AAAAI Secretary-Treasurer Candidates on Their Initiatives for the AAAAI and the A/I Specialty

Secretary-Treasurer candidates, whom if elected eventually ascend to become AAAAI President, answered a series of questions to provide you with a deeper understanding of their goals for the AAAAI as an organization.

This year’s candidates are:

Stuart L. Abramson, MD, PhD, AE-C, FAAAAI, Director of Allergy and Immunology Services at Shannon Clinic/Medical Center in San Angelo, Texas. He is also an Affiliate Clinical Professor at Texas A & M University Naresh K. Vashisht College of Medicine.

Mariana C. Castells, MD, PhD, FAAAAI, is Founder and Director of the Brigham and Women’s Hospital and Dana Farber Cancer Institute Drug Hypersensitivity and Desensitization Center. She is also a Professor of Medicine at Harvard Medical School.

If elected, describe your major initiative and your plans to achieve it. What would be your overall presidential theme and why would you consider this to be important?

Stuart Abramson: Building Success in A/I Advocacy – In clinical care, education and research, advocacy is an area where we can make an impact at a variety of levels – local, county, state and national. All these levels of advocacy in our specialty can make a difference for our patients. Such efforts can affect how well we can deliver care, educate new specialists and prepare for the future by bringing in new clinicians, educators, researchers and combinations thereof to enable advances in our field via new research discoveries and their clinical implementation. I would like to see the AAAAI lead the way in training members for advocacy and mobilize our membership via engagement with lay groups, communities, or with academia, to address some of the most pressing issues in these three areas in our specialty: clinical care, education and research. Albeit a broad initiative, the focus first will be to train members in advocacy methods, then to subsequently hone in on some of the most pressing specific issues facing our field.

Mariana Castells: My initiative would be “Allergy Frontiers in Drug Allergy and Mast Cell Disorders: Patients, Providers and AI.” The allergy field is recognized for its impact in asthma and other diseases, yet drug allergy and mast cell disorders have remained orphan areas. I propose to promote clinical guidelines, research, teaching materials and practical seminars to improve clinical practice and educate allergists, PAs and nurses and to facilitate a conversation to incorporate artificial intelligence. I will work with AAAAI leadership and members to address the visibility of all allergic diseases and improve patient care and quality of life.

The field of allergy/immunology faces a number of challenges and opportunities. A) What would be an example of a particularly important problem or challenge to our field, and how would you address it?

Stuart Abramson: Vaccination programs - One area I feel is of particular importance to the health and well-being of our population is the understanding of the evidence-based medicine regarding vaccinations. This is an area that we should be very concerned about and in which we have expertise as allergist/immunologists. Along with our infectious disease colleagues, I believe that we need to address the science behind all major vaccinations needed from infancy on that are needed to optimally protect the public from preventable diseases and attenuate the severity of others. We need to support ongoing studies to determine further the prevalence of side effects relative to the benefits of vaccination and bring to light what degree of immunity can be achieved. We need to raise awareness of the potential problems that immunodeficient patients as well as unvaccinated individuals may encounter if they are around unvaccinated persons.

Mariana Castells: Pieces of our specialty are taken by other specialties such as dermatology, pulmonology, ENT and gastroenterology, and yet our specialty is the best positioned to alleviate human suffering from allergic and immune diseases by early diagnosis and using state of the art treatments from monoclonal antibodies to food avoidance and oral immunotherapy. The looming threat of allergy specialty extinction has been a common theme of discussion. How viable is our specialty? Are we really necessary? Are insurance companies convinced of our value? To demonstrate our value and critical importance in public health and among medical specialties, it is of paramount importance to increase the awareness of our specialty and the outcomes of allergy treatments across pediatric and adult patients regarding an increase in quality of life and life expectancy. Avoiding extinction requires short- and long-term planning and developing a clear identity for our specialty, whether providing guidance for drug delabeling, desensitizations, food oral immunotherapy, diagnosis and management of mast cell activation disorders, or treatments for allergic rhinitis, severe asthma, atopic dermatitis and other allergic conditions.

B) Give an example of an opportunity for the subspecialty of allergy/immunology and how this could be utilized to advance the specialty?

Stuart Abramson: I feel that there are tremendous opportunities now and in the near future to utilize artificial intelligence (AI) modalities to assist us in better caring for our patients. Personalized medicine includes dealing with individual barriers to adherence as well as understanding the individual molecular basis for adequate or inadequate responses to treatments. I believe that we need to consider AI where it can assist in monitoring patients, providing information and suggestions, adding to diagnostic and treatment plans, as well as communicating with patients in the context of our specialty care. This could help advance our effectiveness in outcomes but we must be vigilant and provide input regarding the accuracy of AI tools being used.

Mariana Castells: The COVID-19 pandemic created an opportunity for virtual visits and more personalized allergy services. Over the last five years I have been conducting virtual visits for new and follow-up patients for drug allergies, mast cell disorders and other allergic disorders with extreme patient satisfaction. The ability to use new technologies, AI and virtual visits will facilitate access to the specialty for the general population, including patients in remote locations, and help the specialty remain viable. Telemedicine can be used frequently in checking symptoms and management options for patients who are too young or old to travel easily. One area that could thrive is delabeling the 20% of the population who believe they are penicillin allergic, focusing on high-risk populations such as pregnant women or patients with cancer requiring bone marrow or stem cell transplant so these patients can see an allergist without being exposed to hospital or clinic environments. This new modality of patient to physician interaction is here to stay, and we must see this as an opportunity to amplify the allergy specialty reach.

Why do you want to be President of the AAAAI?

Stuart Abramson: The AAAAI is my professional home, and I value this immensely. The AAAAI Annual Meeting is my favorite meeting of the year (I have not missed one since 1989 – 37 meetings in a row) and always look forward to reconnecting with many friends and colleagues from across the US and beyond. I truly appreciate the educational programming that takes place every year, but also via opportunities throughout the year sponsored by AAAAI. I want to see the efforts led by the AAAAI in clinical care, education and research succeed and feel that I have the dedication, enthusiasm, knowledge and skills to guide our organization – along with our outstanding EDI staff, Board of Directors and volunteers – on the right path to fulfill our mission. I would like the opportunity to serve in this leadership role as I feel I am now prepared for the time and effort it will take to be successful. With grown children (ages 28+) on their own ways, an additional partner in my practice and my wife’s support, I am ready for this responsibility.

Mariana Castells: I would be greatly honored to serve as the AAAAI President and promote our incredibly important and fascinating specialty. My first encounter with the AAAAI was in 1984 when I presented my first abstract at the NY annual meeting proposing a new allergy to potato and defining its allergens from a little girl who suffered from asthma when inhaling pollen from potato plants and when eating foods containing potato. The poster was promoted, and I gave a TV interview which allowed me to have a first glimpse at the power of public speaking. The study led to my first publication in The Journal of Allergy and Clinical Immunology (JACI) (Allergy to white potato Castells et al JACI 1986). It has been a privilege and an honor to serve on the AAAAI Board of Directors and to be part of the elite group of allergists who shape our specialty and define our identity in the complex health care system. I would like to contribute to further define our specialty and to continue to promote excellence in clinical practice and research for the next generations.

Click here to learn more about both candidates, read their full Q&A and cast your votes. All ballots must be cast online or postmarked on or before December 31 at 5:00 pm CT.