EAT strives to accelerate the most promising ideas in food allergy research toward the clinical testing and expansion of shorter-term treatments and longer term solutions involved in the root causes, triggers and processes of food allergy progression. EAT’s research goals:
Advance scientific and medical research to accelerate diagnostics, treatments, cures and prevention of food allergy
- understand underlying immune mechanisms
- determine genetic and epigenetic factors of food allergy prevalence
- discover role of microbiome in food allergy
- understand basic biology to surface key targets for breakthrough treatments
- identify and accelerate short-term therapies to increase quality of life in patient subsets
Today, the only way to know for certain if someone has a food allergy or to qualify for a clinical study is to have a physician supervised food challenge to each suspecting food. Current skin and blood IgE testing are directional at best as IgE levels are not always accurate predictors of presence or severity. Biomarkers are “used to detect or confirm presence of disease or condition” (NIH). Better biomarkers are desperately needed to avoid dreaded and expensive food challenges as well as better understand the underpinnings of the condition. Eosinophilic Esophagitis suffers the same challenge – the only way to diagnose EoE is through an invasive endoscopy requiring a hospital visit and anesthesia.
Biomarkers IgE: ‘Molecular Gene Expression During Reactions to Food: Identifying Signatures Which Correlate with Severity of Reaction’,
Jonathan Spergel, MD, PhD, Children’s Hospital of Philadelphia
Paul J. Turner, FRACP PhD, Imperial College London
Biomarkers: Eosinophilic Esophagitis (EoE)
‘Developing Non-Invasive Biomarkers for EoE by Genetic Testing and Molecular Profiling of the Buccal Mucosa’
Marc Rothenberg, MD, PhD, Cincinnati Children’s Hospital
Officially coined in 2001, microbiome describes a community of approximately 100 trillion cells, called microbes, located throughout the human body with the largest microbial quantities residing in the gastrointestinal tract. Immunoglobulin E (IgE)-mediated food allergy, meanwhile, is a malady caused by a misfiring of the immune system. However, digestion and intestinal health are increasingly being recognized as critical pieces of the food allergy puzzle. The crux of this intersection seems to lie within gut microbiome and ongoing research of it has indeed been preliminarily revealing of an association with allergic disease pathogenesis.
‘Prebiotic Dietary Fibers to Prevent or Treat Food Allergy’
Cathryn R. Nagler, PhD, University of Chicago
‘Open Label Phase I Trial to Evaluate Safety and Efficacy of Fecal Microbiota Transplantation in Peanut Allergic Patients’
Rima Rachid, MD, Boston Children’s Hospital
Oral Immunotherapy (OIT):
OIT involves introducing one’s immune system to an allergic food by administering small and gradually increasing amounts of that food over time. OIT is not currently an FDA approved treatment for food allergy. Even so, many private practice physicians are offering this to their patients. Further, several companies are working on FDA approvals for this kind of treatment. Many questions have arisen about how to make oral immunotherapy treatment safer and more effective: does OIT cause EoE in some patients? Who is more likely to have severe reactions when going through OIT and who isnt? Which patients experience sustained tolerance and why?
‘Improving Safety for the Food Allergy Asthma Syndrome’
Kari Nadeau, MD, PhD, Stanford University
Sharon Chinthrajah, MD, Stanford University
‘SEAL (Stopping Atopic Dermatitis and Allergy) Study: Prevent the allergic march by enhancing the skin barrier’
Kari Nadeau, MD, PhD, Stanford University
Gideon Lack, MD and Helen Brough, MD, and Susan Chan, MD, King’s College London
Donald Leung, MD, PhD, National Jewish Denver
Eosinophilic Esophagitis (EoE):
Eosinophilic esophagitis (EoE) is a growing type of food allergy characterized by swelling of the esophagus associated with the accumulation of a type of white blood cell called eosinophils. EoE diagnosis is dependent upon an endoscopy followed by removing small pieces of the esophagus, which are then examined for the presence of high levels of eosinophils and associated damage. EoE can often cause debilitating symptoms such as food impaction and digestive distress, and result in restricted diets, and a reduced quality of life.
‘Use of Esophageal String Test to Understand Symptoms, Inflammation and Function in EoE’
Calies Menard-Katcher, MD, MSCS, Children’s Hospital of Colorado
Amanda Muir, MD, Children’s Hospital of Philadelphia
Researchers from the Broad Institute of MIT and Harvard, its partner institutions and Yale School of Medicine have launched an initiative to tackle the science of food allergies. The Food Allergy Science Initiative (FASI), centered at the Broad, taps the combined resources of participating academic and research institutions to help answer key scientific questions surrounding food allergies, the causes of which remain little-understood.
FASI aims to accelerate research into this field and enable the development of new diagnostics and treatments through a coordinated effort that brings together specialists from a variety of disciplines including immunology, gastroenterology, microbiology, computational biology, molecular biology and genetics, as well as bioengineering to tackle key questions related to food allergy. The FASI scientific team is leveraging the Broad’s expertise in genomics and single-cell technologies to tackle five fundamental questions about food sensitivities:
Cellular landscape of the gut: How do epithelial and immune cells in the gut sense and respond to food allergens?
Mechanisms of allergen sensing: How does the body determine how to react to different food components, and how does it determine whether those components are healthy and harmful? How do the gut lining barrier and the immune system manage these sensing mechanisms, and how do they trigger dramatic allergic responses? Can these mechanisms be ‘reprogrammed’ to avoid hypersensitive reactions to food allergens?
Immune response to allergens: How do allergens activate the immune response? What kinds of immune responses are triggered by food allergens, and what are the normal functions of these responses? How can these responses be suppressed, altered, or neutralized?
Microbiota and its role in food allergy: To what extent do the gut microbiota influence food sensitivies and allergic reactions? Are there specific elements of the microbiome that can promote or prevent food allergy? Can the microbiota, or some of its products, be harnessed to reverse the condition?
Clinical and translational projects: Can the make-up of the immune system’s cellular ecosystem inform diagnosis and prognosis of food allergy? Are there changes in the microbiome during infancy and early in life that influence risk for food allergy? Can we identify new, more accurate biomarkers that could aid in diagnosis or treatment?