Do you get hives and have no clue why? Then this episode is for you!

Join Kortney and Dr. Gupta as they unpack chronic spontaneous urticaria (CSU) in a six-part series. You may also have heard of this condition called chronic idiopathic urticaria or spontaneous urticaria.

In this first episode, Kortney and Dr. Gupta dive into the nitty gritty of chronic spontaneous urticaria. They define the medical term "urticaria," commonly known as hives, and discuss how CSU differs from other forms of urticaria. They dive into the symptoms, including the itchy and transient nature of hives, and emphasize that CSU can vary in appearance depending on skin tone. 

What may seem complicated in chronic spontaneous urticaria is that there are no triggers. Instead, Dr. G walks us through the factors that may be culprits to CSU flares, such as stress and certain medications, and she highlights the impact of autoimmune conditions on CSU prevalence.

• Definition and symptoms of urticaria (hives)

More resources about chronic spontaneous urticaria:

• Chronic Urticaria Management, Resources & Glossary of Terms: https://allergyasthmanetwork.org/health-a-z/chronic-urticaria/management-and-resources/

This episode is produced in partnership with The Allergy & Asthma Network. We thank Novartis for sponsoring this episode and the series. 

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

As temperatures rise and weather patterns become more unpredictable, the effects of climate change on respiratory health become even more noticeable.

Dr. Stephanie Lovinsky-Desir, an expert in respiratory health, joins Dr. G and Kortney to discuss how climate change exacerbates respiratory conditions like asthma, particularly affecting vulnerable populations. 

The episode explores why we should consider the connection between climate change and asthma. Understanding the mechanisms behind it is crucial. Dr. Lovinsky-Desir explains how increased temperatures lead to higher levels of air pollution and create “heat islands" in urban areas. Heat islands are urban areas that are significantly warmer than their surrounding rural areas due to human activities. These islands intensify health risks by trapping heat and pollutants, worsening air quality and increasing respiratory distress.

Dr. Lovinsky-Desir and Dr. G share practical measures that are easy to implement and can significantly help us navigate poor air quality. These include wearing masks during high pollution and monitoring air quality through initiatives like the State of the Air Report or your weather app. She also highlights the role of organizations like the American Lung Association in providing resources and support for improving indoor air quality.

We hope this episode helps you better understand climate change's impact on air quality, the overall environment, and lung health. Hopefully, you can take meaningful steps towards a healthier future for all. If you are in doubt about the impacts of climate change, this episode is for you!

• The relationship between air pollution, air quality and climate change

Helpful links

• More about our sponsor, Chiesi: https://www.chiesiusa.com/

Have you ever searched for information on mast cell disease only to be overwhelmed by alarming topics like cancer and stem cell transplants? Then this episode is for you!

Our guest, Dr. Marina Kremyanskaya, joins hosts Dr. G and Kortney to provide insight into the progression of systemic mastocytosis and the available treatment options to improve quality of life and extend lifespan.

Dr. Kremyanskaya distinguishes between indolent and aggressive systemic mastocytosis, shedding light on warning signs indicating disease progression. She offers a detailed exploration of treatment approaches for aggressive mastocytosis, highlighting the evolving treatment plan and differing prognosis from indolent cases. Additionally, Dr. Kremyanskayaa delves into the concept of myeloid malignancy, providing insight into the more challenging aspects of advanced systemic mastocytosis progression.

We also dive into stem cell transplants as a potential cure for advanced systemic mastocytosis. Dr.  Kremyanskaya explains why this option is not immediately pursued due to the complexity of the procedure and the risk of graft-versus-host disease (GvHD), a potential complication associated with stem cell transplants.

What we cover in this episode about advanced systemic mastocytosis:

• Understanding indolent systemic mastocytosis

• Role of chemotherapy in stem cell transplant.

• Mast Cell Disease Overview: https://allergyasthmanetwork.org/health-a-z/mast-cell-diseases/

Why talk to a hematologist about mast cell disease and systemic mastocytosis treatment?

Dr. Douglas Tremblay, a leading hematologist, joins Dr. G and Kortney to discuss the role of a hematologist-oncologist in diagnosing and treating mastocytosis. We discuss bone marrow's vital role in diagnosing and treating systemic mastocytosis. 

Dr. Tremblay discusses the latest KIT inhibitors, a promising group of medications, and explains the difference between indolent and advanced systemic mastocytosis. He clarifies how KIT inhibitors work and emphasizes the importance of managing side effects. Finally, Dr. Tremblay provides insights into the future of KIT inhibitor approval and explores the possibility of participating in a clinical trial for Bezulastinib. 

What we cover in this episode about treating systemic mastocytosis:

• What is a hematologist looking at with mast cell disease patients?

• Bone marrow biopsy for systemic mastocytosis 

• Avapritinib

Dr. Tremblay: https://profiles.mountsinai.org/douglas-a-tremblay

Dr. Tremblay’s email: [email protected] 

Mast Cell Disease Overview: https://allergyasthmanetwork.org/health-a-z/mast-cell-diseases/

What is Anaphylaxis? https://allergyasthmanetwork.org/anaphylaxis/

What is Epinephrine? https://allergyasthmanetwork.org/anaphylaxis/what-is-epinephrine/

The Mast Cell Disease Society: https://tmsforacure.org/

Current studies enrolling patients: https://tmsforacure.org/clinical-trials/

What is it like when an unpredictable disease like systemic mastocytosis forces you to change the trajectory of your life?

As we continue to unpack mast cell disease, Dr. G and Kortney wanted to get the patient's perspective on living with such a complex disease. Tammie joins the podcast to discuss her journey battling mastocytosis, a rare condition affecting mast cells in the body.

If you ever feel alone on your chronic health journey, know you aren’t! Tammie's resilience and wisdom serve as a beacon of hope. We hope this inspires you to approach your health journey with determination and a sense of community.

What we cover in this episode:

Tammie’s mastocytosis journey

The challenges of not getting a proper diagnosis

The pros and cons of being able to google medical conditions

What do to when a doctor does not want to take you on as a patient 

How Tammie separates the disease from her life 

How do you navigate work with a chronic disease?

Working with a mental health team

How do you ask your family/friends for help

Patient's relationship with their healthcare team

Pros and cons of an online community for chronic disease and the importance of a real-life community

Connect with Tammie online:

• TikTok https://www.tiktok.com/@rachelllargentphillips

Resources about mast cell disease:

Mast Cell Disease Overview: https://allergyasthmanetwork.org/health-a-z/mast-cell-diseases/

What is Anaphylaxis? https://allergyasthmanetwork.org/anaphylaxis/

What is Epinephrine? https://allergyasthmanetwork.org/anaphylaxis/what-is-epinephrine/

The Mast Cell Disease Society: https://tmsforacure.org/

Dr. Milner joins us again to discuss two hot topics in managing mast cell disease. We start by demystifying the low histamine diet and sharing when appropriate. The answer may be different from what you expect or want to hear. We also talk about stress, a topic we are learning impacts so many chronic diseases, especially those related to mast cells. Stress can worsen symptoms, and in this episode, both doctors emphasize the importance of stress management techniques.  

What we cover in this episode about low histamine diet and stress management

• Why go on a low histamine diet?

More resources about mast cell disease:

• Mast Cell Disease Overview: https://allergyasthmanetwork.org/health-a-z/mast-cell-diseases/

Where do you begin with mast cell disease treatment when there is such variation among patients? 

Dr. Milner is back with us to discuss the difficulties in treating mast cell activation syndrome and mastocytosis. We will discuss the different approaches to treating mast cell disease and the medications used for mastocytosis treatment. Since no single treatment plan works for everyone, we will explore multiple strategies that can be helpful in managing this condition.

A note: when you hear MCAS mentioned, it stands for Mast Cell Activation Syndrome.

What are the steps taken to treat mast cell diseases?

Histamine blockers: antihistamines for mast cell disease and H2 blockers

Mast cell stabilizers: Cromolyn and Ketotifen

Xolair 

Other medications that have been used but not recommended: aspirin, steroids, Singulair

Epinephrine and anaphylaxis

Tyrosine kinase inhibitors (TKI) for Mastocytosis: Avapritinib, Midostaurin

Safety concerns and side effects of Tyrosine kinase inhibitors

 Multidisciplinary approach to managing mast cell disease

Joshua Milner, MD, is a renowned leader in discovering and understanding genetic diseases leading to allergic symptoms, including Hereditary Alpha Tryptasemia Syndrome, PLAID, PGM3 deficiency, ERBIN mutation, and others. With a background in biology from MIT and an MD with distinction in immunology from Albert Einstein College of Medicine, Dr. Milner has extensive experience in pediatrics and allergy and immunology, serving as chief of the Laboratory of Allergic Diseases at NIAID.

His vision is to leverage genetic variation to improve diagnosis and care for patients with allergic diseases through comprehensive genetic sequencing and functional studies, aiming for personalized medicine and interdisciplinary collaboration in pediatric allergy, immunology, and rheumatology.

More about Dr. Milner: 

https://www.pediatrics.columbia.edu/profile/joshua-milner-md

Mast Cell Disease Overview: https://allergyasthmanetwork.org/health-a-z/mast-cell-diseases/

What is Anaphylaxis? https://allergyasthmanetwork.org/anaphylaxis/

What is Epinephrine? https://allergyasthmanetwork.org/anaphylaxis/what-is-epinephrine/

The Mast Cell Disease Society: https://tmsforacure.org/

FDA Approves AYVAKIT® (avapritinib) as the First and Only Treatment for Indolent Systemic Mastocytosis: https://ir.blueprintmedicines.com/news-releases/news-release-details/fda-approves-ayvakitr-avapritinib-first-and-only-treatment

Our episode on eyelash allergies was so interesting we had to bring you more from our favorite eye Doc, Dr. Luk. We delve into the fascinating world of eyelash health and hygiene, from the importance of cleanliness to the latest trends like eyelash serums and magnetic extensions. We discuss the importance of hygiene, eyelash serums, and magnetic eyelash extensions.

Eyegiene: why you need to clean your eyelashes

How to clean your eyelid margin

How often should you clean your eyelid margins

How to know if it is eczema or blepharitis

What to consider when using lash serums

Are magnetic eyelash extensions a better alternative to traditional eyelash extensions?

Put on your detective hat because we will be diving into how to diagnose mast cell disease!

Dr. G and Kortney are joined by Dr. Josh Milner, one of the top experts in the field of mast cell disease, as they dive into the complexities of diagnosing mast cell disorders, focusing on cases of unexplained anaphylaxis and using this as our guide to understanding all of the tests that doctors do to figure out what is happening with your mast cells. 

From histories to blood and urine tests to Darier's sign, bone marrow biopsies and more, we dig into the many tests needed for the detective work diagnosing mast cell disease. We learn that a nuanced approach is required to diagnose mast cell disorders and the importance of thorough evaluation to differentiate between potential causes.

This podcast was made in partnership with Allergy & Asthma Network. We thank Blueprint Medicines for sponsoring this podcast.

Unexplained anaphylaxis could be linked to mast cell disorders.

Diagnostic tools:

Blood tryptase test (fast but time-sensitive)

Urine metabolite tests (easier, longer window)

Skin rash assessment (urticaria pigmentosa)

Bone marrow biopsy (serious cases)

Symptoms: Sudden episodes, chronic issues like fatigue, depression.

Joshua Milner, MD, is a renowned leader in discovering and understanding genetic diseases leading to allergic symptoms, including Hereditary Alpha Tryptasemia Syndrome, PLAID, PGM3 deficiency, ERBIN mutation, and others. With a background in biology from MIT and an MD with distinction in immunology from Albert Einstein College of Medicine, Dr. Milner has extensive experience in pediatrics and allergy and immunology, serving as chief of the Laboratory of Allergic Diseases at NIAID.

His vision is to leverage genetic variation to improve diagnosis and care for patients with allergic diseases through comprehensive genetic sequencing and functional studies, aiming for personalized medicine and interdisciplinary collaboration in pediatric allergy, immunology, and rheumatology.

More about Dr. Milner: 

https://www.pediatrics.columbia.edu/profile/joshua-milner-md

Mast Cell Disease Overview: https://allergyasthmanetwork.org/health-a-z/mast-cell-diseases/

What is Anaphylaxis? https://allergyasthmanetwork.org/anaphylaxis/

What is Epinephrine? https://allergyasthmanetwork.org/anaphylaxis/what-is-epinephrine/

The Mast Cell Disease Society: https://tmsforacure.org/

Have you ever wondered why your doctor puts their membership in their bios? Why is it relevant to a patient that your allergist is a member of the ACAAI?

This podcast is made possible through Allergy & Asthma Network’s partnership with the American College of Allergy, Asthma and Immunology.

Dr. G and Kortney had the special privilege of interviewing Dr. Gailen Marshall, the president of the American College of Allergy, Asthma, and Immunology (ACAAI). He explains what the ACAAI, also known as the College, does and why this matters to patients. We learn about the resources provided by the College, which offer patients invaluable support in managing their allergies. From accessing specialized care through the "Find an Allergist" tool to engaging with the ACAAI's educational materials and advocacy opportunities, patients are empowered to take control of their treatment journey.

We also dive into Dr. Gailen Marshall's work in psychoneuroimmunology, which sheds light on how both external and internal environments impact allergic reactions. We touch upon Dr. Marshall's Presidential Initiative, CAAPER, which bridges the gap between community and academic allergists, driving innovation in patient treatment. As allergy research continues to advance, Dr. Marshall's leadership underscores the importance of interdisciplinary collaboration and patient-centred care in navigating the complexities of allergic diseases.

What we cover in the episode

• Dr. Marshall’s field of study: Psychoneuroimmunology

Gailen D. Marshall, Jr. MD, PhD, FACP, is the president of the American College of Allergy, Asthma and Immunology and holds distinguished roles as Chair of Allergy and Immunology, Professor of Medicine and Pediatrics, Vice Chair for Research, Director of the Division of Clinical Immunology and Allergy, and Chief of the Laboratory of Behavioral Immunology Research at the University of Mississippi Medical Center in Jackson. 

With a background in both Immunology and Medicine from the University of Texas Medical Branch in Galveston and extensive training at institutions like the University of Iowa and the University of Tennessee at Memphis, Dr. Marshall is renowned for his expertise in integrative approaches to managing inflammatory diseases. His research delves into the impact of psychological stress and environmental factors on immune responses, aiming to identify biomarkers for stress susceptibility.

With over 200 publications and active engagement as a speaker in regional, national, and international forums, Dr. Marshall also served as Editor-in-chief of the Annals of Allergy, Asthma and Immunology, showcasing his leadership in the field. Additionally, he plays a vital role in professional societies like the Southern Society for Clinical Investigation, where he serves as Secretary-Treasurer and contributes to various committees, highlighting his commitment to advancing clinical research and education.