Finding a Cure for Food Allergies

Ending Allergies Together: Finding a Cure For Food Allergies

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When I talk about food allergies to others, a question that comes up again and again is if there’s a cure for food allergies. While I wish there was something that my husband could do or take to make his allergies magically disappear, we’ve come to terms with the reality that his nut allergy will likely be with us for the rest of his life. While we’ve learned to manage food allergies in our everyday life, I was excited to learn about the non-profit E.A.T. (End Allergies Together), which is the only independent organization solely focused on raising money for a cure. 100% of their focus is on raising money for food allergy research. I was lucky enough to talk with one of the founders of E.A.T, Kim Hall, who decided she wanted a cure NOW, and decided to take action in partnership with Elise Bates, another mother she met in a food allergy support group to make it a reality.

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AFW: What inspired you to start E.A.T.?
Kim: My daughter Lindsay was 11 months old when I first fed her scrambled eggs with cheese. She immediately broke out in hives, threw up, and turned blue. I couldn’t believe it, but Lindsay was in anaphylactic shock and her system was shutting down. The call to 911 and the ambulance team saved her life. How could a child who seemingly looked fine one minute be fighting for her life in the next minute? We found out the next day that Lindsay is severely allergies to dairy, eggs and nuts. Lindsay is not alone. Food allergies are an epidemic affecting 1 in 12 children in the United States and it is doubling approximately every 10 years.

Two years ago I met Elise Bates at a local food allergy meeting. Not only did Elise share my passion to find a cure because of her own daughter’s life-threatening allergies, but she also had a vision of how to make a difference. Within a year, our families founded End Allergies Together, Inc. (EAT), a 501(c)(3) nonprofit organization solely dedicated to funding food allergy research.

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AFW: What are the three founding principles of E.A.T.?
Kim: The Three founding principles of E.A.T. are:
1. Unwavering focus on raising money to support the most promising research
2. EAT underwrites its administrative expenses to the extent possible so that everyone’s donation goes to research
3. Funding allocated with support of a medical advisory board of scientists and clinicians, who are leaders in the field but are not seeking research funding for their own studies, so E.A.T’s process remains objective.

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AFW: It’s inspiring that you and Kim met through a food allergy support group and decided to take immediate action. What are the biggest struggles you encounter daily as the parent of a child with food allergies?
Kim: Lindsay is allergic to a trace amount of dairy, egg and nuts so we must be vigilant at every turn. It was hard to find schools that could keep her safe, it is dangerous to eat outside the house and it is nearly impossible to travel. We can only stay in hotels that have kitchens. Birthday parties are the most dangerous and heartbreaking part of managing Lindsay’s food allergies. Eating is a part of life and a way of life and it dictates a lifestyle for any family that is impacted by food allergies.

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AFW: E.A.T. is the only independent organization solely focused on raising money for a cure. This means you won’t venture into advocacy, education, awareness, support, and product development. What factored into the decision to only focus on raising money for research?
Kim: Annual food allergy research costs are an estimated $500 million, and with private and public funding in 2013 there was still a research gap of over $420 million. In order to accelerate new treatments and solutions for this growing epidemic, EAT is laser focused on raising money to bridge this research gap.

The scientific community does not have a fundamental understanding of why food allergies are on the rise, why food allergies occur in some people and not others, why people are allergic to certain foods and not others, why some people have mild reactions and others have life-threatening reactions; etc. These fundamental questions need to be answered in order to have a broad spectrum of effective treatments and ultimately, cures.We can’t answer these questions without a substantial infusion of money to the scientific community.

We do not fund other food allergy related initiatives such as educational programming, educational publications or advocacy related efforts, while these are extremely important initiatives, we believe other organizations do them very, very well.

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AFW: You just announced that E.A.T. will be funding three studies. Can you tell me about each of the studies and how you selected these from the many applications you received?
Kim: EAT received numerous applications to fund a wide spectrum of food allergy research. Each of the grant applications were reviewed by our Medical Advisory Board which is comprised of highly knowledgeable scientists and clinicians who are leaders in the field but not conducting their own studies. The Medical Board unanimously recommended funding the following studies: (please visit the research section on our website for additional information on each study)

Biomarkers
Molecular Gene Expression During Allergic Reactions to Food: Identifying Signatures Which Correlate with Severity of Reactions
Jonathan M. Spergel, MD, PhD, Division of Allergy-Immunology, The Children’s Hospital of Philadelphia, Perelman School of Medicine at University of Pennsylvania
Paul J. Turner, FRACP PhD, Section of Pediatrics (Allergy-Immunology), Faculty of Medicine, Imperial College London, United Kingdom.

Study Summary:
The biggest challenge in managing individuals with food allergy is our current inability to reliably identify those people who are at risk of severe, life-threatening reaction. Our knowledge regarding the mechanisms of food allergic reactions in man is limited, partly due to the fact that animal models are of very limited relevance. We cannot explain why one person will develop life-threatening anaphylaxis to under 1/70 of a peanut, while another will develop only localized itching after eating 3-4 peanuts. Allergy tests (skin prick test size, specific IgE antibody to either a total allergen or allergen component) do not predict the severity or the sensitivity of an individual.  For example, a patient with small skin test can have life-threatening allergic reaction, while another patient with a large skin test may have a mild reaction limited to the skin.

Understanding the mechanisms, and in particular the differences between severe and non-severe allergic reactions, is key to improving patient care. In this research we will take advantage of blood samples from a unique cohort of peanut-allergic patients that have undergone carefully-controlled food challenges to peanut under varying conditions and experienced different types of reactions.  We will use advanced molecular techniques (microarray gene expression CHIP assay) to study expression of genes which are activated during allergic reactions and then result in the release of mediators which cause the reaction. We will analyze these results to identify how the different gene expression signals are associated with the symptoms experienced by patients.   The goal is to identify molecular signatures that correlate with patterns of symptoms allowing us to predict whois at risk for a severe reaction.

Microbiome
Characterization of Prebiotic Dietary Fibers to Prevent or Treat Food Allergies
Cathryn R. Nagler, PhD, Bunning Food Allergy Professor, Professor of Pathology, Medicine, Pediatrics and The College, The University of Chicago

Study Summary:
Immunoregulatory responses induced by commensal bacteria are critical to preventing intestinal inflammation. Whether the intestinal microbiota also plays a role in regulating non responsiveness to the other major luminal constituent – food – has been poorly understood. Murine models developed in our laboratory demonstrate that sensitization to a food allergen is enhanced in mice that have been treated by neonatal antibiotic administration (Abx) or are devoid of commensal microbes (germ free). By selectively colonizing germ free mice we showed that the allergy-protective capacity is contained within the Clostridia, a class of anaerobic spore forming Firmicutes that resides in close proximity to the intestinal epithelium. Reintroduction of a Clostridia-containing microbiota to Abx-treated mice blocks sensitization to a food allergen.

Microarray analysis of intestinal epithelial cells isolated from gnotobiotic mice identified a novel innate mechanism by which Clostridia protect against sensitization to dietary antigens. Clostridia colonization induces the production of the barrier protective cytokine IL-22 by both innate lymphoid cells and T cells in the intestinal lamina propria. IL-22-mediated effector functions, including the production of mucus and anti-microbial peptides, collectively contribute to protection against sensitization by reducing the access of dietary antigen to the systemic circulation. Our mouse model work is supported by translational studies comparing the fecal microbiota of healthy infants to that of infants with cow’s milk allergy (CMA). We find that the CMA infant microbiome has the diverse community structure typical of adults.

Treatment of CMA infants with a tolerance inducing formula supplemented with the probiotic Lactobacillus rhamnosus GG (LGG) is associated with changes in microbial community structure that include the expansion of butyrate-producing Clostridia and significantly higher levels of butyrate detectable in feces. Butyrate, but not other short chain fatty acids, regulates epithelial barrier function in our mouse model. Commensal bacteria produce butyrate by fermentation of insoluble dietary fiber and we also find that mice weaned onto high fiber diets exhibit reduced intestinal permeability to food antigens. Identification of dietary fibers, and their metabolites, which regulate the intestinal epithelial barrier has great promise for the development of novel microbiome modulating approaches to prevent or treat allergic sensitization to food.

Oral Immunotherapy
Improving Safety for the Food Allergy-Asthma Syndrome
Sharon Chinthrajah, MD, Kari Nadeau, MD, PhD, Pulmonary and Critical Care Medicine, Allergy and Immunology, Sean N Parker Center for Allergy and Asthma Research, Stanford University.

Study Summary:
Oral immunotherapy (OIT) is an emerging investigational therapy for food allergy. With multiple small exploratory trials and some large randomized-controlled phase 2 trials recently published, there is clear progress and interest toward making this a treatment option for patients suffering from food allergies. Understanding who is at risk for more severe reactions during OIT, the immunological mechanisms underlying the increased risk, and how to make OIT a safer process would help to make this therapy more widely available.

In patients with food allergy, asthma is a risk factor for a life threatening reaction.1,2 Interestingly, both diseases have overlapping immune mechanisms leading to allergic inflammations characterized by eosinophils, allergic antibodies, such as IgE, and T helper cells (Th2 cells). Though T cells are understood to be central mediators of both asthma and food allergy separately, little is known about the contribution of different T cell subsets to a combined food allergy-asthma syndrome. Recently, we have shown that omalizumab, an anti-IgE antibody extensively studied in asthma, can also be used in conjunction with OIT to desensitize patients to their food allergies in a safe and expedient manner, compared to OIT alone.4

We will to understand distinct food allergic phenotypes and determine the relative contributions of T cell subsets in these different groups and how this contributes to the safety of OIT in patients undergoing OIT with and without Omalizumab. Results from these studies will improve our understanding of the interaction between food allergy and asthma, and lead to the understanding of how omalizumab may increase safety and symptoms of these diseases during oral immunotherapy.

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AFW: How can we help?
Kim: You can donate here, every $1 counts as 100% of net proceeds that are being donated to advance food allergy research. Shop on Amazon? Add us on Amazon Smile where 0.5% of the price of your eligible purchases will be donated to E.A.T.!

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