Download friday, september 30, 2016

CSACI 71ST ANNUAL SCIENTIFIC MEETING
71e RÉUNION ANNUELLE SCIENTIFIQUE DE LA SCAIC
PROGRAM
PROGRAMME
September 28 to October 2, 2016
Du 28 septembre au 2 octobre 2016
Le Westin Montréal
Montréal, Québec
Canadian Society of Allergy and Clinical Immunology
La Société canadienne d’allergie et d’immunologie clinique
REGISTRATION DESK HOURS
FOYER (Outside of MONTRÉAL Ballroom)
Wednesday, September 28
Thursday, September 29
Friday, September 30
Saturday, October 1
Sunday, October 2
15:00-18:00
06:45-17:00
06:45-17:00
06:45-16:00
06:45-12:00
Plan to visit the Exhibit area
and meet the CSACI Sponsors
EXHIBIT DATES AND HOURS (recommended)
Friday, September 30
Saturday, October 1
Sunday, October 2
06:45-15:00
06:45-14:00
06:45-11:00
Have sponsor/exhibitor representatives
initial your “Passport” and enter to
win a (1) $600 gift certificate from Apple!
MEETING LOCATION
Le Westin Montréal
270 rue Saint Antoine Ouest,
Montréal, QC H2Y 0A3
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
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Welcome,
We are very proud to host our 71st meeting of the Canadian
Society of Allergy and Clinical Immunology. This year brings
together an outstanding faculty of Canadian and international
speakers who will share their expertise and insights as they
cover the wide spectrum of clinical and basic sciences.
As the primary Canadian gathering for the allergy community,
it will provide an excellent opportunity for specialists and
researchers in the field of allergy, asthma, and clinical
immunology as well as allied health professionals from Canada
and around the world to meet and share their knowledge in an
atmosphere conducive to medical, scientific and social
interaction.
Have a great meeting!
Dr. Sandy Kapur
CSACI President
SAVE THE DATE
2017 CSACI ASM
October 11-15, 2017
Allstream Center and Hotel X
Toronto, ON
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
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2016 ANNUAL SCIENTIFIC MEETING
PLANNING COMMITTEE
WHY YOU SHOULD ATTEND!
Dr. Sandy Kapur, CSACI President
Dr. Paul Keith, 2016 Program Chair
Dr. David Fischer, CSACI Vice-President, CPD Committee
Dr. Harold Kim, CSACI Treasurer, CPD Committee
Dr. Susan Waserman, CAAIF President, OSCE Chair, CPD
Committee
As the premier meeting of the allergy, asthma and
immunology community, this conference provides
several unique and engaging educational
opportunities for the participant – such as:
Dr. Zainab Abdurrahman, NREP Co-Chair
Dr. Dean Befus, CSACI Board
Dr Jean-Nicolas Boursiquot, 2016 Program Committee
Dr. Edmond Chan, CSACI Board
Dr Hugo Chapdelaine, 2016 Program Committee
Dr. Lori Connors, CPD Committee Chair
Dr. Anne Ellis, FIT Bowl Chair and Abstract Co-Chair
Dr. David Fahmy, FIT Representative
Ms. Linda Kirste, Allied Health Co-Chair
Dr. Jason Lee, Asthma Section Chair
Dr. Sean Mace, Rhinosinusitis Chair
Dr. Doug Mack, Anaphylaxis Chair
Dr. Bruce Mazer, 2016 Program Committee
Dr. Christine McCusker, 2016 Program Committee
Dr. Elaine Medoff, 2016 Program Committee
Dr. Andy O’Keefe, NREP Co-Chair
Dre Marie-Noel Primeau, 2016 Program Committee
Ms. Jo-Anne St-Vincent, Allied Health Co-Chair
Dr. Stuart Turvey, Immunology Chair
Dr. Hari Vliagoftis, Abstract Co-Chair
•
Ms. Louise Tremblay, Executive Director
Ms. Alexi Campbell, Manager
PROGRAM OBJECTIVES
The CSACI Annual Scientific meeting’s main objectives are
to provide current information about the diagnosis,
treatment and management in allergy, asthma and
immunology. This meeting is a setting for interdisciplinary
exchange among professionals and provides an excellent
opportunity for participants to interact with colleagues and
experts in the field. By participating in this conference,
attendees can expect to evaluate new trends, techniques,
therapies and diagnostic procedures in allergy, asthma and
immunology.
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
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Interact with an impressive faculty of Canadian
and international speakers;
Network with colleagues across settings and
disciplines;
Translate scientific discoveries into your practice;
Learn about policy issues that directly affect you;
Raise questions, debate the issues, plan follow-up
studies, and discuss results;
Discuss your own research and observation;
Meet with poster presenters to learn about their
research objectives; and
Visit a number of exhibit booths featuring
products and services specifically designed for
professionals in allergy, asthma and immunology.
TARGET AUDIENCE
The CSACI Annual Scientific meeting is intended for
clinicians, researchers, trainees/students, and allied
health professionals involved in research, treatment
and management of diseases in allergy, asthma and
immunology.
CSACI MISSION AND VISION STATEMENT
The mission of the Canadian Society of Allergy and
Clinical Immunology is the advancement of the
knowledge and practice of allergy, clinical
immunology, and asthma for optimal patient care. The
Society is also dedicated to improving the quality of
life of people with allergies through research,
advocacy, continuing professional development and
public education.
EVALUATIONS
Delegates can provide feedback on Annual Meeting
Sessions they attend by using the Annual Meeting app
or by visiting the CSACI website.
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ANNUAL GENERAL MEETING
DISCLOSURE
All CSACI members are invited to attend the CSACI
and CAAIF AGMs
Friday, September 30, 2016
1415-1515
Montréal Ballroom
Faculty and Moderator Disclosure:
Current CME guidelines state that participants in should be
aware of any affiliation or financial interest that could
affect the speaker’s presentation(s). Faculty and
moderators have completed conflict of interest
declarations and those potential conflicts will be listed in
the announced at the beginning of each session.
Participants will be eligible to win a prize!
ACCREDITATION - (Section 1 & Section 3)
This event is seeking approval for an accredited
group learning activity (Section 1 & Section 3) as
defined by the Maintenance of Certification Program
of the Royal College of Physicians and Surgeons of
Canada.
Please refer to the final program for accredited
sessions.
AMA PRA Category 1 Credit™
Through an agreement between the Royal College of
Physicians and Surgeons of Canada and the
American Medical Association, physicians may
convert Royal College MOC credits to AMA PRA
Category 1 Credits™. Information on the process to
convert Royal College MOC credit to AMA credit can
be found at:
www.ama-assn.org/go/internationalcme.
CERTIFICATE OF ATTANDANCE
All participating delegates will receive an email
containing their “Certificate of Attendance”
following the meeting.
PROGRAM CHANGES AND
CANCELLATIONS
Please note: The CSACI reserves the right to
substitute faculty or to cancel or reschedule sessions
because of low enrollment or other unforeseen
circumstances.
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
The intent of this disclosure requirement is not to prevent a
speaker with a conflict of interest from making a
presentation but to make known the relationship, in
advance, to the audience. It is intended that any conflict be
openly identified so that with full disclosure of the facts,
attendees may form their own judgments about the
presentation.
In addition, all members of the annual scientific program
committee have also completed their declaration and have
announced at each teleconference or meeting any financial
interest in commercial organizations that may have a direct
or indirect interest in the subject matter of his/her
presentation. A “financial interest” may include, but is not
limited to, being a direct shareholder in the organization;
being on retainer with the organization; or having research
or honoraria paid by the organization. An “affiliation” may
be holding a position on an advisory committee or some
other role of benefit to a sponsoring organization.
DISCLAIMER
The material presented at this meeting represents the
opinion of the speakers and not the views of the CSACI.
Attendees participating in this medical education program
do so with full knowledge that they waive any claim they
may have against the CSACI for reliance on any information
presented during these educational activities. The CSACI
does not guarantee, warrant or endorse any commercial
products or services.
PLEASE NOTE THAT BREAKFASTS AND
LUNCHES WILL BE SERVED BOTH ON
THE 9TH AND 11TH FLOORS.
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VISIT OUR 2016 SPONSORS AND EXHIBITORS
The CSACI meeting has proven to be a great opportunity for a collegial interchange of ideas and product
information between physicians and our corporate partners. The exhibit area is the exclusive room for
meals and breaks. The exhibiting companies and organizations will provide you with the latest information
on products and services available to physicians, researchers and allied health professionals in the field of
allergy/immunology. For more information on exhibiting companies and organization, please look at the
Annual Meeting app.
Don't miss the opportunity to participate in the CSACI Passport Program. Pick
up your passport at the CSACI Registration Desk; then visit our participating
sponsors and exhibitors, and have your passport signed. Drop off your
completed passport at the registration desk.
You will be entered to win some really
great prizes, including
one (1) $600 gift card from Best Buy!
PLEASE NOTE THIS MEETING
IS FRAGRANCE FREE
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
APP QR CODE
Sponsored by Stallergenes
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CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
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CSACI SOCIAL EVENTS
The CSACI will be holding two social events that will provide you with an opportunity to connect with
fellow delegates in a more relaxed environment. This includes the opening reception to be held on
Friday, September 30 from 18:30 to 20:00. Dr. Sandy Kapur will present plaques to our corporate
partners.
On the evening Saturday October 1, the CSACI Executive and Board will be hosting the CSACI dinner.
Prizes will be presented for the best posters and awards to pay special homage to our speakers and
exemplary CSACI members for their outstanding achievements in the allergy, asthma and immunology
field.
CAAIF Inaugural Gala
CAAIF’s Inaugural Gala, to be held on Thursday, September 29, 2016 from 19:00 to 22:00 (Ruelle des
Fortifications, inside the World Trade Center) to help raise funds to further research into the causes,
prevention and treatment of allergic diseases and to educate health care professionals, patients and
the public about the advances in research and treatment.
Follow the CSACI Annual Meeting on Twitter
While you’re in Montréal, use
#CSACI16 when you tweet to
participate in onsite
conversations & share what
you’re learning with your
colleagues
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
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WEDNESDAY, SEPTEMBER 28, 2016
1530-1645
Riopelle
ROYAL COLLEGE SPECIALTY COMMITTEE MEETING (closed)
Chair: Dr. Fanny Silviu-Dan
1600-1730
Victoria
CAAIF BOARD MEETING (closed)
Chair: Dr. Susan Waserman
1800-2130
Victoria
CSACI DINNER & BOARD MEETING (closed)
Chair: Dr. Sandy Kapur
1830-2000
St-Jacques
NREP DINNER & MEETING (closed)
Chairs: Dr. Zainab Abdurrahman & Dr. Andy O’Keefe
2100-2230
Grande Place
FIT|NREP|ALLERGEN|CSACI PROGRAM DIRECTORS NETWORKING RECEPTION
Chair: Dr. Anne Ellis
THURSDAY, SEPTEMBER 29, 2016
0715-0800
Ste-Hélène
FIT OSCE BREAKFAST & ORIENTATION
Chairs: Dr. David Fahmy, Dr. Jaclyn Quirt & Dr. Michael Fein
0715-0800
St-Jacques
OSCE EXAMINERS BREAKFAST & ORIENTATION
Chairs: Dr. Susan Waserman & Dr. Bill Moote
0810-1000
Fortifications
OSCE CONCURRENT SESSIONS
Chairs: Dr. Susan Waserman & Dr. Bill Moote
0900-1200
CONCURRENT SESSIONS
TRAINEE CAREER DEVELOPMENT WORKSHOP
Chair: Dr. Harissios Vliagoftis
Talking It Up Without Dumbing It Down
Speaker: Jocelyne Whitehead, McGill University
Palais
OBJECTIVES:
By the end of these sessions participants will be able to:
Discuss your research and other complicated topics for a variety of audiences from
job interviews to friends and family.
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
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THURSDAY, SEPTEMBER 29, 2016
1000-1100
St-Jacques
PROGRAM DIRECTORS COMMITTEE MEETING
Chair: Dr. Lori Connors
1000-1330
Ste-Hélène
FIT WORKSHOP (restricted to Fellows-in-Training)
Chairs: Dr. David Fahmy, Dr. Jaclyn Quirt & Dr. Michael Fein
OBJECTIVES*:
By the end of these sessions participants will be able to:
1000-1030
Victoria
Introduction to Immunotherapy
Speaker: Dr. Harold Kim, Kitchener, ON
Objectives*:
• Discuss Types of immunotherapy available
• Review Indications, contraindications and efficacy
• Discuss Options for scheduling including pre-seasonal dosing
1030-1130
Victoria
Case Based Sessions
Speakers: Dr. David Fahmy, Hamilton, ON, Dr. Jaclyn Quirt, Hamilton,
ON & Dr. Harold Kim, Kitchener, ON
Objectives*:
• Discuss practical aspects of ordering subcutaneous immunotherapy
• Define indications and contraindications of immunotherapy
• Discuss practical aspects ordering of sublingual immunotherapy
1130-1230
Ste-Hélène
Lunch & FIT Election
1230-1330
Ste-Hélene
St-Jacques
and McGill
Financial Management, Case Based Sessions
Speakers: Ms. Jessica Raphael, Mr. Joseph Bakish and Mr. Morris Jacobson
(Richardson GMP Montréal office)
PARTICIPANTS WILL BREAK OUT IN THREE ROOMS FOR GROUP
DISCUSSIONS
1200-1230
Montréal
SPONSORED LUNCH
1230-1330
Montréal
LUNCHEON SYMPOSIUM
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
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THURSDAY, SEPTEMBER 29, 2016
1345-1400
Montréal
1400-1810
Montréal
ABSTRACT ORAL PRESENTATIONS
By the end of this session participants will be able to:
• Describe Canadian allergy and immunology research endeavours
CSACI
Eiman Al-Selahi
T-cell receptor rearrangement, peripheral blood eosinophilia, and
solid tumors
AllerGen
Raphael Hanna
Cord blood dendritic cell profiles and year one atopic
manifestations in the Canadian Healthy Infant Longitudinal
Development (CHILD) Study
AllerGen
Marylin Desjardins
The interleukin-4 (IL-4) & interleukin-21 (IL-21) in vitro assay
distinguishes patients with more non-infectious complications of
Common Variable Immunodeficiency (CVID)
IMMUNODEFICIENCY CANADA SYMPOSIUM ON PRIMARY IMMUNODEFICIENCY
Chairs: Françoise Le Deist, CHU Sainte-Justine, University of Montreal and
Christine McCusker Montreal Children’s Hospital, McGill University Health Centre
Sponsored by:
1400-1405
1405-1430
1430-1455
Introduction and Welcome
Chaim M. Roifman. The Hospital for Sick Children, University of Toronto,
Toronto, ON
OBJECTIVES FOR ALL SESSIONS:
By the end of these sessions participants will be able to:
Michael Keller, Children’s National Medical Center, Washington, DC
Virus-specific T-cell therapy for treatment of SCID and related primary
immunodeficiency disorders
• Explain the methodology of adoptive T-cell therapy as treatment for
viral infections in patients with PI Disorders
• Discuss clinical results of recent and current trials of virus-specific T-cell
therapy
• Discuss current advances in virus-specific T-cell therapy, including third
party banking, new viral targets and genetically modified T-cells
Elie Haddad, CHU Ste-Justine, University of Montreal, Montreal, QC
Immune reconstitution after transplantation in SCID
• Describe the kinetics of immune reconstitution after Transplantation for
SCID
• Explain the impact of immune reconstitution on survival and quality of
life
• Delineate the factors that may influence the immune reconstitution
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
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THURSDAY, SEPTEMBER 29, 2016
1400-1810
IMMUNODEFICIENCY CANADA SYMPOSIUM ON PRIMARY IMMUNODEFICIENCY
Cont’d
OBJECTIVES FOR ALL SESSIONS:
By the end of these sessions participants will be able to:
1455-1515
Stuart Turvey, BC Children’s Hospital, University of British Columbia,
Vancouver, BC
Finding new human immunodeficiencies: JAK1 gain-of-function causes a novel
autosomal dominant immune dysregulatory and hypereosinophilic syndrome
• Idenitfy that next generation sequencing is accelerating the discovery
of new human primary PI
• Summarize the clinical presentation and treatment options for patients
with JAK1 gain-of-function mutations
• Recognize the value of molecularly-targeted "precision Immunology"
1520-1605
Lightning Talks
Chairs: Peter Dent, McMaster University and Kyla Hildebrand, UBC
1520-1535
Hani Hadi1 1Department of Allergy, Asthma and Immunology, Children’s
Mercy Hospital and Clinics, Kansas City, MO, Could it Have Been Avoided?
HSV Encephalitis Secondary to a TLR Defect
• Discuss innate immune deficiencies, in particular Toll-Like-Receptor 3
(TLR-3) deficiency in patients with severe herpes simplex virus
infections.
Guilhem Cros1, Roxane Labrosse1, Isabel Fernandez1, Françoise Le Deist1, Éric
Fortin1, Elie Haddad1 1CHU Sainte-Justine, University of Montreal, Montreal,
QC Refractory auto-immune uveitis, successfully treated by sirolimus as an
autoimmune manifestation of an hemizygous FoxP3 mutation
• Discuss genetic testing of patients with early-onset type 1 diabetes and
other autoimmune manifestations.
Yael Dinur Schejter1, Brenda Reid1, Daniele Merico3, Chaim M. Roifman1,2
1
Division of Immunology and Allergy, Department of Pediatrics; 2Canadian
Centre for Primary Immunodeficiency; The Hospital for Sick Children,
University of Toronto; 3Deep Genomics, University of Toronto, Toronto,
Ontario, Novel mutations in the RNU4ATAC gene define obligatory domain
changes for Roifman Syndrome
• Discuss distinct clinical and genetic aspects of Roifman Syndrome.
1535-1550
1550-1605
1605-1620
BREAK
1620-1635
Adam Byrne1, Reza Alizadehfar1, Christine Lejtenyi1, Bruce Mazer1, Christine
McCusker1 1Division of Pediatric Allergy and Immunology, Department of
Pediatrics, Montreal Children’s Hospital, McGill University Health Center,
Montreal, QC Treatment of Idiopathic Pneumonia Syndrome PostHematopoietic Stem Cell Transplant with Etanercept and Rituximab in a
STAT3-deficient Hyper-IgE Patient
• Explain the treatment of patients with Hyper-IgE Syndrome and the
complications of hematopoietic stem cell transplant in this group.
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
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THURSDAY, SEPTEMBER 29, 2016
1400-1810
IMMUNODEFICIENCY CANADA SYMPOSIUM ON PRIMARY IMMUNODEFICIENCY –
Cont’d
OBJECTIVES FOR ALL SESSIONS:
By the end of these sessions participants will be able to:
1635-1650
1650-1705
1705-1720
1720-1735
1735-1750
1750-1805
Hannah Roberts1, Stuart Turvey1 1Division of Allergy and Clinical Immunology,
Department of Pediatrics, University of British Columbia, BC Children’s
Hospital, Vancouver, BC, Activated PI3K-delta syndrome is a novel
immunodeficiency caused by a gain-of-function mutation in PIK3CD
• Utilize a case presentation to strengthen knowledge on Activated PI3Kdelta.
Willa Liao1, Chaim M. Roifman1,2 1Division of Immunology and Allergy,
Department of Pediatrics; 2Canadian Centre for Primary Immunodeficiency;
The Hospital for Sick Children, University of Toronto, Toronto, ON A novel
mutation in LIG4 leading to severe combined immunodeficiency, eczema,
failure to thrive and microcephaly.
• Describe the unique clinical presentation and histological findings of an
infant with a novel LIG4 mutation.
Victoria Cook1, Connie L. Yang2, Anna F. Lee3, Kyla J. Hildebrand1, Anne
Junker1, Stuart E. Turvey1 1Division of Clinical Immunology and Allergy,
Department of Pediatrics; 2Division of Respirology, Department of Pediatrics;
3
Department of Pathology and Laboratory Medicine; University of British
Columbia, Vancouver, BC Interstitial Lung disease in infancy: An unusual
presentation of CD40 ligand deficiency
• Identify interstitial lung disease as a possible presenting feature of
primary immunodeficiency.
Roxane Labrosse1, Guilhem Cros1, Hélène Decaluwe1, Colette Deslandres2,
Françoise Le Deist1, Isabel Fernandez1, Elie Haddad1 1Division of Clinical
Immunology & Rheumatology, Department of Pediatrics; 2Division of
Gastroenterology, Pediatric Department; CHU Sainte-Justine, University of
Montreal, Montreal, QC Neonatal Chronic Granulomatous Disease with
Severe Multisystemic Inflammatory Involvement
• Discuss very early-onset inflammatory manifestations in chronic
granulomatous disease.
Andrew O’Keefe1, Alison Haynes1, Lesley Turner1, Paul Dancey1 1Division of
Pediatrics, Faculty of Medicine, Memorial University, St. John's, NL.
Primary Immunodeficiency's grand masquerade: Leukocyte adhesion
deficiency type 1 presenting with pyoderma gangrenosum
• Analyze the breadth of presentation of primary immunodeficiency
diseases.
Alexandra Langlois1, Reza Alizadehfar1, Bruce Mazer1, Christine McCusker1
1
Division of Pediatric Allergy and Immunology, Department of Pediatrics,
Montreal Children’s Hospital, McGill University Health Center, Montreal, QC
Multiple intestinal atresia with combined immune deficiency: a case report
• Recognize multi systemic involvement in a patient presenting with
intestinal atresia and immunodeficiency.
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
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THURSDAY, SEPTEMBER 29, 2016
1400-1810
IMMUNODEFICIENCY CANADA SYMPOSIUM ON PRIMARY IMMUNODEFICIENCY –
Cont’d
1805-1810
1900-2200
World Trade Center
Abstract winners (presented by Chaim Roifman and Richard Thompson)
Best abstract –
2nd place best abstract –
3rd place best abstract –
CAAIF INAUGURAL GALA
(5 minute walk from Le Westin)
FRIDAY, SEPTEMBER 30, 2016
0700-0730
9th and 11th floor
BREAKFAST
(Participants pick up their food and proceed to either Montréal or Fortification
Ballrooms)
0730-0830
Montréal
BREAKFAST SYMPOSIUM
(Speaker presentation broadcasted simultaneously in Fortification Ballroom)
0840-0900
Montréal
ABSTRACT ORAL PRESENTATIONS
By the end of this session participants will be able to:
Objectives*:
• Describe Canadian allergy and immunology research endeavours
CSACI
Hani Hadi
AllerGen
Rishma Chooniedass
Likelihood of sensitization to alternate ingredients in
patients evaluated for chocolate allergy
Second chances: reflections on the use of epinephrine
for anaphylaxis
CSACI
Herman Tam
Prescription Patterns of Epinephrine Auto-Injectors for
Treatment of Anaphylaxis in Manitoba Children
AllerGen
Sofianne Gabrielli
CSACI
Marta Ponce
Assessing basophil activation pathways via flow
citometry in the context of food allergy
AllerGen
Bassel Dawod
Examining the role of soluble TLR2 in regulating the
development of food allergy
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
Drug-induced anaphylaxis visits: a 4-year follow-up
study in two Emergency Departments in Montreal
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FRIDAY, SEPTEMBER 30, 2016
0900-1100
Montréal
PLENARY SESSION I – FOOD ALLERGY
Chair: Dr. Bruce Mazer
BY THE END OF THESE SESSIONS PARTICIPANTS WILL BE ABLE TO*:
Objectives*:
0900-0925
Food-protein Induced Enterocolitis
Speaker: Dr. Kirsi Jarvinen-Seppo, Rochester, NY
Objectives*:
• Recognize the clinical presentation of FPIES
• Explain the diagnostic workup for FPIES including differential
diagnosis
• Describe management and natural history of FPIES
0925-0950
Hypereosinophillic Syndromes
Speaker: Dr. Amy Klion, Bethesda, MD
Objectives*:
• Define hypereosinophilic syndrome (HES)
• Classify HES subtypes using the current approach
• Outline therapeutic options for the treatment of HES
0950-1015
Peanut Allergy Cohort - SECTION 3 CREDIT SESSION
Speaker: Dr. Elinor Simons, Winnipeg, MB
Objectives*:
• Discuss existing knowledge regarding the development and
prevention of peanut allergy
• Describe research being undertaken using data from a Canadian
birth cohort study and how it may further our understanding of
peanut allergy diagnosis and prevention
• Interpret how new information will affect recommendations to
families of young children with and without peanut allergy
1015-1040
Markers of Tolerance to Food Allergens
Speaker: Dr. Thomas Eiwegger, Toronto, ON
Objectives*:
• Provide an overview on markers that reflect tolerance
development to food allergens in utero and early in life.
• Provide an overview on what we have learned mechanistically
from oral immunotherapy. To clarify terminology such as
desensitization, sustained unresponsiveness and tolerance
development.
• Discuss natural tolerance development in previously food allergic
individuals, what we can learn from these patients and in vitro
markers that may help us to predict tolerance development in vivo.
1040-1100
DISCUSSION PERIOD
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
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FRIDAY, SEPTEMBER 30, 2016
1100-1120
St-Antoine &
Ville Marie
Montréal
NUTRITION & NETWORKING BREAK
9th Floor and 11th floor
1130-1230
INTEREST SECTION BREAKOUT MEETINGS & ABSTRACT ORAL PRESENTATIONS
BY THE END OF THESE SESSIONS PARTICIPANTS WILL BE ABLE TO*:
Objectives*:
Discuss current issues in specialty topics in Allergy and Clinical Immunology
Fortifications
Anaphylaxis & Adverse Reactions
Chair: Dr. Doug Mack
Topic: Oral Immunotherapy and its readiness for allergist clinical practice.
Objectives*:
Review recent literature surrounding oral immunotherapy
Discuss the application to allergist clinical practice
CSACI
Victoria Cook
Needs assessment for allergy education mobile app: Review of
patient, parent and physician views
CSACI
Victoria Cook
A Systematic Assessment of mHealth Apps for Atopic Dermatitis SelfManagement
Montréal
Pediatrics
Chair: Dr. Kyla Hildebrand
Topic: A year of advocacy projects in food allergy
Objectives*:
Describe an advocacy project led by CSACI members involving an international
collaboration and systematic review assessing evidence for food avoidance in school
settings
Ste-Hélène
Immunology
Chair: Dr. Stuart Turvey
Topic: Update on Canadian newborn screening for severe combined
immunodeficiency (SCID).
Objectives:
Understand the approach to newborn screening for SCID.
Appreciate the current status of newborn screening for SCID across Canada.
Riopelle
Rhino-Sinusitis
Chair: Dr. Paul Keith
Topic:
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
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FRIDAY, SEPTEMBER 30, 2016
1130-1230
INTEREST SECTION BREAKOUT MEETINGS & ABSTRACT ORAL PRESENTATIONS
BY THE END OF THESE SESSIONS PARTICIPANTS WILL BE ABLE TO*:
Objectives*:
Discuss current issues in specialty topics in Allergy and Clinical Immunology
CONTINUED
McGill
Asthma
Chair: Dr. Ken Liew
Topic: From Basic Science to Clinical Care
Objectives*:
• Review relevant basic immunology pertaining to pathophysiology of asthma
• Familiarize ourselves with asthma biologics and mechanisms of action
St-Jacques
Allied Health
Chairs: Ms. Jo-Anne St-Vincent and Ms. Linda Kirste
Topic: Caregivers’ Lived Experience of Anaphylaxis: Educational Strategies for Knowledge
Translation
Speaker: Ms. Rishma Chooniedass
1230-1255
9th and 11th floor
LUNCH
(Participants pick up their food and proceed to either Montréal or Fortification Ballrooms)
1255-1355
Montréal
LUNCH SYMPOSIUM
(Speaker presentation broadcasted simultaneously in Fortification Ballroom)
1355-1410
Montréal
ABSTRACT ORAL PRESENTATIONS
By the end of this session participants will be able to:
• Describe Canadian allergy and immunology research endeavours
1415-1515
Montréal
CSACI
Persia Pourshahnazari
AllerGen
Young Woong Kim
AllerGen
Mark Tenn
CSACI
Kateryna Vostretsova
Study of the effects of complementary and
alternative medicine (CAM) on the practice of
allergy in primary care and subspecialty settings:
preliminary data from the subspecialty survey
Investigating systemic immune responses in the
pathophysiology of allergic rhinitis under the nasal
allergen challenge model
Nasal and peripheral blood group 2 innate lymphoid
cells (ILC2) levels in response to nasal allergen
challenge in participants with allergic rhinitis
Observational study of pollen counts in British
Columbia from 2000-2015
CSACI & CAAIF AGMS
Chairs: Dr. Sandy Kapur & Dr. Susan Waserman
(CSACI MEMBERS ONLY)
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
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FRIDAY, SEPTEMBER 30, 2016
1515-1705
Montréal
CONCURRENT SESSIONS
HANDS ON|SIMULATION WORKSHOPS - FOR SECTION 3 CREDITS
Chairs: Dr. Lori Connors, Dr. Victoria Cook and Dr. Rebecca Pratt
BY THE END OF THESE SESSIONS PARTICIPANTS WILL BE ABLE TO*:
Objectives*:
1515-1525
1515-1700
Palais
Introduction and Explanations – Drs. Connors, Cook and Pratt
SESSION 1 - PATCH TESTING
ROOM: MCGILL
1525-1555
Group A
1600-1630
Group B
1635-1705
Group C
Objectives*:
• Describe indications and contraindications of
patch testing
• Apply standard contact allergen patches
• Interpret patch test results
SESSION 2 - PROCEDURAL SKILLS
ROOM: STE-HÉLÈNE
1525-1555
Group A
1600-1630
Group B
1635-1705
Group C
Objectives*:
• Summarize indications and contraindications of
interosseous (IO) and intravenous (IV) access
• Describe sterile technique
• Insert IO’s and IV’s
SESSION 3 - ADVANCED
COMMUNICATION SKILLS
ROOM: MONTRÉAL
1525-1555
Group A
1600-1630
Group B
1635-1705
Group C
Objectives*:
• Construct and approach to communication with
an emotional patient
• Utilize FIFE in clinical encounters
• Provide and receive feedback on communication
skills
CONCURRENT SESSIONS
MECHANISMS OF ACTION TO THERAPEUTIC APPLICATION
IMMUNOTHERAPY FOR ALLERGIC DISEASES – CHALLENGES AND SOLUTIONS
Chair: Dr. Harissios Vliagoftis
BY THE END OF THESE SESSIONS PARTICIPANTS WILL BE ABLE TO*:
Objectives*:
1515-1545
Subcutaneous and sublingual allergen immunotherapy: clinical utility
and mechanisms
Speaker: Dr. Thomas Eiwegger, Toronto, ON
Objectives*:
• Review the immunological mechanisms (cellular and humoral) that
result in allergic symptoms and highlight the sequence of events
that are modified during allergen immunotherapy.
• Discuss mechanistic differences between sublingual and
subcutaneous immunotherapy in the literature and whether there
is any evidence for differences regarding clinical efficacy.
• Review markers for clinical response and on the length of
effectiveness of allergen immunotherapy.
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
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FRIDAY, SEPTEMBER 30, 2016
1515-1700
Ramezay
CONCURRENT SESSIONS
MECHANISMS OF ACTION TO THERAPEUTIC APPLICATION
IMMUNOTHERAPY FOR ALLERGIC DISEASES – CHALLENGES AND SOLUTIONS
CONTINUED
BY THE END OF THESE SESSIONS PARTICIPANTS WILL BE ABLE TO*:
Objectives*:
1545-1615
Peptide Immunotherapy: Applications & Mechanisms
Speaker: Dr. Mark Larché, Hamilton, ON
Objectives*:
• Review the rationale for the development of novel allergen
immunotherapy strategies
• Review clinical results from trials of peptide immunotherapy
• Review mechanisms of action of peptide immunotherapy
1615-1645
New Development in Immunotherapy for Food Allergy: Approaches
& Mechanisms
Speaker: Dr. Philippe Bégin, Montréal, QC
Objectives*:
• Compare current approaches to food immunotherapy
• Discuss differences in underlying therapeutic mechanisms
1645-1655
ABSTRACT ORAL PRESENTATIONS
By the end of this session participants will be able to:
• Describe Canadian allergy and immunology research endeavours
CSACI
François Graham
Daily peanut introduction in peanut-allergic patients with high
reaction thresholds: a case series
AllerGen
Elizabeth Simms
Ara h 1 peptide immunotherapy protects against severe
peanut-induced anaphylaxis and induces PD-1+ CD4+ T cells
1655-1700
Conclusion
1600-1630
NUTRITION BREAK
Foyers of Montréal (11th floor), Ramezay, McGill, and Ste-Hélene (8th Floor)
1715-1845
Fortifications
FIT BOWL*
Chair: Dr. Anne Ellis
1845-2000
St-Antoine &
Ville Marie
Montréal
OPENING RECEPTION WITH EXHIBITORS
9th Floor
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
Page 19
SATURDAY, OCTOBER 1, 2016
0700-0730
9th and 11th floor
BREAKFAST
(Participants pick up their food and proceed to either Montréal or Fortification
Ballrooms)
0730-0830
Montréal
BREAKFAST SYMPOSIUM
(Speaker presentation broadcasted simultaneously in Fortification Ballroom)
0840-0900
Montréal
ABSTRACT ORAL PRESENTATIONS
By the end of this session participants will be able to:
• Describe Canadian allergy and immunology research endeavours
AllerGen
Cristina Longo
Weight Status and Time to First Exacerbation in Children with
Mild to Moderate Asthma: Is there a Dose-Response
Relationship?
AllerGen
Keely Loewen
AllerGen
Danay MaestreBatlle
Prenatal antibiotic exposure and childhood asthma: a
population-based study
CSACI
Dhaifallah Alotaibi
AllerGen
ChenXi (Yolanda)
Yang
Annika Klopp
AllerGen
0900-1015
Montréal
The effects of phthalate and toll-like receptor ligand coexposure on whole blood innate immunology
Lipopolysaccharide Inhibits Interleukin–13-induced CCL26 in
Human Airway Epithelial cells
Discovery of biomarkers that can diagnose western red cedar
asthma
Do infants fed expressed breast milk have an increased
risk of developing childhood asthma compared to
directly breastfed infants?
PLENARY SESSION II – ASTHMA & RHINITIS
Chair: Dr. Ken Liew
BY THE END OF THESE SESSIONS PARTICIPANTS WILL BE ABLE TO*:
Objectives*:
0900-0930
•
•
•
Integrating Emerging CRS Concepts into Comprehensive Patient
Care: A Translational Approach
Speaker: Dr. Martin Desrosiers, Montréal, QC
Objectives:
Comprehend how emerging concepts in bacteriology, host immunity
and barrier function interact in the development and persistence of
chronic rhinosinusitis
Identify the translational implications of basic research as it relates to
new therapeutic targets and strategies.
Elaborate comprehensive management plans for patients with “hardto-treat” CRS.
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
Page 20
SATURDAY, OCTOBER 1, 2016
0900-1015
Montréal
PLENARY SESSION II – ASTHMA & RHINITIS
Chair: Dr. Ken Liew
CONTINUED
BY THE END OF THESE SESSIONS PARTICIPANTS WILL BE ABLE TO*:
Objectives*:
0930-0940
Discussion Period
0940-1005
Assessment of Airway Hyperresponsiveness
Speaker: Dr. Donald Cockcroft, Saskatoon, SK
Objectives:
• Interpret Methacholine challenges
• Explain the concepts of direct and indirect stimuli and their
sensitivity and specificity
• Identify important caveats re: interpretation of challenges tests
1005-1015
Discussion Period
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
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SATURDAY, OCTOBER 1, 2016
0845-1600
Ramezay
CONCURRENT SESSIONS
ALLIED HEALTH SYMPOSIUM & ABSTRACT ORAL PRESENTATIONS
Chairs: Ms. Jo-Anne St. Vincent & Ms. Linda Kirste
BY THE END OF THESE SESSIONS PARTICIPANTS WILL BE ABLE TO*:
Objectives*:
0845-0900
Welcome and introductions
0900-0945
Mechanisms and unusual presentations of anaphylaxis
Speaker: Dr. Anne Ellis, Kingston, ON
Objectives*:
• Describe the essential pathophysiologic mechanisms of anaphylaxis
and list several causative agents
• Diagnose anaphylaxis
• Manage anaphylaxis appropriately; recognizing priority role of
epinephrine
• Describe the use of ancillary management strategies
• Describe features and predictors of biphasic reactions
Celiac disease and other gluten sensitivities
Speaker: Dr. Martha Dirks, Montréal, QC
Objectives*:
• Review the most accurate screening tests to rule in our rule out
suspected celiac disease
• Distinguish celiac disease from non-celiac gluten sensitivity and to
be able to counsel patients –clients accordingly
• Know the groups at increased risk for developing celiac disease
Oral food challenges risks, benefits and lived experiences
Speakers: Dr. Bruce Mazer and Ms. Maria Harvey, Montréal, QC
Objectives* – Ms. Harvey:
• Describe the role OFC plays in diagnosis-treatment –living with
food allergies
• Reflect on the experience of the OFC from patient’s prospective
Objectives* – Dr. Mazer
• Define life threatening food allergy and contrast to other forms of
food intolerance.
• Explain how food allergies are diagnosed and the problems with
the different types of tests used
• List the potential benefits of food challenges whether they
demonstrate that a child remains allergic or has outgrown their
allergy.
1000-1100
1115-1225
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
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SATURDAY, OCTOBER 1, 2016
0845-1600
Ramezay
CONCURRENT SESSIONS
ALLIED HEALTH SYMPOSIUM & ABSTRACT ORAL PRESENTATIONS
CONTINUED
BY THE END OF THESE SESSIONS PARTICIPANTS WILL BE ABLE TO*:
Objectives*:
1230-1245
Allied Health Poster Presentations
By the end of this session participants will be able to:
• Describe Canadian allergy and immunology research endeavours
CSACI
Saiful Huq
CSACI
Sara Johnson
1345-1445
1445-1530
1530-1600
Grande Place
1600-1700
Respiratory Analysis of Healthy and ‘Wheezy’ Sounds from
Children’s Emergency
Qualitative studies of teen experiences living with FoodInduced Anaphylaxis (FIA): a meta-aggregation
Shared decision making: putting patients at the centre of clinical care
Speaker: Allyson Shephard
Objectives*:
• Explain the fundamental principles of shared decision making and
its relevance to clinical, evidence-based practice
• Describe preference misdiagnosis and means to avoid it
• Describe decision support strategies and tools that can be
integrated into clinical practice to facilitate shared decision making
with patients and families
New and emerging theraputic agents for asthma management
Speaker: Dr. Harissios Vliagoftis
Objectives*:
• Compare and contrast the opportunities/problems arising from the
variety of corticosteroid, long-acting b agonist and combination
inhalers available for the treatment of asthma and the variety of
devices used for their delivery
• Describe the role of long acting anticholinergic medications for the
treatment of asthma
• Summarize the expanding field of biologics and other targeted
therapies for the treatment of asthma and other allergic diseases
Hands-on practice with new inhaler devices
Objectives*:
• Teach patients and families how to use various inhaler devices
Allied Health wine & cheese reception (meet & greet)
Election of new section co-chair
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
Page 23
SATURDAY, OCTOBER 1, 2016
1015-1030
Montréal
ABSTRACT ORAL PRESENTATIONS
By the end of this session participants will be able to:
• Describe Canadian allergy and immunology research endeavours
Kingston Allergy Birth Cohort (KABC); Exposome
Characteristics and Parentally-Reported Respiratory Outcomes
to Age 2
AllerGen
Michelle North
AllerGen
John Paul Oliveria
IgE+ memory B cells subsets are higher in the airways of mild
allergic asthmatics compared to healthy controls
CSACI
Yahya Fiteih
CSACI
Mihaela Paina
Role of receptor interacting protein 2 in allergic airway
inflammation
Nasal inflammatory biomarkers in pediatric cystic fibrosis with
and without nasal polyposis: a cross-sectional comparative
study
1030-1200
Grande Place
8th Floor
POSTER VIEWING & JUDGING SESSION
Chairs: Dr. Anne Ellis & Dr. Harissios Vliagoftis
Objectives:
By the end of these sessions, participants will be able to:
• Discuss current issues of importance to an interest section
• Describe potential collaborations within an interest section
• Describe current research in Allergy and Clinical Immunology
1040-1110
St-Antoine,
Ville Marie
Montréal
NUTRITION BREAK
9th Floor
1200-1230
St-Paul
POSTER JUDGING MEETING (closed)
Chairs: Dr. Anne Ellis & Dr. Harissios Vliagoftis
1215-1245
9th and 11th floor
LUNCH
(Participants pick up their food and proceed to either Montréal or Fortification
Ballrooms)
1245-1345
Montréal
LUNCH SYMPOSIUM
(Speaker presentation broadcasted simultaneously in Fortification Ballroom)
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
Page 24
SATURDAY, OCTOBER 1, 2016
1400-1500
Montréal
1500-1515
PLENARY SESSION III – DRUG ALLERGY & DERMATITIS
Chair: Dr. Harold Kim
Objectives*:
By the end of these sessions, participants will be able to:
1400-1420
Evaluation of Drug Allergy: What’s In Our Toolbox?
Speaker: Dr. David Khan, Dallas, TX
Bram Rose Memorial Lectureship
Objectives*:
• Explain the predictive value of drug skin testing
• Outline when and how placebo testing can be incorporated in drug
allergy testing.
• Discuss the safety, types and interpretation of drug challenges.
1420-1430
Discussion Period
1430-1450
Assessment of Contact Dermatitis
Speaker: Dr. Linda Moreau, Montréal, QC
Objectives*:
• Assess appropriate cases for patch testing
• Interpret basic patch testing
1450-1500
Discussion Period
Abstract Oral Presentations
The Role of Anesthesiologists in the Management of
CSACI
Savannah Grodecki Patients With a Suspected Penicillin Allergy
CSACI
Andrew Wakeman
Retrospective Review of Beta Lactam Allergy Prevalence in a
Referral Population
1515-1645
FREE TIME
1515-1645
CAAIF RUN IN MONT ROYAL
1500-1515
Runners/walkers meet at the Westin Hotel lobby where buses will be waiting to bring
participants to Mont- Royal (see map)
1530-1615
CAAIF RUN/WALK (start and finish) Mont-Royal
1615-1645
End of the Run/Walk – Buses waiting to return participants at the Westin Hotel (see map)
Special award medals will be presented at the CSACI dinner on Saturday night.
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
Page 25
SATURDAY, OCTOBER 1, 2016
1545-1645
Bonsecours
JOURNAL MEETING (closed)
Chair: Dr. Richard Warrington
1600-1700
Viger
INDUSTRY SUMMIT – ROUNDTABLE DISCUSSION (closed)
Corporate Members & CSACI Executive
1745-1900
Montréal
CASE REPORT PRESENTATIONS
Chairs: Dr. Anne Ellis & Dr. Harissios Vliagoftis
By the end of this session participants will be able to:
• Describe Canadian allergy and immunology research endeavours
CSACI
Sanju Mishra
An adverse reaction to omalizumab in a severe asthmatic patient
CSACI
Andrea Burke
Questioning the dogma of “physician-diagnosed asthma”
CSACI
Chun Che
Cross Reactive Conundrums: What is the allergen?
CSACI
Lucy Duan
Serious allergic reaction with the fifth dose of sublingual
immunotherapy for grass-pollen allergy
CSACI
Hani Hadi
Dramatic resolution of acute necrotizing eosinophilic myocarditis
with a brief, high-dose steroid course
CSACI
Roxane Labrosse
A Pediatric Case of Selective Fixed Drug Eruption to Amoxicillin
CSACI
Lana Rosenfield
Late presentation of possible terminal compliment deficiency with
recurrent Neisseria meningitides infection
CSACI
Sanju Mishra
Insulin allergy to insulin glargine 300 units/mL (Toujeo®) and other
insulin derivatives in a type 2 diabetes mellitus patient
CSACI
Ori Scott
Long-term Clinical Outcome in Adenosine Deaminase-Deficient
Patients following Treatment: A Longitudinal Single-Centre
Experience (1985-2015)
1930-2000
Foyer Fortifications
CSACI RECEPTION
2000-2200
Fortifications
CSACI DINNER, AWARDS & ABSTRACT PRESENTATIONS
Chair: Dr. Sandy Kapur
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
Page 26
SUNDAY, OCTOBER 2, 2016
0700-0730
9th and 11th floor
BREAKFAST
(Participants pick up their food and proceed to either Montréal or Fortification
Ballrooms)
0730-0830
Montréal
BREAKFAST SYMPOSIUM
(Speaker presentation broadcasted simultaneously in Fortification Ballroom)
0840-1030
Montréal
PLENARY SESSION IV – LITERATURE REVIEW
Chair: Dr. Sandy Kapur
Objectives*:
By the end of these sessions, participants will be able to:
0840-0910
0910-0940
0940-1000
1000-1030
St-Antoine &
Ville Marie
Montréal
BASIC IMMUNOLOGY
Speaker: Dr. Christine McCusker, Montreal, QC
Objectives*:
• Outline new cutting edge research in immunology over the past
year
• Examine how the data will impact our understanding of immune
responses
• Discuss potentials for translation of basic science to the bedside
PEDIATRIC ALLERGY
Speaker: Dr. Wade Watson, Halifax, NS
Objectives*:
• Describe the results of important pediatric allergy publications in
the last 12 months.
• Discuss the implications of new findings in the pediatric allergy
literature on your clinical practice.
DISCUSSION PERIOD
NUTRITION & NETWORKING BREAK
9th Floor
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
Page 27
SUNDAY, OCTOBER 2, 2016
0840-1030
Montréal
1100-1120
Montréal
PLENARY SESSION IV – LITERATURE REVIEW - CONTINUED
1030-1050
Adult Allergy and Immunology
Speaker: Dr. Paul Keith, Hamilton, ON
Objectives*:
• Describe the results of important adult allergy and immunology
publications in the last 12 months.
• Discuss the implications of new findings in the adult allergy and
immunology literature on your clinical practice.
1050-1100
Discussion Period
PLENARY SESSION V – HOT TOPIC
APPROACH TO MARIJUANA ALLERGY
Chair: Dr. Stuart Carr
Speaker: Dr. Lori Connors, Halifax, NS
By the end of this session, participants will be able to:
Objectives*:
• Explain different types of hypersensitivity reactions to cannabis
• Outline major allergen of cannabis and potential cross-reactivity
• Generate a diagnostic and therapeutic plan for management of marijuana allergy
1120-1130
1115-1130
Montréal
Discussion Period
CLOSING REMARKS BY NEW CSACI PRESIDENT
Chair: Dr. David Fischer
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
Page 28
SAVE THE DATE!
2017 ANNUAL SCIENTIFIC MEETING
October 11-15, 2017 | Toronto, ON
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
Page 29
The Canadian Society of Allergy and Clinical Immunology would like to
gratefully acknowledge the following companies:
La société canadienne d'allergie et d'immunologie clinique souhaite remercier
chaleureusement les entreprises suivantes:
PATRONS
SILVER
BRONZE
OTHER FINANCIL SUPPORT
Meeting app:
CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY
FIT Bowl:
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