I’ve not heard much about functional approaches for asthma. Obviously, it’s inflammatory in nature, but have you found any common patterns in asthma patients that could guide assessment and treatment?

Dr. Amy Nett:  I would say I haven’t actually had a patient who has come only for asthma. I have patients who have asthma as part of their presentation, and I don’t know that I can say there is a common pattern other than just being kind of an “allergic” patient in general. There you might start thinking about something such as mast cell activation syndrome. Mast cell activation syndrome, again, I don’t really think of it as necessarily a diagnosis or an answer in and of itself because even there you’re saying, well why is there like an inappropriate mast cell response? Whenever it’s asthma, you’re right. You need to think about there is an immune imbalance because it’s inflammatory, but you also think an immune imbalance because this is generally—it can be associated with immunoglobulin imbalances. No common patterns that I think of. I see it frequently, but it’s always part of another picture, and what that picture is varies quite a bit.