The Itch: Allergies, Asthma, Eczema & Immunology

#143 - Meet the President of the ACAAI: Dr. Cherie Zachary

We continue our tradition of interviewing the incoming president of the American College of Allergy, Asthma & Immunology to learn what is top of mind for the field and what it means for patients and families.

Dr. Cherie Zachary joins us to share her personal journey into allergy and immunology as both a lifelong patient and clinician. She explains what the ACAAI does and why increasing representation in medicine is critical for improving allergy outcomes. The conversation also tackles the allergist shortage, how physicians are trained, and what is being done to expand fellowship opportunities and improve access to care.

What we cover in our episode about Dr. Zachary & ACAAI

• What the ACAAI actually does for allergy care: How the College supports clinicians and provides patients with trusted, evidence-based education.

• How lived experience shapes leadership: How Dr. Zachary’s own allergic diseases influenced her path into allergy and immunology.

• Why representation matters for allergy outcomes: How culturally responsive care and physician diversity improve trust and health outcomes.

• Why there are not enough allergists: How training bottlenecks contribute to long wait times and limited access to care.

• Historically Black Colleges and Universities (HBCUs): Her focus on expanding exposure to allergy through HBCUs and the ACAAI SPARK program.

More resources about what we discussed

• American College of Allergy, Asthma, and Immunology

• Listen: Ep. 77: Food Allergy and Its Impact on the Black Community

• Listen: Ep. 108: Interview with Dr. James Tracy

• Listen: Ep. 66: Interview with Dr. Gailen D. Marshall, Jr.

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Made in partnership with The Allergy & Asthma Network.

We thank the American College of Allergy, Asthma, and Immunology for their support of Allergy & Asthma Network and this podcast. 

#142 - Inside Allergy & Asthma Network: Education, Advocacy, and Patient Voice

Allergy & Asthma Network has spent more than four decades helping people living with asthma, allergies, and related immune conditions navigate care, access trustworthy education, and make their voices heard.

In this episode, we talk with Lynda Mitchell, CEO of Allergy & Asthma Network. Lynda shares how becoming a food allergy and asthma mom in the early 1990s shaped her career and led her into patient advocacy work. We get into how Allergy & Asthma Network supports patients and families through four mission pillars: education, outreach, advocacy, and research.

What we cover in our episode about Allergy & Asthma Network

• Trusted Messengers and culturally responsive education, and why information is more effective when it comes from people who reflect and understand the community
• Free virtual asthma coaching, and how one-on-one self-management education helps people improve daily asthma control and reduce emergency care
• Patient voice research, what it is, how it differs from clinical trials, and why diversity in clinical trial participation matters
• Advocacy efforts like Capitol Hill Day and PALI, and how patient stories influence laws and policies that affect asthma and allergy care
• Ways to get involved, including resources for patients, caregivers, and healthcare providers who want to support or participate in Allergy & Asthma Network’s work

More resources about Allergy & Asthma Network

• Allergy & Asthma Network 
• Sign-up for the Allergy & Asthma Network’s Newsletter 
• Get involved with clinical trials and research 
• More about the PALI information session (February 18, 2026)
• Advocacy information
• Virtual asthma coaching program (free asthma self-management education)

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Made in partnership with The Allergy & Asthma Network.

#141 - The Peds-AIRQ explained: pediatric asthma control

Asthma is one of the most common long-term conditions in children. It is a leading cause of missed school and emergency room visits. Doctors use tools (validated questionnaires) to assess how well a child’s asthma is controlled and whether their medicine is helping. Some tools only ask about symptoms, which can miss children who are still at risk for asthma attacks.

The lead author, Dr. Kevin Murphy, joins us to talk about “Pediatric Asthma Impairment and Risk Questionnaire: A Control Assessment for Children Aged 5 to 11 Years,” published July 2025 in Journal of Allergy and Clinical Immunology: In Practice.

The Peds-AIRQ was designed to improve how doctors identify uncontrolled asthma in children by asking about both current symptoms and past asthma attacks. This approach helps avoid missing children who may seem okay day to day but are at higher risk for future flare-ups.

What we cover in this episode

• Why asthma control in children can be hard to measure
• What “controlled asthma” really means
• Why past asthma attacks matter, even when symptoms seem mild
• What the Peds-AIRQ is and how it works
• How this tool may support better conversations between families and doctors

DOWNLOAD THE INFOGRAPHIC

More asthma in kids resources 

• Take the Peds-AIRQ questionnaire 
• What is asthma?
• Asthma in Babies and Children
• Childhood Asthma: A Complex Condition That Doesn’t Have to Be So Complicated - video

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The Itch Review, hosted by Dr. Gupta, Kortney, and Dr. Blaiss, explores allergy and immunology studies, breaking down complex research in conversations accessible to clinicians, patients, and caregivers. Each episode provides key insights from journal articles and includes a one-page infographic in the show notes for easy reference.

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Made in partnership with The Allergy & Asthma Network.

Thanks to AstraZeneca for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

#140 - Why Sleep Matters for Allergies, Asthma, and Eczema

Sleep plays a critical role in managing allergies, asthma, and eczema, yet it is often overlooked in conversations about allergic disease.

Sleep affects mood, focus, immune function, and inflammation, all of which influence how allergic conditions show up day to day. Poor sleep can worsen asthma symptoms, increase allergy flares, and make eczema harder to control. At the same time, allergies and asthma can disrupt sleep, creating a cycle that is difficult to break.

Dr. Carol Yuan-Duclair, a sleep specialist, joins us to explore how sleep impacts allergic conditions and overall health. She breaks down what good sleep actually looks like, how to know if you are getting enough rest, and how sleep quality can directly affect allergies, asthma, and eczema.

This conversation focuses on practical guidance for patients and families, including environmental changes, medication considerations, and when it may be time to seek help from a sleep specialist.

What we cover in this episode about sleep and allergic disease

• Why sleep is essential for health and immune function: How sleep affects inflammation, mood, and overall health, and why poor sleep can worsen allergic disease.

• What good quality sleep actually looks like: The difference between sleep quality and sleep quantity, and how to tell if your sleep is truly restorative.

• The two-way relationship between sleep and allergies: How allergies can disrupt sleep, and how poor sleep can worsen allergy symptoms, creating a difficult cycle.

• Practical ways to improve sleep when you have allergies: Sleep hygiene basics, exercise timing, and creating a healthier bedroom environment.

• When medications or symptoms mean it is time to see a specialist: How allergy medications can affect sleep, how eczema fits into the picture, and when ongoing sleep issues may signal the need for a sleep specialist.

#139 - Understanding Food Allergy Labels & "May Contain" in the U.S.

Reading food labels can feel like a full-time job when you or your child has food allergies. Even when you know what to avoid, labels can still be confusing, especially when you run into “may contain” warnings.

Marion Groetch, a registered dietitian with decades of experience in food allergy care and education, joins us to unpack all things food labels. Together, we break down U.S. allergen labeling laws, what parts of the package actually matter, and why “may contain” statements are a much grayer area than most people realize. We also share practical tips for navigating so-called “mystery ingredients” like natural flavors and oils, when it is worth contacting a manufacturer, and how to avoid being more restrictive than necessary while still staying safe.

What we cover in our episode about food labels:

• What U.S. labeling laws require: How FALCPA and the FASTER Act protect families by requiring clear disclosure of the Top 9 major allergens.
• Where allergy information actually lives on a label: Why the ingredients list and “Contains” statement matter most, and why front-of-package claims should be ignored.
• What “may contain” actually means: Why these statements are voluntary and unregulated, and what that means for real-world decision-making.
• Foods that fall outside labeling laws: Common situations where allergen labeling is not required, including deli foods, restaurant meals, airline meals, and alcohol.
• How to avoid over-restricting your diet: Practical guidance on mystery ingredients, higher-risk products, and when contacting a manufacturer actually makes sense.

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Made in partnership with The Allergy & Asthma Network.

Thanks to Genentech for sponsoring today’s episode.

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

#138 - Prevalence of KIT D816V in anaphylaxis or systemic mast cell activation

Clonal mast cell disease is often missed because symptoms vary from person to person, tryptase levels can be normal, and bone marrow biopsies are hard to get. For some people, unexplained or very severe anaphylaxis may be an early sign of a clonal mast cell disease.

In this episode, we review “Prevalence of KIT D816V in anaphylaxis or systemic mast cell activation,” published in October 2025 in the Journal of Allergy and Clinical Immunology. This paper, known as the PROSPECTOR trial, is looking at how often the KIT D816V mutation can be found using a blood test in adults who have had anaphylaxis or systemic mast cell activation symptoms.

We break down why KIT D816V matters, how it connects to systemic mastocytosis, why HaT needs to be considered, and how newer blood tests may help doctors catch clonal mast cell disease earlier.

What we cover in our episode about KIT D816V and anaphylaxis:

• Setting the stage: Understanding mast cell activation and anaphylaxis.
• Why KIT D816V matters: How this mutation fits into clonal mast cell disease, what blood testing can reveal, and when doctors still turn to a bone marrow biopsy.
• Making sense of tryptase and hereditary alpha-tryptasemia (HaT): Why baseline tryptase, the “20% + 2” rule, and HaT can make screening more complicated than it seems.
• What the PROSPECTOR trial uncovered: How often KIT D816V appeared in people with anaphylaxis, and other results on tryptase and HaT.
• How this helps patients: What these findings mean for anyone with unexplained or severe anaphylaxis, and how doctors combine KIT testing, tryptase, HaT, and symptoms to decide on next steps.

Other podcast episodes about mast cell disease:

• Ep. 127: Management of indolent mastocytosis - A clinical yardstick
• Ep. 126: Management of mast cell activation syndrome - A clinical yardstick
• Ep. 121: Avapritinib vs Placebo in Indolent Systemic Mastocytosis - PIONEER Trial
• Ep. 118: The ISM Disconnect - Do Patients and Providers Agree on Symptom Control?
• Ep. 70 How do stress and low histamine diets impact mast cell disease?
• Ep. 63: Mast Cell Diseases & Systemic Mastocytosis: The Basic Science
• Ep. 65: The Symptoms and Triggers of Mast Cell Disease

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The Itch Review, hosted by Dr. Gupta, Kortney, and Dr. Blaiss, explores allergy and immunology studies, breaking down complex research in conversations accessible to clinicians, patients, and caregivers. Each episode provides key insights from journal articles and includes a one-page infographic in the show notes for easy reference.

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Made in partnership with The Allergy & Asthma Network.

Thanks to Blueprint Medicines for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

#137 - Diagnosing Chronic Rhinosinusitis with Nasal Polyps (CRSwNP)

Persistent congestion, pressure, or a reduced sense of smell often gets mistaken for allergies or a stubborn cold when it may be something more, like chronic rhinosinusitis with nasal polyps (CRSwNP). Getting the right diagnosis is the first step toward real relief.

Dr. Tonya Farmer, a board-certified ENT, joins Kortney and Dr. G to explain how chronic rhinosinusitis with nasal polyps (CRSwNP) is diagnosed. She walks us through the full evaluation: what symptoms matter, what a nasal endoscopy actually shows, when a CT scan is needed, and how type 2 inflammation fits into the picture.

What we cover about diagnosing CRSwNP:

• Key symptoms: Persistent congestion, drainage, facial pressure, and especially loss of smell are major red flags for CRSwNP.
• Why duration matters: Chronic means 12 weeks or longer. If symptoms keep coming back or never truly improve, it’s time to look deeper.
• The physical exam: ENTs use nasal endoscopy to see swelling, mucus, or polyps that aren’t visible from the outside.
• When CT scans are needed: Imaging helps confirm sinus inflammation and shows the extent of polyp growth.
• Additional testing: Allergy testing, IgE levels, eosinophils, and other immune markers help identify type 2 inflammation and guide next steps.
• When to see a specialist: If antibiotics, steroids, or over-the-counter treatments aren’t helping, ask for a referral to an allergist or ENT. Early diagnosis can prevent worsening symptoms and reduce the need for surgery.

Set the foundations: Ep. 133: What is Chronic Rhinosinusitis with Nasal Polyps (CRSwNP)?

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Made in partnership with The Allergy & Asthma Network.

Thanks to Sanofi-Regeneron for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

#136 - Food Allergy Treatments: What to Ask Your Doctor

Avoidance has long been the standard for managing food allergies. But new options, such as oral immunotherapy (OIT) and biologic medications like Xolair (omalizumab), are changing the landscape. With more choices available, many patients and parents are wondering how to start the conversation with their allergist and what questions to ask.

Kortney and Dr. Payel Gupta talk with Dr. Shahzad Mustafa, a board-certified allergist and immunologist, about how patients can navigate today’s food allergy treatments with confidence. Together, they explore what to consider before starting OIT or Xolair, how to set realistic expectations, and why strict avoidance is still the right choice for many families.

What we cover about food allergy treatment options:

• Food Allergy Avoidance: Why it remains an effective and valid approach for many, and how to make it work in daily life, including the nuances that make every case unique.
• Oral Immunotherapy (OIT): What it involves, who it’s best suited for, and what families should know about time, cost, and safety.
• Xolair (omalizumab): How this injection therapy works to reduce reactions from accidental exposures and what it doesn’t do.
• Setting expectations: How to talk with your allergist about your goals, quality of life, and what “success” really looks like.

More episodes about food allergies

• Ep. 129: Omalizumab for Multiple Food Allergies – The OUtMATCH Trial
• Ep. 98: Food Allergy Treatment and Management

More resources about food allergies

• Food Allergy Treatment & Management

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Made in partnership with The Allergy & Asthma Network.

Thanks to Genentech for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

 

#135 - Food Allergies in School: A School Nurse’s Perspective

When it comes to keeping kids with food allergies safe at school, school nurses are often the quiet heroes behind the scenes. From managing allergy action plans and emergency responses to training teachers and organizing care for hundreds of students, their role is essential, but often misunderstood.

Kortney and Dr. Payel Gupta sit down with Elizabeth Elliott, a school nurse and President of the Maryland Association of School Health Nurses. Liz shares what really happens inside the health room and how school nurses coordinate care for students with food allergies and asthma. Plus, why communication between families and school staff is key to keeping kids safe.

After this episode, you’ll have a whole new appreciation for your school nurse and a better understanding of how to partner with them to make every school day safer for kids with allergies.

What we cover about food allergy management at school:

• The school nurse’s role: How nurses bridge communication between families, teachers, and doctors to keep children with food allergies safe and included during the school day.
• Coordinating care: How school nurses use action plans and 504s to ensure everyone, from teachers to cafeteria staff, knows how to keep kids safe.
• Training and emergency preparedness: How school nurses teach staff to recognize anaphylaxis, use epinephrine, and stay calm during an emergency.
• Field trips, cafeterias, and bus safety: What goes into planning safe experiences beyond the classroom, and why “no-food on the bus” rules really matter.
• Advocating for resources: How families can support their school nurses and advocate for better funding, staffing, and allergy awareness in schools.

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Made in partnership with The Allergy & Asthma Network.

Thanks to Genentech for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

#134 - How Dupilumab Reduces Mucus Burden in Asthma - VESTIGE Trial

Mucus plugging is a challenge in asthma care. It’s thick, sticky mucus that blocks the airways and doesn’t respond to regular inhalers. Even when inflammation improves, these plugs can lower lung function, limit how well medicine works, and make asthma harder to control.

In this episode, we break down the study: “Effect of Dupilumab on Mucus Burden in Patients with Moderate-to-Severe Asthma,” published October 28, 2025. The analysis looks at whether dupilumab (Dupixent), a biologic that blocks IL-4 and IL-13, can lower mucus burden and improve lung function, especially in people who start with a high “mucus plug score.”

What we cover in our episode about dupilumab and mucus plugging

• Why mucus plugging matters in asthma: Discover how thick, sticky mucus can block airways, make it harder to breathe, and why standard inhalers and steroids don’t clear these plugs.
• How dupilumab may help: Learn how this biologic blocks IL-4 and IL-13, two key drivers of type 2 inflammation that increase mucus production and thickness.
• Inside the VESTIGE study: Hear how researchers measured mucus burden using CT scans and “mucus plug scores” to see if dupilumab could reduce plugging in moderate-to-severe asthma.
• What the results showed: Find out how dupilumab lowered mucus plug scores, reduced airway inflammation, and improved lung function (FEV₁), especially in people with high mucus burden.
• What this means for patients: Learn why identifying and treating mucus plugging may help improve breathing, reduce flare-ups, and make asthma easier to manage day to day.

📌INFOGRAPHIC to follow along 

RESOURCES:

• What is asthma?

• What is type 2 inflammation?

• When Asthma Is More Than Just Asthma: Type 2 Inflammation

• More about dupilumab (Dupixent)

The Itch Review, hosted by Dr. Gupta, Kortney, and Dr. Blaiss, explores allergy and immunology studies, breaking down complex research in conversations accessible to clinicians, patients, and caregivers. Each episode provides key insights from journal articles and includes a one-page infographic in the show notes for easy reference.

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A special collaboration with the American Thoracic Society. 

This podcast was made in partnership with Allergy & Asthma Network.

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.