypersensitivity was diagnosed in 9 patients (18.4%), mostly by positive ST results (8 cases) and in 1 case by DPT, which elicited acute bronchospasm. Cross-reactivity occurred in both immediate and non-immediate groups. CONCLUSION:In this cohort of patients with confirmed AX allergy, cross-reactivity to PPZ-TZB occurred in approximately one-fifth of cases, most frequently identified by ST. These results emphasize that systematic allergy workup-particularly ST followed by DPT when result is negative-is essential before prescribing PPZ-TZB in patients with AX hypersensitivity.

Netherton syndrome (NS) is a rare congenital barrier disorder caused by pathogenic variation in SPINK5, resulting in severe epidermal dysfunction and immune dysregulation. Although dupilumab is increasingly used in NS, molecular data describing treatment-associated tissue responses remain limited, particularly in genetically complex presentations. We investigated treatment-associated molecular trajectories during IL-4Rα blockade in two siblings with NS carrying heterozygous compound SPINK5 (c.2468dup & c.2243 A > G) and FLG (p.Arg501*) variants. Longitudinal whole-exome sequencing and paired bulk RNA sequencing of peripheral blood and lesional skin were performed before and after six months of dupilumab therapy. Transcriptomic changes were evaluated using effect-size– and rank-based approaches and contextualized through integration with publicly available NS reference datasets. Across both compartments, post-treatment transcriptional profiles exhibit coordinated shifts toward healthy-control–like expression states. Blood transcriptomes show reduced inflammatory, metabolic, and proliferative signatures alongside modulation of FURIN and increase expression of PAPPA, LPAR5, CELSR1, and ARHGEF19. Skin transcriptomes transition from neurosensory and follicular programs toward lipid metabolic organization, keratinocyte differentiation, and cornified-envelope–associated pathways. Cross-compartment integration highlights shared treatment-associated transcripts, including ADAM23, and candidate markers of immune–epithelial recalibration. Together, this exploratory dual-compartment longitudinal analysis provides rare molecular insight into biologic treatment response in a genetically complex NS context and establishes a foundational reference for future genotype-informed and biomarker-oriented studies. Netherton syndrome is a rare inherited skin disorder that causes severe inflammation and a weakened protective skin barrier. Although dupilumab is increasingly being used to treat this condition, its effects on the underlying biological mechanisms are not yet fully understood. To investigate this, we studied two siblings with Netherton syndrome and analyzed blood and skin samples collected before treatment and after six months of therapy. We found that dupilumab was associated with reduced inflammatory activity and gene expression patterns that became more similar to those seen in healthy individuals. These findings suggest that dupilumab may help restore both immune balance and skin barrier function, providing new insight into its mechanism of action and supporting the development of more personalized treatment strategies for people with Netherton syndrome. Bajo-Santos et al. longitudinally profile blood and skin transcriptomes before and after dupilumab treatment in two siblings with genetically complex Netherton syndrome. They observe that IL-4Rα blockade shifts molecular signatures toward healthy-like states, reducing inflammation and promoting epidermal differentiation and barrier-repair pathways.

Background & aims:Eosinophilic esophagitis (EoE) is a chronic inflammatory disorder in which IgG4 involvement is unclear. We aimed to evaluate immunoglobulin G4 (IgG4) in eosinophilic esophagitis (EoE) and investigate the correlation among IgG4-positive plasma cells in esophageal tissue, total serum immunoglobulin E (IgE), specific IgE, and specific IgG4 (sIgG4) levels to six foods (milk, egg, wheat, soy, peanut, and seafood). Methods:A retrospective observational study with prospective patient inclusion was conducted from 2017 to 2024 in a real-world setting. Clinical, endoscopic, therapeutic, and outcome characteristics of the patients were collected. Positive staining was defined as >10 IgG4-positive plasma cells per HPF. Peripheral blood analyses included measurements of total IgE, specific IgE, and sIgG4. Results:Seventy-eight patients were included. Patients with positive histological staining exhibited a significantly higher proportion of endoscopic edema (16.1% vs. 2.1%) (p = 0.045; RR = 8.8, 95% CI:1-79.8) and a greater need for second-line treatment (64.5% vs. 41.3%) (p = 0.04; RR = 2.5, 95% CI:1-6.6). Patients with positive IgG4 histological staining exhibited significantly higher median concentrations of serum sIgG4 to milk casein (50.1 mgA/L vs. 11.2 mgA/L; p = 0.005; r = 0.31) and egg (63.4 mgA/L vs. 20.1 mgA/L; p = 0.011; r = 0.28) than those with negative stain. Patients who did not show histological response to first-line treatment had significantly higher concentrations of sIgG4 to casein (31.8 mgA/L vs. 18.6 mgA/L, p = 0.03; r = 0.26) and egg (45.46 mgA/L vs. 19.2 mgA/L, p = 0.03; r = 0.27). Conclusion:Serum sIgG4 levels to casein and egg were associated with infiltration of IgG4-positive plasma cells in esophageal tissue and a worse disease prognosis.

TSLP is an alarmin released upon activation of epithelia in response to various external stimuli and is involved in type 2 cytokine-mediated pathological disorders. The formation of a high-affinity heterodimeric receptor complex, comprising the thymic stromal lym-phopoietin receptor (TSLPR) chain and IL-7Rα, is required for signaling. This study investigated whether TSLP and TSLPR expression in peripheral blood or nasal polyps could provide a valuable approach for the molecular phenotyping of patients with chronic rhinosinusitis with nasal polyps (CRSwNP). The study population comprised 156 unre-lated Caucasian individuals, including 45 controls and 111 patients with CRSwNP. Quantitative PCR analysis of TSLP and TSLPR was performed on the population study’s peripheral blood and nasal biopsy. The data were analyzed for potential associations, and possible use as a biomarker was studied. Significant differences were observed in TSLP and TSLPR blood expression between the control group and patients. Similarly, the expression of TSLP observed in biopsy samples was statistically significantly elevated in the polyp tissue of the patient compared with healthy controls. The combination of TSLP and TSLPR expression testing with peripheral blood eosinophils represents a more specific biomarker in patients exhibiting low eosinophil values. Further investigation of TSLP/TSLPR mRNA levels in peripheral blood may yield new minimally invasive biomarkers.

Background: Managing patients with severe asthma with an eosinophilic phenotype (SEA) with comorbid respiratory conditions such as chronic rhinosinusitis with nasal polyps (CRSwNP) continues to encounter significant challenges and lack of coordinated management among treating physicians. Objective: The OverSEA study aims to provide insights into current clinical practices and formulate recommendations for managing these patients. Methods: The two-round Delphi survey, conducted March-June 2023, was developed by a multidisciplinary 11-member Scientific Committee including pulmonologists, allergists, and ear, nose and throat specialists, and involved 205 experts from these specialties across 8 European countries. Consensus was defined as ≥70% agreement. Topics covered included the initial assessment, treatment, follow-up, and multidisciplinary management of patients with SEA and CRSwNP. Results: There was a consensus that evaluating for CRSwNP (88%), allergic rhinitis (79%), chronic rhinosinusitis without nasal polyps (77%), and aspirin/nonsteroidal anti-inflammatory-exacerbated respiratory disease (71%) is crucial for diagnosing upper respiratory tract comorbidities in patients with SEA. The necessity of a multidisciplinary approach for all stages of disease management (diagnosis, 82%; treatment decision-making, 83%, follow-up, 79%), and the usefulness of biologics in simultaneously managing asthma and CRSwNP symptoms (87%) were emphasized. Conclusion: The OverSEA study is the largest European initiative providing recommendations for optimizing the management of patients with SEA and comorbid CRSwNP. It underscores the importance of evaluating patients with SEA for comorbid upper airways diseases, particularly CRSwNP, and promotes a multidisciplinary approach, encouraging pulmonologists, allergists, and otorhinolaryngologists to collaborate closely to streamline patient diagnosis, follow-up, and treatment decisions.

BACKGROUND:Asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) are both type 2 (T2) inflammatory diseases that frequently co-occur and are interconnected through shared immunological pathways. The anti-IL-5 monoclonal antibody mepolizumab has shown efficacy in reducing eosinophilic inflammation and improving clinical outcomes. However, the molecular mechanisms underlying response to treatment, particularly at the transcriptomic level, remain underexplored. We aimed to investigate peripheral blood transcriptomic changes and identify potential biomarkers associated with dual super-response to mepolizumab in patients with severe asthma and CRSwNP. METHODS:The study population comprised 29 participants (19 patients with severe asthma and CRSwNP and 10 healthy controls). Whole blood RNA sequencing was performed before and after treatment with mepolizumab in 6 patients, followed by validation of candidate genes using qPCR. Clinical responses were assessed using the FEOS score (FEV1, exacerbations, oral corticosteroids, symptoms) and lung function measurements, and the 22-item Sino-Nasal Outcome Test (SNOT-22) score. RESULTS:Mepolizumab significantly improved clinical parameters, including exacerbation rates, asthma control, and the SNOT-22 score. Transcriptomic analysis identified 156 differentially expressed genes after treatment with mepolizumab, significantly enriching immune and inflammatory pathways. Twelve candidate genes were studied. Three of these genes (PNPLA1, C3AR1, and RGS1) were validated as potential predictors of super-response to treatment of asthma and CRSwNP. Baseline expression levels of RGS1 were associated with dual super-response in asthma and CRSwNP. CONCLUSION:This study provides new insights into transcriptomic changes following mepolizumab treatment and highlights RGS1 as a potential biomarker for predicting dual super-response in asthma and CRSwNP. Our findings contribute to precision medicine approaches and support the identification of optimal candidates for anti-IL-5 therapy.