Episodes

New HEDIS measures are changing the expectations around asthma follow-up, creating an important opportunity for primary care providers to look beyond the exacerbation itself. This episode explores the 2026 HEDIS Follow-Up After Acute and Urgent Care Visits for Asthma (AAF-E) measure and what clinicians should consider assessing during that critical 30-day follow-up. We discuss asthma control, medication adherence and inhaler technique, environmental and allergic triggers, specific IgE testing, a...

More than 1 in 4 children with food allergy live in food-insecure families, highlighting a challenge that extends well beyond allergen avoidance. This episode explores how food insecurity, socioeconomic status, access to care, insurance coverage, geographic barriers, medication affordability, and access to allergen-free foods can affect food allergy management and quality of life. The conversation covers diagnostic accuracy, unnecessary elimination diets, targeted specific IgE testing, testing w...

About 30% to 40% of the world’s population is affected by some form of allergic disease, making allergy a routine consideration in primary care. But as interest in the microbiome grows, clinicians and patients face an important question: what does the evidence actually tell us about its role in allergic disease? This episode explores immune development, the hygiene and biodiversity hypotheses, food allergy, early-life tolerance, the gut-skin axis, atopic dermatitis, asthma, allergic rhinitis, an...

Many diagnoses involve laboratory diagnostics, yet patients with autoimmune and allergic disease still face delayed or incomplete testing. In this live recording of ImmunoCAST from Lab Week 2026, featuring allergist Dr. Zachary Rubin and autoimmune specialist Dr. Crista Prates, we examine how laboratories can close the gap with smarter clinician partnerships, reflex and tiered testing, ANA follow-up strategies, anti-CCP and rheumatoid factor interpretation, and comprehensive aeroallergen and foo...

A 7% sensitization rate by 3 months of age highlights how early allergic disease can begin, making early recognition critical for long-term patient outcomes. In this episode, internationally recognized allergy researcher and pediatric allergist Dr. Anna Asarnoj shares insights from the landmark BAMSE birth cohort and her decades of research on how allergies develop, evolve, and sometimes resolve over time. Together, we explore the atopic march, early-life sensitization, component-resolved diagno...

Few scientists have shaped modern allergy medicine as profoundly as Dr. Thomas Platts-Mills. From pioneering research on dust mite allergens and environmental drivers of asthma to helping uncover the IgE-mediated mechanism behind alpha-gal syndrome, his discoveries have transformed how clinicians diagnose and manage allergic disease. In this special episode, Dr. Platts-Mills shares the stories behind some of allergy's most important breakthroughs, including the landmark studies that established ...

Dr. Ruchi Gupta, board-certified pediatrician and founding director of the Center for Food Allergy and Asthma Research (CFAAR), and PA Gary Falcetano joined forces on a Food Allergy Research and Education (FARE) webinar to discuss nuances and insights for managing food allergies across a patient’s life. In this episode we share some of the important questions that were asked about specific IgE blood testing, skin testing, component resolved diagnostics, oral food challenges, guideline updates, a...

Food allergy diagnosis is still too often driven by tests instead of history, leading to unnecessary restriction and missed opportunities for targeted care. In this episode, we invite Dr. Anna Nowak-Wegrzyn, a leading researcher in food allergy and Director of Pediatric Allergy and Immunology Division at NYU Grossman School of Medicine, to help unpack the core clinical challenge of distinguishing true food allergy from sensitization, and discuss practical approaches to history-directed testing, ...

Asthma affects over 26 million people in the U.S., yet outcomes can vary dramatically based on factors beyond disease severity. This episode explores the critical gap between diagnosis and optimal asthma control, focusing on how socioeconomic status, access to care, and environmental exposures shape patient outcomes. Through a mock case study, we examine disparities in healthcare access, allergist availability, and treatment adherence, alongside key topics such as epidemiology, risk stratificati...

With 29 million golfers in the U.S. and an estimated 7.25 million affected by spring allergies, seasonal respiratory symptoms can meaningfully affect performance and daily function. This episode explores how tree and grass pollen exposure, overlapping sensitizations, and indoor allergens can combine to drive rhinitis, fatigue, sleep disruption, and reduced daytime performance. We discuss regional pollen patterns, why pine pollen is often less clinically important than oak and juniper, how to avo...

A large 2024 study found that a comprehensive respiratory allergen profile captured more than 98% of seasonal sensitizations, highlighting a major challenge in respiratory allergy care: testing with single allergens can miss the full picture. In this episode, we explore the most optimized regional respiratory profiles and how they improve diagnostic yield, reduce duplicate testing, and help clinicians identify polysensitization across trees, weeds, molds, and indoor allergens. We also discuss ho...

Wheat allergy, celiac disease, and non-specific gluten intolerance all share overlapping gastrointestinal symptoms that can confound primary care diagnosis. This episode addresses the core diagnostic challenge of distinguishing IgE-mediated wheat allergy (including ω-5 gliadin–associated wheat-dependent exercise-induced anaphylaxis) from celiac disease and non-celiac gluten intolerance. We cover epidemiology, clinical presentations and timing of IgE reactions, component-resolved diagnostics, ser...

Celebrate our 50th episode by diving in to hear some of our favorite insights from the many allergy experts we’ve welcomed to ImmunoCAST. In this episode, we’ve curated clinical clips from guests like Dr. Zachary Rubin, Dr. David Golden, Dr. Ruchi Gupta, and more. From the mental health impacts of food allergy to the relationship between allergies and intimacy, the nuances of venom allergy, and diagnostic strategies for alpha gal syndrome, we’re looking back at the valuable knowledge shared acro...

Nearly 11% of U.S. adults meet criteria for a convincing food allergy, yet most clinicians underestimate both the prevalence and unique challenges of adult-onset disease. This episode addresses the frequent misdiagnosis and clinical uncertainty surrounding new symptoms in adults by highlighting epidemiology, risk factors for delayed and severe reactions, high-yield history-taking, diagnostic pitfalls, and guideline-supported use of specific IgE and component-resolved diagnostics. Listeners will ...

For primary care providers, seeing a patient presenting with atopic dermatitis (eczema) is common, yet misconceptions persist regarding its underlying cause and optimal management. This episode tackles the critical clinical dilemma: when and how should specific IgE testing for food and environmental allergens shape routine eczema care? Key topics include the evolution of pathophysiology—shifting focus from allergy-driven disease to barrier dysfunction and type 2 inflammation—plus risk stratifica...

In this episode, we sit down with ImmunoCAST host Gary Falcetano, PA, to discuss the insights he wishes he had when he first began treating and managing allergy patients, along with the knowledge he has gathered from speaking with thousands of clinicians across the country. Gary addresses common misconceptions surrounding skin prick testing and in vitro blood testing, highlights region-specific allergen patterns, explores the nuances of risk stratification in asthma and respiratory allergies, an...

Over 99% of homes contain at least one allergen, with 75% harboring three to six, yet winter allergies often masquerade as stubborn “colds” or recurrent respiratory infections. This episode confronts the core diagnostic challenge of differentiating allergy-driven symptoms from viral, bacterial, or non-allergic triggers in colder months. We delve into indoor allergen epidemiology, risk stratification for polysensitized patients, syndrome overlap in differential diagnosis, and utility of location-...

In this episode, we tackle the challenge of separating allergy fact from fiction in an age of rampant online misinformation. Dr. Zachary Rubin, a double board-certified pediatrician and allergist, shares insights on common allergy myths circulating on social media. We explore misconceptions about food allergies vs. intolerances, respiratory allergies, eczema management, anaphylaxis treatment, and allergy testing interpretation. Learn how to navigate patient conversations about gluten sensitivity...

Did you know that a dog allergy could be linked to unexplained infertility? This episode delves into fascinating allergy case studies and how component-resolved diagnostics can help uncover hidden connections. From wheat-dependent exercise-induced anaphylaxis in children to severe sesame reactions despite negative clinical history, learn what these interesting cases can teach us about the impact of allergen component sensitization and how innovative testing using components can broaden our under...

Imagine a child diagnosed with a life-threatening food allergy – how does this impact their mental health and family dynamics? In this episode, we explore the often-overlooked psychological aspects of food allergies. Licensed therapist Tamara Hubbard, MA, LCPC, shares insights on helping patients and families navigate anxiety, risk assessment, and social challenges. We discuss strategies for clinicians to address mental health concerns during allergy diagnoses, manage family conflicts, and recog...

Did you know that peanut-triggered anaphylaxis jumps by 85% during Halloween? This startling statistic underscores the critical need for healthcare providers to address food allergy management proactively. This episode tackles the complex interplay between food allergies and Halloween festivities, offering insights into accurate diagnosis, emotional impact assessment, and practical safety strategies. We discuss the importance of allergen component-resolved diagnostics in risk stratification, the...

Did you know that up to 70% of adults with seasonal allergies may experience symptoms of pollen food allergy syndrome (PFAS)? This often-overlooked condition can mimic true nut allergies, leading to unnecessary dietary restrictions. In this episode, we tackle the challenge of differentiating PFAS from primary nut allergies. We explore the molecular basis of cross-reactivity between pollen and food proteins, discuss key diagnostic approaches using testing with allergen components, and provide ins...

A tick bite in Maine leads to an unexpected diagnosis, challenging our understanding of alpha-Gal syndrome's geographic boundaries. This episode unravels the expanding reach of this unique allergic condition, now found from coast to coast and linked to multiple tick species. We explore recent case studies that highlight the need for increased clinical suspicion, even in non-endemic areas. Learn about the diverse symptom presentation, from delayed anaphylaxis to chronic urticaria and GI distress,...

Did you know that IgE, the antibody responsible for allergic reactions, is 30,000 times less abundant than other immunoglobulins in the body? This staggering fact underscores the importance of highly sensitive allergy diagnostics. In this episode, we pull back the curtain on what happens to allergy diagnostic blood samples after they leave your clinic. Clinical laboratory expert Jessica Murphy, MLS (ASCP), guides us through the intricate process of specific IgE testing, from sample processing to...