What is a food allergy

Dr. Marc McMorris grew up on a farm in northcentral Pennsylvania. He received his medical degree from Jefferson Medical College in Philadelphia in 1985. He came to the University of Michigan for his pediatric residency and served a Chief Resident from 1988-1989. Following 3 years as a pediatric ER attending he returned to the University of Michigan and completed his Allergy and Immunology fellowship in 1994. Families love Dr. McMorris ability to hear with sensitivity, and they appreciate his tender approach to children.

What is a food allergy

For 3 years, Dr. McMorris served as Medical Advisor for Food Anaphylaxis Education, Inc., a nonprofit Michigan education organization before becoming Director of the University of Michigan Food Allergy Service. The Food Allergy and Anaphylaxis Network of Virginia awarded him the Muriel C. Furlong Award for making a difference.

What is a food allergy

He has been recognized as one of the University of Michigan Health Systems Top 100 Physicians, received the University of Michigan Department of Pediatrics Top 10% Faculty Teaching Award and was inducted into the University of Michigan Department of Medicine Clinical Excellence Society in 2013. He volunteers for food allergy educational activities for Michigan families, schools, places of worship, professional organizations and health care providers. He has participated in research evaluating anaphylaxis care, school readiness for students with food allergies, self-reported reactions to peanut and tree nuts, and the impact of food allergies on quality of life for families with food allergies.

He is considered an expert in every aspects of food allergies. He currently serves as Medical Director for the Dominos Farms Allergy Specialty Clinic/Food Allergy Clinic and Clinical Service Chief for the Division of Allergy and Clinical Immunology.

Investigators at the National Institutes of Health own found that sesame allergy is common among children with other food allergies, occurring in an estimated 17% of this population. In addition, the scientists own found that sesame antibody testing — whose utility has been controversial — accurately predicts whether a kid with food allergy is allergic to sesame.

The research was published on Oct. 28 in the journal Pediatric Allergy and Immunology.

«It has been a challenge for clinicians and parents to determine if a kid is truly allergic to sesame,» said Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), part of NIH. «Given how frequently sesame allergy occurs among children who are allergic to other foods, it is significant to use caution to the extent possible when exposing these children to sesame.»

Sesame is among the 10 most common childhood food allergies.

Only an estimated 20% to 30% of children with sesame allergy outgrow it. Severe reactions to sesame are common among sesame-allergic children. About 1.1 million people in the United States, or an estimated 0.23% of the U.S. population, own sesame allergy, according to a recently published study funded by NIAID. These factors underscore the need to optimize recognition and diagnosis of this allergy. The Food and Drug istration is currently considering whether to include sesame in the list of allergens that must be disclosed on food labels.

Standard allergy tests — the skin-prick test and the allergen-specific antibody test — own been inconsistent in predicting an allergic reaction to sesame.

Numerous studies evaluating the utility of these tests for sesame allergy own included only children suspected to own sesame allergy.

What is a food allergy

Taking a diverse approach, scientists led by Pamela A. Frischmeyer-Guerrerio, M.D., Ph.D., deputy chief of the NIAID Laboratory of Allergic Diseases and chief of its Food Allergy Research Unit, evaluated the sesame antibody test in a group of 119 children with food allergy whose sesame-allergic status was unknown.

The researchers offered children in the study an oral food challenge — the gold standard for diagnosing food allergy — which involved ingesting gradually increasing amounts of sesame under medical supervision and seeing if an allergic reaction occurred. Children who recently had had an allergic reaction to sesame or were known to tolerate concentrated sesame, such as tahini, in their diet were not offered an oral food challenge.

The scientists found that 15 (13%) of the 119 children were sesame-allergic, 73 (61%) were sesame-tolerant, and sesame-allergic status could not be sure for 31 (26%) children, mainly because they declined the oral food challenge.

Among the 88 children whose sesame-allergic status was definitive, 17% had sesame allergy.

The scientists measured the quantity of an antibody called sesame-specific immunoglobulin E (sIgE) in the blood of these 88 children. With this data and information on the children’s sesame-allergic status, the researchers developed a mathematical model for predicting the probability that a kid with food allergy is allergic to sesame. According to the model, children with more than 29.4 kilo international units of sIgE per liter of serum own a greater than 50% chance of being allergic to sesame. This model will need to be validated by additional studies, however, before it can be used in clinical practice.


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Materials provided by NIH/National Institute of Allergy and Infectious Diseases.

Note: Content may be edited for style and length.


Journal Reference:

  • The key component of this research is dendritic cells, which serve as the gate-keepers of the immune system and are present in tissues in contact with the external environment, such as the skin and the inner lining of the nose, lungs, stomach and intestines.
  • Kristin Sokol, Marjohn Rasooly, Caeden Dempsey, Sheryce Lassiter, Wenjuan Gu, Keith Lumbard, Pamela A Frischmeyer‐Guerrerio.

    Prevalence and Diagnosis of Sesame Allergy in Children with IgE‐Mediated Food Allergy. Pediatric Allergy and Immunology, 2019; DOI: 10.1111/pai.13143

  • Gordon’s pioneering treatment involves producing dendritic cells in a test tube and then exposing them to a unique stir of proteins, a vitamin A-related acid naturally occurring in the human gut, and to the allergen, in this case, peanut or ovalbumin (egg white protein). The modified dendritic cells are then reintroduced into the mouse. 
  • Using this technique, the researchers were capable to almost eliminate the allergic reaction by converting allergen-sensitive immune cells into cells that mimic the response seen in healthy, non-allergic individuals.  

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Cite This Page:

NIH/National Institute of Allergy and Infectious Diseases.

«Researchers estimate 17% of food-allergic children own sesame allergy: Scientists discover sesame antibody testing predicts sesame allergy in food-allergic children.» ScienceDaily.

What is a food allergy

ScienceDaily, 4 November 2019. <www.sciencedaily.com/releases/2019/11/191104112932.htm>.

NIH/National Institute of Allergy and Infectious Diseases. (2019, November 4). Researchers estimate 17% of food-allergic children own sesame allergy: Scientists discover sesame antibody testing predicts sesame allergy in food-allergic children. ScienceDaily. Retrieved January 29, 2020 from www.sciencedaily.com/releases/2019/11/191104112932.htm

NIH/National Institute of Allergy and Infectious Diseases. «Researchers estimate 17% of food-allergic children own sesame allergy: Scientists discover sesame antibody testing predicts sesame allergy in food-allergic children.» ScienceDaily.

www.sciencedaily.com/releases/2019/11/191104112932.htm (accessed January 29, 2020).

Clinical Practice in Walnut Creek and Brentwood offices.

Dr. Jacobs completed his Internal Medicine residency at David Grant USAF Medical Middle, then his fellowship in Allergy/Immunology at Wilford Hall USAF Medical Middle in San Antonio, TX. He completed nine years of service in the USAF and was the previous Chief of Internal Medicine for the 28th Medical Group at Ellsworth AFB in South Dakota.

Dr. Jacobs joined Allergy and Asthma Medical Group in 1999.

He is the Medical Director of Allergy and Asthma Clinical Research, Inc. and has published extensively in a number of peer reviewed medical journals. He is a member of the American Academy of Allergy, Asthma and Immunology; American College of Allergy, Asthma and Immunology; American Thoracic Society; European Academy of Allergy and Clinical Immunology; and past president of the Western Society of Allergy, Asthma and Immunology.

Dr.

Jacob’s areas of interest are the treatment of hereditary angioedema, chronic sinusitis, atopic dermatitis/food allergy, asthma and primary immunodeficiency.

“This discovery reverses food allergies in mice, and we own numerous people with allergies volunteering their own cells for us to use in lab testing to move this research forward,” said professor John Gordon, lead scientist behind the discovery just published in the current issue of the Journal of Allergy and Clinical Immunology.

The findings open the door to test this new allergy treatment in “humanized mice”—mice with non-existent immune systems implanted with cells from a human immune system, for example, from a peanut-allergic person.

With Health Canada approval, the first human trial could start in about one year, Gordon said. 

“If we can reliably ‘cure’ food allergies, or related conditions such as asthma or autoimmune diseases such as multiple sclerosis with this new therapy, it would be life-changing for affected individuals.”

Roughly 2.5 million Canadians self-report having at least one food allergy.  Anaphylaxis, defined as a severe rapid-onset allergic reaction, can be life-threatening and treatment options are limited.

The discovery involves generating a type of naturally occurring immune cell that sends a signal to reverse the hyper-immune response present in allergic reactions.  That signal triggers another “off switch” that turns off reactive cells further along the allergic pathway. 

“We predict the treatment could be on the market within the next five to 10 years,” said Gordon, who is also a research leader in the Allergy, Genes and Environment (AllerGen) Network.

AllerGen—part of the federally funded Networks of Centres of Excellence program—aims to assist Canadians address the challenges of living with asthma, allergies, anaphylaxis and related immune diseases.

Gordon’s team will collaborate with other AllerGen investigators located at the U of S, McGill University, Queen’s University, McMaster University, and University of Alberta to pilot the new technique.

“This discovery portends a major breakthrough towards a therapeutic reversal of food allergen sensitivity,” said Dr. Judah Denburg, scientific director and CEO of AllerGen. “The treatment prevents anaphylactic responses in what were previously fully sensitive mice, opening the door for translating this therapy into the clinic.”

There is compelling evidence this technique could be effective in humans.  In 2010, Gordon’s team demonstrated they could reverse an asthmatic response in human cells in a test tube.

Using three applications of a similar therapy in a 2012 study, the researchers effectively eliminated asthma in afflicted mice, within only eight weeks.

“Even if we only cure 25 per cent of subjects, we will dramatically improve the health of those individuals, and also reduce healthcare system expenses,” said Gordon, who worked with Wojciech Dawicki, a research associate and the primary author and lead researcher in this study. Master’s student Chunyan Li and lab technicians Xiaobei Zhang and Jennifer Town also worked on the project.

Here’s how the technique works:

  1. Gordon’s pioneering treatment involves producing dendritic cells in a test tube and then exposing them to a unique stir of proteins, a vitamin A-related acid naturally occurring in the human gut, and to the allergen, in this case, peanut or ovalbumin (egg white protein).

    The modified dendritic cells are then reintroduced into the mouse. 

  2. The key component of this research is dendritic cells, which serve as the gate-keepers of the immune system and are present in tissues in contact with the external environment, such as the skin and the inner lining of the nose, lungs, stomach and intestines.
  3. Using this technique, the researchers were capable to almost eliminate the allergic reaction by converting allergen-sensitive immune cells into cells that mimic the response seen in healthy, non-allergic individuals.  

The treatment reduced the observed symptoms of anaphylaxis, and lowered other key protein markers in the allergic response by up to 90 per cent.

Food allergy is a growing public health issue in Canada.

Currently, there is no known cure. According to the Canadian Institute for Health Information, an estimated 171,000 Canadians visited emergency rooms for allergic reactions from 2013 to 2014, the rate of anaphylaxis visits increased by 95 per cent from 2006 to 2014, and the severity of reactions is increasing.

Gordon said the new technique also shows promise for treating autoimmune disorders such as multiple sclerosis. “It would take extremely little to adapt the therapy for autoimmune diseases,” he said.

Funding for the research was provided by the Canadian Institutes of Health Research and the AllerGen Networks of Centres of Excellence.

 

S aureus in Children With Eczema May Frolic a Role in Development of Food Allergies

Young children with severe eczema who are infected with Staphylococcus aureus may be at a higher risk of developing a food allergy, investigators at King’s College London found in a new study.

Published in the Journal of Allergy and Clinical Immunology, the study sought to investigate the association of S aureus colonization with specific Immunoglobulin E (sIgE) production with common food allergens and allergies in early childhood independent of eczema severity.

“It is well established that patients with eczema are frequently affected by colonization of their skin (and their nose) with Staphylococcus aureus,” Olympia Tsilochristou, MD, a physician at King’s College London and the first author on the study, told Contagion®.

“The authors, therefore, set [out] to investigate [whether] patients with eczema are more prone to develop food sensitization/allergy if they are colonized with this bacterium.”

Investigators collected nasal and skin swabs from young children with severe eczema enrolled in the Learning Early About Peanut Allergy (LEAP) and LEAP-On (12-month extension of the LEAP study: Persistence of Oral Tolerance to Peanut) studies at baseline and at 12, 30, and 60 months of age, and cultured them for S aureus.

Sensitization was identified via measuring sIgE levels, peanut allergies were identified primarily via oral food challenge, and persistent egg allergies were identified primarily via skin prick tests.

A entire of 48.8% of the 640 participants had some form of S aureus colonization (32.2% skin and 32.3% nasal) on at least 1 LEAP study visit, though most of the children had positive test results only once. Participants between 4 and 11 months of age recorded the greatest rates of colonization (18% for skin and 15% for nose).

S aureus colonization and concurrent eczema severity (measured via the SCORAD index) were significantly associated across every study time points.

Participants who has S aureus isolated from their skin also had higher levels of IgE antibodies to hen’s egg and peanuts than those who never had S aureus during approximately a 4-year follow-up. Children with S aureus present on their skin or in their noses were 1.57 (95% CI, 1.02-2.42; P = .042) times more likely to own their egg allergies persist at age 5 or 6 years compared with children who were not colonized with the bacterium.

“This is significant as most children with [an] egg allergy generally outgrow this at an earlier age,” Tsilochristou said.

“[The] authors also reported that the children that had S aureus were more likely to develop [a] peanut allergy despite them being fed with peanut from early ages as part of the LEAP study protocol. This was particularly exciting as it suggests that S aureus infection may own potentiated an accelerated form of peanut allergy development and/or inhibited tolerance mechanisms through peanut consumption.”

Of note, Tsilochristou pointed out, was that the results were independent of eczema severity.

The study results indicate that clinicians should consider S aureus as an additional risk factor in the development of food allergies, and also as a potential environmental factor when considering future interventions in inducing or maintaining tolerance to food allergens.

According to Tsilochristou, future studies may focus on advanced techniques and interventional methods of eradicating S aureus in early infancy.

To stay informed on the latest in infectious disease news and developments, please sign upfor our weekly newsletter.JUN 04, 2019 | ALEXANDRA WARD


make a difference: sponsored opportunity

Cite This Page:

NIH/National Institute of Allergy and Infectious Diseases.

«Researchers estimate 17% of food-allergic children own sesame allergy: Scientists discover sesame antibody testing predicts sesame allergy in food-allergic children.» ScienceDaily. ScienceDaily, 4 November 2019. <www.sciencedaily.com/releases/2019/11/191104112932.htm>.

NIH/National Institute of Allergy and Infectious Diseases. (2019, November 4). Researchers estimate 17% of food-allergic children own sesame allergy: Scientists discover sesame antibody testing predicts sesame allergy in food-allergic children. ScienceDaily. Retrieved January 29, 2020 from www.sciencedaily.com/releases/2019/11/191104112932.htm

NIH/National Institute of Allergy and Infectious Diseases.

«Researchers estimate 17% of food-allergic children own sesame allergy: Scientists discover sesame antibody testing predicts sesame allergy in food-allergic children.» ScienceDaily. www.sciencedaily.com/releases/2019/11/191104112932.htm (accessed January 29, 2020).

Clinical Practice in Walnut Creek and Brentwood offices.

Dr. Jacobs completed his Internal Medicine residency at David Grant USAF Medical Middle, then his fellowship in Allergy/Immunology at Wilford Hall USAF Medical Middle in San Antonio, TX.

He completed nine years of service in the USAF and was the previous Chief of Internal Medicine for the 28th Medical Group at Ellsworth AFB in South Dakota.

Dr. Jacobs joined Allergy and Asthma Medical Group in 1999. He is the Medical Director of Allergy and Asthma Clinical Research, Inc. and has published extensively in a number of peer reviewed medical journals. He is a member of the American Academy of Allergy, Asthma and Immunology; American College of Allergy, Asthma and Immunology; American Thoracic Society; European Academy of Allergy and Clinical Immunology; and past president of the Western Society of Allergy, Asthma and Immunology.

Dr.

Jacob’s areas of interest are the treatment of hereditary angioedema, chronic sinusitis, atopic dermatitis/food allergy, asthma and primary immunodeficiency.

“This discovery reverses food allergies in mice, and we own numerous people with allergies volunteering their own cells for us to use in lab testing to move this research forward,” said professor John Gordon, lead scientist behind the discovery just published in the current issue of the Journal of Allergy and Clinical Immunology.

The findings open the door to test this new allergy treatment in “humanized mice”—mice with non-existent immune systems implanted with cells from a human immune system, for example, from a peanut-allergic person.

With Health Canada approval, the first human trial could start in about one year, Gordon said. 

“If we can reliably ‘cure’ food allergies, or related conditions such as asthma or autoimmune diseases such as multiple sclerosis with this new therapy, it would be life-changing for affected individuals.”

Roughly 2.5 million Canadians self-report having at least one food allergy.  Anaphylaxis, defined as a severe rapid-onset allergic reaction, can be life-threatening and treatment options are limited.

The discovery involves generating a type of naturally occurring immune cell that sends a signal to reverse the hyper-immune response present in allergic reactions.  That signal triggers another “off switch” that turns off reactive cells further along the allergic pathway. 

“We predict the treatment could be on the market within the next five to 10 years,” said Gordon, who is also a research leader in the Allergy, Genes and Environment (AllerGen) Network.

AllerGen—part of the federally funded Networks of Centres of Excellence program—aims to assist Canadians address the challenges of living with asthma, allergies, anaphylaxis and related immune diseases.

Gordon’s team will collaborate with other AllerGen investigators located at the U of S, McGill University, Queen’s University, McMaster University, and University of Alberta to pilot the new technique.

“This discovery portends a major breakthrough towards a therapeutic reversal of food allergen sensitivity,” said Dr. Judah Denburg, scientific director and CEO of AllerGen.

“The treatment prevents anaphylactic responses in what were previously fully sensitive mice, opening the door for translating this therapy into the clinic.”

There is compelling evidence this technique could be effective in humans.  In 2010, Gordon’s team demonstrated they could reverse an asthmatic response in human cells in a test tube. Using three applications of a similar therapy in a 2012 study, the researchers effectively eliminated asthma in afflicted mice, within only eight weeks.

“Even if we only cure 25 per cent of subjects, we will dramatically improve the health of those individuals, and also reduce healthcare system expenses,” said Gordon, who worked with Wojciech Dawicki, a research associate and the primary author and lead researcher in this study.

Master’s student Chunyan Li and lab technicians Xiaobei Zhang and Jennifer Town also worked on the project.

Here’s how the technique works:

  1. Gordon’s pioneering treatment involves producing dendritic cells in a test tube and then exposing them to a unique stir of proteins, a vitamin A-related acid naturally occurring in the human gut, and to the allergen, in this case, peanut or ovalbumin (egg white protein). The modified dendritic cells are then reintroduced into the mouse. 
  2. The key component of this research is dendritic cells, which serve as the gate-keepers of the immune system and are present in tissues in contact with the external environment, such as the skin and the inner lining of the nose, lungs, stomach and intestines.
  3. Using this technique, the researchers were capable to almost eliminate the allergic reaction by converting allergen-sensitive immune cells into cells that mimic the response seen in healthy, non-allergic individuals.  

The treatment reduced the observed symptoms of anaphylaxis, and lowered other key protein markers in the allergic response by up to 90 per cent.

Food allergy is a growing public health issue in Canada.

Currently, there is no known cure. According to the Canadian Institute for Health Information, an estimated 171,000 Canadians visited emergency rooms for allergic reactions from 2013 to 2014, the rate of anaphylaxis visits increased by 95 per cent from 2006 to 2014, and the severity of reactions is increasing.

Gordon said the new technique also shows promise for treating autoimmune disorders such as multiple sclerosis. “It would take extremely little to adapt the therapy for autoimmune diseases,” he said.

Funding for the research was provided by the Canadian Institutes of Health Research and the AllerGen Networks of Centres of Excellence.

 

S aureus in Children With Eczema May Frolic a Role in Development of Food Allergies

Young children with severe eczema who are infected with Staphylococcus aureus may be at a higher risk of developing a food allergy, investigators at King’s College London found in a new study.

Published in the Journal of Allergy and Clinical Immunology, the study sought to investigate the association of S aureus colonization with specific Immunoglobulin E (sIgE) production with common food allergens and allergies in early childhood independent of eczema severity.

“It is well established that patients with eczema are frequently affected by colonization of their skin (and their nose) with Staphylococcus aureus,” Olympia Tsilochristou, MD, a physician at King’s College London and the first author on the study, told Contagion®.

What is a food allergy

“The authors, therefore, set [out] to investigate [whether] patients with eczema are more prone to develop food sensitization/allergy if they are colonized with this bacterium.”

Investigators collected nasal and skin swabs from young children with severe eczema enrolled in the Learning Early About Peanut Allergy (LEAP) and LEAP-On (12-month extension of the LEAP study: Persistence of Oral Tolerance to Peanut) studies at baseline and at 12, 30, and 60 months of age, and cultured them for S aureus.

Sensitization was identified via measuring sIgE levels, peanut allergies were identified primarily via oral food challenge, and persistent egg allergies were identified primarily via skin prick tests.

A entire of 48.8% of the 640 participants had some form of S aureus colonization (32.2% skin and 32.3% nasal) on at least 1 LEAP study visit, though most of the children had positive test results only once. Participants between 4 and 11 months of age recorded the greatest rates of colonization (18% for skin and 15% for nose).

What is a food allergy

S aureus colonization and concurrent eczema severity (measured via the SCORAD index) were significantly associated across every study time points.

Participants who has S aureus isolated from their skin also had higher levels of IgE antibodies to hen’s egg and peanuts than those who never had S aureus during approximately a 4-year follow-up. Children with S aureus present on their skin or in their noses were 1.57 (95% CI, 1.02-2.42; P = .042) times more likely to own their egg allergies persist at age 5 or 6 years compared with children who were not colonized with the bacterium.

“This is significant as most children with [an] egg allergy generally outgrow this at an earlier age,” Tsilochristou said.

“[The] authors also reported that the children that had S aureus were more likely to develop [a] peanut allergy despite them being fed with peanut from early ages as part of the LEAP study protocol. This was particularly exciting as it suggests that S aureus infection may own potentiated an accelerated form of peanut allergy development and/or inhibited tolerance mechanisms through peanut consumption.”

Of note, Tsilochristou pointed out, was that the results were independent of eczema severity.

The study results indicate that clinicians should consider S aureus as an additional risk factor in the development of food allergies, and also as a potential environmental factor when considering future interventions in inducing or maintaining tolerance to food allergens.

According to Tsilochristou, future studies may focus on advanced techniques and interventional methods of eradicating S aureus in early infancy.

To stay informed on the latest in infectious disease news and developments, please sign upfor our weekly newsletter.JUN 04, 2019 | ALEXANDRA WARD


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