Ep. 271: Updates from AAAAI 2026

This year, the American Academy of Allergy, Asthma, and Immunology (AAAAI)/World Allergy Organization (WAO) Joint Congress was held in Philadelphia, Pennsylvania, centered on the theme 'Advancing Precision Medicine from Discovery to Patient Care'. While these meetings are filled with complex research and new developments, what matters most to patients and families is what it all means for their daily life with food allergies. Joining us to break it all down in his signature warm and easy-to-understand style is FAACT's Medical Advisory Board Chair, Dr. Shahzad Mustafa, who will share the key takeaways that patients and families should know from this important meeting.

Resources to keep you in the know:

• AAAAI

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Transcript

Caroline: Welcome to FAACT's Roundtable, a podcast dedicated to navigating life with food allergies across the lifespan. Presented in a welcoming format with interviews and open discussions,

each episode will explore a specific topic, leaving you with the FAACTS to know or use.

Information presented via this podcast is educational and not intended to provide individual medical advice.

Please consult with your personal board-certified allergist or healthcare providers for advice specific to your situation.

Hi everyone, I'm Caroline Moassessi and I am your host for the FAACT Roundtable podcast.

I am a food allergy parent and advocate and the founder of the Grateful Foodie Blog. And I am FAACT's Vice President of Community Relations.

Before we start today's podcast, we would like to take a moment to thank Genentech for being a kind sponsor of FAACT's roundtable podcast. Also, please note that today's guest was not paid by or sponsored by Genentech to participate in this specific podcast.

This year, the American Academy of Allergy, Asthma and Immunology's scientific meeting was held in Philadelphia, Pennsylvan centered on the theme Advancing Precision Medicine from Discovery to Patient Care. While these meetings are filled with complex research and new developments, what matters most to families is what it all means for the children in daily life with food allergies.

Joining us today to break it all down in his signature warm and easy-to-understand style is FAACT's Medical Advisory Board Chair, Dr. Shahzad Mustafa, who will share the key takeaways parents and caregivers should know from this important meeting.

Welcome back Shahzad to FAACT's Roundtable podcast. You are a fan favorite.

Shahzad: Thanks so much for having me.

Caroline: Well, you're very welcome. And for our listeners who may be joining us for the first time,

Dr. Mustafa prefers to go by his first name, Shahzad. He's not only a board certified allergist, but also a parent of a child with food allergies, which brings such a meaningful perspective to our conversations.

So Shahzad, before we dive into the updates from the Quad AI meeting, can you help families understand what Qatai is and why these annual meetings are so important for advancing care and food allergies and beyond?

Shahzad: Yeah, so the AAAAI stands for the American Academy of Allergy, Asthma, and Immunology.

It's one of our two kind of big governing bodies or academic collaborations. The other one being the American College of Asthma, Allergy and Immunology.

Each has a big annual meeting. The AAAAI was just this past week in Philadelphia. It's actually the biggest continuing medical education conference for allergy and immunology in the world.

Several thousand allergists in Philadelphia with a chock full agenda of sessions on topics of cutting edge research and hopefully where the field is going. And it's a great opportunity obviously for all of us to go and learn, but also to network with colleagues, catch up with old friends and kind of talk shop,

even over dinner and drinks. And the types of so many future collaborations that I've had have come from just casual conversations at these meetings.

It's a great opportunity, it's really fun.

Caroline: Someone who goes as an observer and to represent FAACT at our booth and during sessions and so forth. I have to say,

wearing my parent hat, it just blows my mind and excites me because you do see the collaboration starting, you do see people start talking and someone mentions something and someone's doing something in their lab and then all of a sudden, boom, there is some new research and there' innovation happening,

like right there. So it's a pretty stunning event and it's global.

Shahzad: I mean, there's individuals from many, many countries there. So that that perspective is always unique. Different perspectives, different ways, different healthcare systems doing things differently. So the opportunity to learn from each other is absolutely invaluable.

Caroline: That it is.

And this year's theme focused on precision medicine, a term that many families are hearing more often now in the news.

So can you help us understand what precision medicine really means and how does it connect to food aller?

Shahzad: Yeah. So precision medicine is a concept of.

We kind of do studies on populations, right? A study has 500 people, 1,000 people, but we're really treating individuals and every individual is completely different and unique.

So rather than applying study results to an individual, we're going to try to better understand the individual and do precise medicine that applies to them, not just the study.

That's hard to do.

There's lots of examples of this that people understand. Breast cancer, for example, Right. How do you treat breast cancer? And if I ask anyone on the street, usually they respond by well, it depends.

And they're right. Your breast cancer is different than my breast cancer.

Is it localized? Is it metastatic? Does it involve the lymph nodes? There's receptors in breast cancer that people are aware of. Estrogen, progesterone,

or too new.

Are those positive? Negative. And then based on all this information, we try to tailor therapy to that.

Right. So that's an example.

Asthma before used to be a one size fits all. Everyone does the same thing. Now we're really, really.

The word is phenotyping asthma. We're trying to understand Your asthma, is it allergic? Is it non allergic? Is it eosinophilic? Is it non eosinophilic? Do you have allergic antibody?

Was it adult onset or did it start in childhood?

Are you black or Hispanic or Caucasian? All of these things impact your asthma care. And then we're trying to tailor therapy in that space.

And now we're doing the same in food allergy. And this is something that's quite new, actually. When I trained,

food allergy was food allergy. If you're peanut allergic, you're peanut allergic.

Now there's people with low thresholds or high sensitivity. There's people with high thresholds or low sensitivity.

Previous history of reactions predict, you know, potentially how we go in the future. So we're trying to bring this very individualized approach to food allergy as well. And we can talk certainly more about that.

Caroline: That's really exciting.

And so, okay, so thinking back on the meeting, what were the key insights that really stood out to you as an allergist? And then why do they matter to our community?

Shahzad: Yeah, so I think historically for food allergy, we've had a very passive approach of avoidance of your food allergen and treatment of accidental ingestions. That's really starting to shift.

It's really starting to shift to more proactive approach and therapies for food allergy. There was a lot of discussion on what's currently available and then what may be available over the coming years.

Just some highlights, a lot to talk about. Oral immunotherapy sessions on sublingual immunotherapy or drops under the tongue for your food. And there's now more and more data and data was presented, including at an oral abstract on epicutaneous immunotherapy for peanuts or the peanut patch.

So those are kind of immunotherapies and I'll talk about precision medicine in the setting of that. And then there's a lot of talk about Omalizumab, or brand name Xolair, which is FDA approved for food allergy.

And the most recently published data, which is from stage three of the outmatch study of natural. Not only can Xolair increase the amount of food it takes for you to have an allergic reaction, so it protects you from accidental exposures.

There now may be an opportunity to start someone on Xolair, introduce their food allergen and even pull the Xolair and they can continue to consume a certain amount of their food allergen.

I mean,

that's fascinating.

So some of that data was Also presented in the world of immunotherapy. We have a lot to learn about precision medicine. We have a lot to do get better at.

But what really, really I heard a lot of at this meeting was the importance of starting immunotherapy for food allergens at a young age.

Age being a huge predictor of not only success, but side effects.

That theme came up over and over again, regardless of whether it was oral immunotherapy where your child is consuming the allergen, or even epicutaneous apenant patch.

Age as being a real marker of success and tolerability of these therapies. And that is exciting and it's a little bit anxiety provoking for me because access to allergists can be very limited.

Wait times can be long and age is time sensitive.

So a lot of talk about that kind of tying it in with your precision medicine.

Caroline: And so with those therapies, they have to be done by an allergist. Right. So a person cannot go to just either general PCP or pediatrician.

Shahzad: Well, that's a fantastic question to date, for sure. Oral immunotherapy and sublingual immunotherapy that require frequent office doses for updosing are done by an allergist. And there's an argument to be made that should always be done by an allergist.

Just to be provocative or there is a discussion. Access to allergists is limited. Many allergists don't have the ability to have these frequent appointments.

Even when you have access. The frequency appointments is a big demand, not only for the patients, but and the families, but for the clinician.

With the hopeful approval of epicutaneous peanut oral immunotherapy or the peanut patch,

where the family or the child will be doing a patch daily, there may be an opportunity. I still think everyone with a true fruit allergy deserves to see an allergist.

But for some of this care to transition back to primary care, I'm not saying that's the right answer.

There's people who would probably get very upset at me for even suggesting it as a possibility.

But allergists, you know, we talk about this with penicillin allergy, Caroline. And there's 30 million people in America who think they're allergic, but 95% aren't. And we want to try to tell them if they're not allergic because penicillin remains the best antibiotic on the planet.

Allergists can't do that alone. There's just too many Patients and not enough of us.

So I really do think we need to partner and couple with our primary care community, particularly pediatricians. Now, what that looks like, I have no idea. It's complicated.

But I think that conversation's gonna happen.

Caroline: Wow. Lots of exciting things here.

So now, looking at the patient,

were there any moments or important pieces of information that you would like families to explore with their allergist? So anyone listening today, if they were gonna see their allergist in the next couple of months, is there anything that they could bring up and say, hey, I heard, or is there anything that you think that they should just consider in general in their life and then bring that back to their physician?

Shahzad: Yeah, I think right now there's a phrase that comes up a lot at these meetings, Carolyn. Shared decision making.

It's essentially choices.

Everyone with a food allergy should know there are choices for therapy or management, let's say. And one of those choices is avoidance. That's perfectly appropriate. If avoidance works for you, that's great.

But there are therapeutic choices. There's also choices in what form of epinephrine you want to carry.

Right. We know there's intramuscular epinephrine, FDA approved injections, but there's FDA approved intranasal epinephrine, too.

And other types of delivery systems are being actively studied and may be available as soon as within a year or so. So I think choices is the key here.

Everyone with a food allergy historically avoided the food and had an intramuscular epinephrine auto injector. That's not true. That's antiquated. That's very passive. I encourage families to have conversations with their allergists about what are the appropriate choices for them, for them, their family, their child,

what are the appropriate management choices? And then you get to pick. There's no right or wrong. And this is where precision medicine and individual choice is so important.

Caroline: Okay, so circling back to the precision medicine and the shared decision making, those look like those go hand in hand. Can you discuss this some more?

Shahzad: Yeah. So precision medicine is. I'm trying to understand the individual more than a population and tailor treatment to them.

We have a lot to learn in this space. For most disease states, we are getting better, but we have a lot to learn.

Shared decision making is. Me as the clinician. I give you the information you need to make the right decision for your value system.

All right? These are the pros and cons of the choices you have and that you get to pick. Some people will pick one thing, some People will pick another thing.

No one's right, no one's wrong. We all bring our own value goals, our old value systems, our own risk aversion to the, to the table.

So precision medicine is kind of tailoring treatment options and then shared decision making is as a group. I don't tell you what to do, you don't tell me what to do.

We work as this as a team and decide what's best for you. And the beauty of medicine is different families and different patients given the same opportunities will make different decisions.

And that's not wrong. That's, that's great. That's actually the right way to do this.

Caroline: Well, and especially I think this becomes so important when you're dealing with different cultures or even just whether you're living city or rural and your access. It seems that the one size fits all just doesn't even work demographically.

Shahzad: Yeah, no, there's cultures, there's values. Some people are more open to taking risk with treatment. Some people want to minimize pharmaceutical interventions.

Age. I'll go back to age. A one year old with a peanut allergy is very different than an 87 year old with peanut allergy. I think that seems obvious,

but it's the same condition.

So those people are probably going to have very different approaches to management. Right.

And they should, I think.

So it takes in all of these variables that you simply can't account for and it gives you,

it gives space for a discussion and a space for choice and respect for the choice that people end up at.

It's the right way to do things and I will tell you, it can be difficult. It takes a long time.

Some people don't want to really have an active part in the decision making.

Doc, tell me what to do. I think those days are a little bit numbered, but we still get that.

So it's an enjoyable process. It's a great, worthwhile, rich conversation.

And I think the word I would take away from these meetings and in the food allergy space is choice.

Caroline: I love that because that's going to just impact the outcome so much more when everyone's bought in and everyone's working together and there's not any kind of resistance.

You're always so wise. I love this. I love our conversations with you.

So as we come to a close, what final thoughts would you like to share with our listeners?

Shahzad: Yeah, I think the world of food allergy is in an exciting time. There's new therapies that have emerged and we're learning more about em. Like Omalizumab. Or Zolair. We're learning more about that.

We're learning more about oral immunotherapy. There's other emerging therapy. There was research presented on a type of medicine called the BTK inhibitor, which is would be a pill for food allergy that's been approved in chronic hives and the that stuff is being studied in food allergies.

So we've already learned a lot. There's obviously a lot more to learn and it's an exciting time. But I encourage individuals who think they have a food allergy to seek out a conversation with a board certified allergist about their choices for management.

Historically, maybe it was okay to be managing food allergies in the primary care setting, but right now with all this advanced diagnostics, therapies and all these choices, I really do think it's worthwhile seeing an allergist and having a conversation and coming to the decisions that best for you and your family.

Caroline: Once again, brilliant wise words to end on. Thank you so much for your time. You're obviously super busy. You've been gone for days out of the practice and now you're back in.

So thank you so much for spending your time with us today.

Shahzad: Thanks so much for having me.

Caroline: You're welcome.

Before we say goodbye today, I just want to take one more moment to say thank you to Genentech for their kind sponsorship of FAACT's Roundtable Podcast. Also, I want to note that today's guest was not paid by or sponsored by Genentech to participate in this specific podcast.

Thank you for listening to FAACT's Round Table Podcast. Stay tuned for future episodes coming soon.

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