From rising demand for comprehensive IgE profiles to the emergence of molecular allergen diagnostics, laboratories are central to how clinicians prepare for and manage September’s asthma spike.
Interview by Alyx Arnett
As September arrives, so does an annual surge in asthma-related hospitalizations—a phenomenon known as Asthma Peak Week. This period, typically the third week of the month, accounts for nearly a quarter of all yearly asthma admissions.
To help laboratorians and clinicians understand the science behind this spike, Clinical Lab Products spoke with Gary Falcetano, PA, senior manager of global medical and scientific affairs in allergy at Thermo Fisher Scientific. Falcetano explains how allergens intersect with viral infections to create a high-risk season for patients with asthma.
He also highlights the role diagnostic testing plays in pinpointing triggers and how lab professionals can support clinicians in developing personalized management plans for asthma patients.Â
CLP: Why is September often associated with a spike in asthma-related hospitalizations?
Falcetano: This spike is due to a convergence of environmental and viral triggers that can exacerbate asthma symptoms in both children and adults.
First, ragweed pollen—one of the most potent seasonal allergens—reaches its highest levels during this time. Similarly, mold spores increase as leaves begin to fall and decompose. At the same time that these environmental triggers arise, children are returning to school, where exposure to respiratory viruses like rhinovirus, respiratory syncytial virus, influenza, and COVID-19 becomes more likely.
Additionally, perennial indoor allergens such as dust mites and pet dander remain constant triggers and are often overlooked as contributors to baseline or chronic airway inflammation. When these indoor allergens are combined with seasonal and viral exposures, the cumulative effect often leads to poorly controlled asthma and a significant rise in acute episodes requiring hospitalization.
CLP: What role do environmental allergens and respiratory viruses play in worsening asthma symptoms this time of year?
Falcetano: Environmental allergens and respiratory viruses are two of the most significant drivers of asthma exacerbations in the fall, and their impact is often amplified when they occur together. On the allergen side, ragweed pollen peaks in September and is a major seasonal trigger. Approximately 15% of Americans are allergic to ragweed, which contributes to pollen allergies in about 26% of adults and 19% of children nationwide. The plant thrives across many regions, and its pollen can travel up to 400 miles, making avoidance difficult.
In addition, mold spores from decaying leaves and vegetation become increasingly airborne this time of year. For patients with allergic asthma, these exposures can lead to inflammation of the airways, especially if not managed proactively.
Respiratory viruses, on the other hand, can lead to rapid-onset asthma exacerbations by directly inflaming the airway lining, increasing mucus production, and reducing airflow. This is especially concerning in children, who have smaller airways to begin with.
Notably, when patients are exposed to both—for instance, a child returning to school who is allergic to ragweed and also contracts rhinovirus—the inflammatory response can be amplified, leading to more frequent and severe exacerbations.
This is why healthcare providers should consider a dual-prevention strategy:
- Identifying and managing allergic sensitizations
- Encouraging vaccinations and hygiene to reduce viral exposure
Together, this approach helps to break the cycle of inflammation before it leads to hospitalization or loss of asthma control.
CLP: How does diagnostic testing help identify allergic triggers more accurately?
Falcetano: Diagnostic testing provides clinicians with objective data that supports more accurate identification of allergic triggers, something that can be difficult to achieve through patient history alone. Understanding exactly which allergens a patient is sensitized to is critical in guiding targeted management, such as avoidance strategies, environmental control measures, and decisions around immunotherapy.
For labs, offering robust and regionally relevant allergen profiles ensures clinicians have the precise information needed to tailor care. When patients understand their triggers, they’re more likely to engage with their treatment plans, avoid unnecessary medications, and reduce the risk of uncontrolled symptoms or exacerbations.
Ultimately, diagnostic testing enhances clinical confidence, improves decision-making, and helps drive better outcomes for patients with allergic asthma or rhinitis.
CLP: What tests are most commonly used to detect sensitization to environmental and respiratory allergens in clinical labs?
Falcetano: The most commonly used tests in clinical laboratories to detect environmental and respiratory allergens are specific Immunoglobulin E (IgE) blood tests.
Specific IgE blood tests allow clinicians to detect sensitizations to a broad profile of allergens—both seasonal and perennial. Advanced laboratory platforms, such as Thermo Fisher’s Phadia Laboratory Systems, offer high-quality, reliable specific IgE testing with comprehensive respiratory allergen profiles tailored to specific geographies. This enables efficient and precise identification of relevant triggers and supports informed clinical decision-making.
Together, these diagnostic tools help clinicians develop more personalized treatment plans and improve allergy and asthma management through accurate allergen identification.
CLP: How can lab professionals support clinicians in developing personalized management plans for asthma patients?
Falcetano: Lab professionals play a critical role in supporting clinicians by providing accurate and timely diagnostic data that informs personalized asthma management plans. By ensuring high-quality testing and clear reporting of allergen sensitization profiles, labs enable clinicians to pinpoint the specific environmental and respiratory triggers affecting each patient.
Using advanced testing platforms, labs can deliver comprehensive profiles that cover a broad spectrum of seasonal and perennial allergens relevant to the patient’s geography. This detailed information helps clinicians tailor avoidance strategies, select appropriate immunotherapies, and adjust medication plans to better control asthma symptoms.
Additionally, lab professionals can assist by collaborating with clinicians to interpret complex test results and offering guidance on best practices for testing protocols. This partnership helps optimize patient outcomes by supporting targeted, evidence-based treatment approaches.
CLP: Are you seeing changes in testing demand or patterns during peak allergy and asthma seasons?
Falcetano: Yes, testing demand often increases significantly during peak allergy and asthma seasons, particularly in late summer and early fall. As patients and clinicians become more aware of seasonal triggers like ragweed pollen and molds, there’s typically a surge in requests for specific IgE blood tests to identify relevant allergens.
Clinicians often use these test results to prepare personalized management plans ahead of high-risk periods, such as Asthma Peak Week in September. Additionally, labs may notice a shift toward more comprehensive allergen profile testing during these times, reflecting the need to evaluate multiple potential triggers simultaneously.
This seasonal fluctuation underscores the importance of efficient lab workflows and timely reporting to support proactive patient care when the risk of exacerbations is highest.
CLP: What role does patient education and adherence play in reducing severe asthma outcomes?
Falcetano: Patient education and adherence to prescribed treatment plans are fundamental to reducing severe asthma outcomes. Understanding the nature of asthma, its triggers, and how to manage symptoms empowers patients to take control of their condition proactively.
Through education, patients learn to detect warning signs of asthma exacerbations and understand how to stay away from substances that trigger their allergies and respiratory viruses. The regular use of controller medications proves essential because it addresses airway inflammation and decreases both the number and intensity of asthma attacks.
Adherence, however, remains a challenge. Research indicates that often patients stop following their medication instructions when they experience no symptoms during the summer months. The practice of not taking medication properly results in uncontrolled asthma when seasonal triggers become active during the fall season.
HCPs, together with their care teams, need to stress the necessity of regular medication use and correct inhaler practices for patients before Asthma Peak Week arrives. Patients who receive proper asthma education and follow their treatment plans can successfully prevent acute visits and even hospitalizations while maintaining improved lung function.
CLP: What advancements in allergy and asthma diagnostics could improve patient care in the coming years?
Falcetano: Molecular diagnostic techniques now enable HCPs to detect individual allergen proteins in addition to complete allergen extracts. The identification of specific allergen proteins through these methods enables clinicians to be even more precise in their diagnoses and to potentially even predict the severity and development of disease.Â
For example, many laboratories now offer pet molecular allergen components as a reflex test following positive whole allergen-specific IgE results for dog, cat, or horse dander. These pet allergen components can help to differentiate between irrelevant cross-reactivity and primary allergies to a particular species. They also can help with pet selection, such as whether a female dog will be better tolerated than a male dog by an individual patient, and even assist specialists with better developing immunotherapy prescriptions.
Remote monitoring tools and digital health technologies will expand their influence in healthcare systems. The combination of wearable devices and mobile applications that monitor environmental exposures and symptoms and medication usage enables clinicians to receive immediate patient data for developing customized asthma treatment plans.
The advancement of laboratory automation systems, together with data analytical capabilities, will boost testing speed while enabling laboratories to generate quicker results that lead to better decisions.
ID 26214556 © Gardendreamer | Dreamstime.com
