AAAAI Annual Meeting to explore paradigm shifts in allergy, asthma practice

Change is far from incremental in allergy and asthma care based on the speakers and presentations scheduled for the American Academy of Allergy, Asthma & Immunology Annual Meeting in San Antonio from Feb. 24 to 27.

“At the meeting we will be focusing on paradigm shifts,” Jonathan A. Bernstein, MD, FAAAAI, incoming AAAAI president, told Healio. “Hopefully, this will advance the way we treat allergic disease and provide optimal care to our patients.”

Built around the theme of “Optimizing Scope of Practice,” the meeting will include more than 250 hours of content across more than 225 live and prerecorded sessions in 15 educational tracks.

“There’s obviously a lot going on in our specialty,” Bernstein said.

Plenary presentations

The meeting will kick off with the presidential plenary session on Friday, Feb. 24, titled “Paradigm Shifts in Drug Allergy.”

During this session, Tanya Laidlaw, MD, FAAAAI, will address aspirin-exacerbated respiratory disease, Elizabeth Phillips, MD, FAAAAI, FIDSA, will discuss severe cutaneous adverse reactions, and David A. Khan, MD, FAAAAI, will provide updates in drug allergy parameters.

“Dr. Khan is passionate about drug allergy, and he will be talking about several important practice changers in the approach to patients with a history of drug allergy,” Bernstein said.

The plenary on Saturday, Feb. 25, will explore the “Impact of Climate Change and Environmental Hazards on Allergic Disease,” with Rachel L. Miller, MD, FAAAAI, and Cezmi A. Akdis, MD, FAAAAI. Topics will include urban chemical exposures, wildfire smoke, immune dysregulation in asthma and skin barrier dysfunction.

“We’re all exposed to the effects of global warming. These present as natural and man-made disasters,” Bernstein said. “Wildfires, industrial pollution, detergents, xenobiotics — these all interact with our immune system. While our innate and adaptive immune system helps protect us from these dangers, when they break down or malfunction, unforeseen health issues can develop.”

The recent prevalence of allergic diseases parallel these changes, Bernstein continued.

“We’ll discuss what we know about the effects of environmental change on allergic sensitization and identify the areas for future research because there are still a lot of gaps in knowledge,” he said.

The Sunday plenary on Feb. 26 will spotlight “Atopic Dermatitis: New Insights from Bench to Bedside to Populations,” with Richard Gallo, MD, PhD; Mark Boguniewicz, MD, FAAAAI; and Lynda C. Schneider, MD, FAAAAI. Lectures will discuss bacteriotherapy, practice parameter updates and other treatment advances.

“There’s a common theme in these talks with respect to epithelial barrier disruption, which allows interaction between the host and external microbes,” Bernstein said.

Bacteria that colonize the skin can produce enterotoxins that permeate through the skin and upregulate type 2 inflammatory responses, he explained.

“We’re starting to translate our knowledge into the next generation of different probiotics that are succeeding in randomized clinical trials to help prevent the unwanted effects of microbes that are driving atopic dermatitis and potentially other allergic diseases associated with epithelial barrier disruption,” he said.

During “Food Allergy Insights: Novel Observations in the Diagnosis and Management of Food Allergy” on Monday, Feb. 27, speakers Ruchi S. Gupta, MD, MPH; Wayne Shreffler, MD, PhD, FAAAAI; and Kari C. Nadeau, MD, PhD, FAAAAI, will address racial disparities, T-cell suppression and expansion of oral immunotherapy.

“This is an area that is of extreme interest to our membership. It happens to be the largest committee group that we have in our organization indicative of its popularity,” Bernstein said. “These talks will highlight unique features of food allergy and how they specifically affect underserved populations. There is a critical need for allergists to consider social determinants of health in the management of food allergy.”

Household names

As COVID-19 has transformed everyday life over the past 3 years, Peter J. Hotez, MD, PhD, DSc, and Rochelle P. Walensky, MD, MPH, have become household names. They also will be speaking during the AAAAI Annual Meeting.

Hotez, who is dean of the National School of Tropical Medicine, professor of pediatrics and molecular virology and microbiology at Baylor College of Medicine and co-director of the Texas Children’s Center for Vaccine Development, will give the 2023 Keynote on “Global Vaccines and Vaccinations: The Science vs. the Antiscience” on Saturday, Feb. 25.

“He is an internationally recognized physician-scientist. His keynote will focus on addressing both vaccine equity and the rising aggressive antiscience empire,” Bernstein said. “There has been a significant amount of misinformation about vaccines in general, and I believe he will address the evolution of these negative sentiments in his talk.”

Walensky, director of the CDC, is scheduled to give a brief virtual presentation on Monday, Feb. 27. She will discuss the current state of SARS-CoV-2 and COVID-19 vaccine recommendations, which will include the future of booster vaccinations.

Also, the presentation will discuss the current evidence surrounding allergic reactions associated with COVID-19 vaccinations and acknowledge the AAAAI’s contributions to this work.

In addition to providing recent data pertaining to these issues, Walensky will provide her perspective and insights of how the pandemic crisis will continue to affect society and our health in the future as well.

“We are honored to have someone of Dr. Walensky’s caliber addressing the conference. The AAAAI has worked closely with the CDC and the [National Institute of Allergy and Infectious Diseases] since the beginning of the pandemic,” Bernstein said.

Bernstein noted that the collective expertise of allergists and immunologists who manage many of the comorbid conditions contributing to more severe COVID-19 illness such as asthma and immunodeficiency position these specialists as key players in the management of acute and chronic COVID-19 disease.

“We are proud of the collaborative work we’ve conducted with the CDC and look forward to Dr. Walensky’s message,” Bernstein said. “It is sure to be a highlight of this year’s annual meeting.”

Other events

The educational tracks will cover a range of topics, including workshops that address patch testing, digital technologies in asthma, skin biopsies, oral food challenges, infant anaphylaxis and other important clinical issues, Bernstein said.

“You’ll hear a lot about the utilization of biologics for many different conditions, and how they are advancing our clinical understanding of inflammation,” he continued. “There will be many posters and oral presentations highlighting advancements with some of the newer therapies being developed for asthma, eosinophilic esophagitis, chronic urticaria, atopic dermatitis, food allergy, hereditary angioedema and mast cell disorders.”

Many of these sessions were specifically designed with the meeting’s theme of “Optimizing Scope of Practice” in mind to help allergists expand the current care they provide by addressing clinical conditions they may not have seen or developed proficiency with during their training, Bernstein said.

Some of these conditions may currently be outside their normal comfort zone, he continued, but by taking advantage of these workshops and didactic sessions, they can improve their skills in these areas.

“For example, many trainees may have had limited experience with evaluation and management of immunodeficiency, never learned how to perform skin biopsies or nasal endoscopy or feel uncomfortable taking care of adults or children if they trained in pediatrics or internal medicine, respectively,” Bernstein said.

“Providing resources that help our young allergists develop the skills and comfort level to see a diversity of patient problems increases the value of allergists/immunologists to our medical community,” he continued.

In addition, the meeting will incorporate training and career development for members who are focused on serving as educators as part of their professional responsibilities in addition to options for trainees and newer practitioners as they begin their careers.

“The training and career development program is designed to help fellows in training and new allergists learn more about the AAAAI resources offered for academic and clinical practice, how to apply for grants and awards and network with mentors who can advise how to navigate through this process,” Bernstein said.

On Saturday, Feb. 25, the AAAAI Foundation will present its 2023 Faculty Development Awards as well, with four early career researchers receiving 3-year grants of $240,000 to support their work.

“This is the fundraising branch of our organization, which focuses on funding young investigative researchers so that we continue to cultivate the next generation of researchers who hopefully will be successful in obtaining NIH funding,” Bernstein said.

Sara Barmettler, MD, is investigating the impact of and risk for infections in secondary hypogammaglobulinemia. Alberta Wang, MD, MS, is exploring early-life miRNA programming of asthma and allergic diseases.

Santiago Alvarez-Arango, MD, is researching the pathogenesis of non-IgE-mediated immediate drug hypersensitivity reactions. David Hill, MD, PhD, FAAAAI, is focused on the contribution of interferon-mediated epithelial cell MHC class II expression to EoE.

“Supporting these basic, translational and clinical investigators with this funding while they continue to develop their academic research careers is extremely important for strengthening our specialty,” Bernstein said.

Meanwhile, AAAAI committees will gather to chart the organization’s course for the next year. The exhibit hall will feature more than 120 health care companies, nonprofit and professional organizations and other stakeholders in allergy, asthma and immunology.

And with so much dedicated to treating patients, attendees who want to tend to their own wellness can take part in yoga, guided breathwork, meditation and sound bowl sessions as well as a 5K run/walk through Hemisfair Park supporting the AAAAI Foundation.

“It’s going to be an excellent meeting with a lot of options to choose from. There’s always so much more than one can absorb. But there’s always something for everybody, which is what makes the Academy meeting so productive for those who attend,” Bernstein said.

“For our first-time AAAAI attendees or young members, it’s important to pace yourself, so plan your days ahead to ensure you attend the sessions that are most important to your immediate needs,” he continued.

“I am confident that this year’s AAAAI curriculum will succeed in its mission of increasing the allergist’s scope of practice. Our hope is that our colleagues will start to medically manage patient conditions they previously did not feel comfortable addressing, as it is of dire importance for our specialty,” Bernstein said.

Reference:

• Final program of AAAAI Annual Meeting. https://www.aaaai.org/Aaaai/media/Media-Library-PDFs/About/am23-FinProg-v19_lores-FINAL.pdf. Published Feb. 3, 2023. Accessed Feb. 7, 2023.

For more information:

Jonathan A. Bernstein, MD, FAAAAI, can be reached at bernstja@ucmail.uc.edu.