Geoffrey Chupp, MD, Yale School of Medicine

Patients taper their own inhalers, and payers approve on exacerbations alone. The panel closes on where the evidence runs out and where documentation and advocacy take over.

With an anti-alarmin option that does not require a biomarker, selection could have become simpler. Dr. Hanania explains why it stays multifactorial, and why he waits before judging response.

Clinicians define control as no exacerbations and no hospital stays. Dr. Ross argues patients define it differently, and that the gap between the two should drive treatment decisions.

Evidence places biologics at GINA Step 5, and that is where reimbursement holds them. Dr. Hanania and Dr. Wechsler examine the case for moving earlier, and what it would require.

Seven approved agents across four targets, spanning two decades of approvals. Dr. Wechsler maps the class, then names the 40% of exacerbations it still does not prevent.

Biologics have displaced a procedure that once filled the fellowship schedule. The panel weighs what replaced aspirin desensitization, and how sinus surgery rates changed with it.

Not every patient with nasal polyps is allergic, and no test reliably separates those who are. The panel discusses how referral patterns skew what each specialist believes.

Anatomy separated the sinuses from the lungs, and specialty training reinforced the split. The panel makes the case that the evidence describes a single organ with one disease process.

The assumption that anti-alarmin therapy is the answer for low T2 disease meets the trial evidence. Dr. Wechsler walks through where the efficacy signal actually concentrates.

Alarmins are now leading therapeutic targets, yet no biomarker measures them. Dr. Hanania explains what blocking TSLP reveals downstream, and where the real measurement gap lies.

Dr. Wechsler and Dr. Ross describe how they read overlapping results and what they weigh when no single marker dominates.

A treatable trait is easier to endorse than to define. The panel works through what qualifies, and why extrapulmonary traits deserve the same attention as the airway itself.

Phenotype, endotype, and treatable trait are used loosely and often interchangeably. The panel defines each term and tests where the boundaries between them break down.

One cytokine sits above the rest. Dr. Hanania explains why TSLP earns the label of master regulator, and why blocking it reaches inflammation that current therapies cannot.

The airway epithelium is no longer understood as a passive wall. The panel traces how a barrier is now thought of as an immune organ, and what that shift means for severe asthma.