Viaskin Peanut May Offer First Epicutaneous Treatment for Peanut Allergy

MedicalResearch.com Interview with:

Todd Green MD Vice President, Medical Affairs North AmericaDBV TechnologiesAssociate Professor of PediatricsUniversity of Pittsburgh School of Medicine

Dr. Green

Todd Green MD 
Vice President, Medical Affairs North America
DBV Technologies
Associate Professor of Pediatrics
University of Pittsburgh School of Medicine

MedicalResearch.com: What is the background for this announcement? What is Viaskin Peanut?

Response: Peanut allergy is one of the most common food allergies and can cause severe, potentially life-threatening allergic reactions, including anaphylaxis. Unfortunately, there are no FDA-approved treatment options for peanut or other food allergies – leaving patients with avoidance and readiness to manage reactions to accidental exposures as their only option.

Viaskin Peanut uses epicutaneous immunotherapy or EPIT, a method of delivering biologically active compounds to the immune system through the skin. Patients receive about 1/1,000th of a peanut with each daily dose of peanut protein – the equivalent of one peanut every three years – which activates the immune system with very minimal exposure.

In February 2019, DBV announced that its planned resubmission of the Biologics License Application (BLA) to the U.S. Food and Drug Administration (FDA) for Viaskin Peanut in the treatment of peanut-allergic children 4 to 11 years of age is anticipated in the third quarter of 2019.

DBV is working diligently on its resubmission package, bringing us one step closer to providing an FDA-approved treatment for peanut-allergic children and their families. Viaskin Peanut previously received Breakthrough and Fast Track designations for the treatment of peanut-allergic children from the FDA in 2015 and 2012, respectively. 

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Viaskin Peanut: Convenient Potential Treatment Option for Peanut Allergy

MedicalResearch.com Interview with:

Dr. Matthew GreenhawtDirector, Food Challenge and Research UnitChildren’s Hospital Colorado

Dr. Greenhawt

Dr. Matthew Greenhawt
Director, Food Challenge and Research Unit
Children’s Hospital Colorado

MedicalResearch.com: What is the background for this study?

Response: In the US, nearly one million children suffer from a peanut allergy and severe reactions to food allergens are not uncommon – yet there is significant unmet need in the food allergy immunotherapy space, as there are no currently approved treatment options. That being said, we are encouraged by the efficacy and safety data, which support Viaskin Peanut as a convenient and well-tolerated potential treatment option for the peanut allergy.

In the pivotal Phase III clinical trial (PEPITES) just published in The Journal of the American Medical Association (JAMA), Viaskin Peanut – the first epicutaneous immunotherapy (EPIT) in development that leverages the skin to activate the immune system – provided statistically significant desensitization in peanut-allergic children ages 4-11 years old. Patients who were treated with active therapy were more likely to have increased their eliciting dose to peanut (the amount of peanut protein ingested before an objective allergic reaction was seen during a double-blind, placebo-controlled food challenge) by a required amount as compared to patients treated with a placebo patch. The improvement suggests a reduced risk of allergic reaction to accidental peanut ingestion in the group treated with Viaskin Peanut, with no change seen in the placebo group.

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Sesame Allergies More Common and Severe Than Recognized

MedicalResearch.com Interview with:

Ruchi Gupta MD MPHMary Ann & J Milburn Smith Senior Scientist in Child Health ResearchDirector, Science & Outcomes of Allergy & Asthma Research (SOAAR) ProgramProfessor of Pediatrics & MedicineClinical Attending    Ann & Robert H. Lurie Children's Hospital of ChicagoInstitute for Public Health and MedicineNorthwestern Feinberg School of Medicine

Dr. Gupta

Ruchi Gupta MD MPH
Mary Ann & J Milburn Smith Senior Scientist in Child Health Research
Director, Science & Outcomes of Allergy & Asthma Research
Professor of Pediatrics & Medicine
Clinical Attending
Ann & Robert H. Lurie Children’s Hospital of Chicago
Institute for Public Health and Medicine
Northwestern Feinberg School of Medicine

Christopher M. Warren,  PhDUniversity of Southern CaliforniaLos Angeles, CA

Dr. Warren

 

Christopher M. Warren,  PhD
University of Southern California
Los Angeles, CA

 

 

MedicalResearch.com: What is the background for this study?

Response: Readers may be familiar with the so-called “top 8” food allergens (i.e. peanut, tree nut, cow’s milk, fin fish, shellfish, egg, wheat and soy), which are responsible for the majority of food allergies in the US.  However, in recent years increasing attention has been paid to sesame allergy, which evidence suggests can lead to anaphylaxis, frequently results in accidental exposure among affected patients, and is infrequently outgrown.  Until now, only one 2010 study has systematically assessed the prevalence of sesame among both US children and adults.  It concluded that sesame allergies were reported by approximately .1% of the US population.

However, this study, which surveyed a sample of approximately 5000 US households only captured 13 individuals with reported sesame allergy, which limited the authors’ ability to draw more detailed conclusions about the specific characteristics of sesame allergy in the United States.    Continue reading

Boiled Peanut Immunotherapy For Peanut Allergy

MedicalResearch.com Interview with:
Dr Paul Turner FRACP PhD
MRC Clinician Scientist and Clinical Senior Lecturer, Imperial College London
Honorary Consultant in Paediatric Allergy & Immunology
Imperial College Healthcare NHS Trust
Hon Consultant, Royal Free Hospital / Royal Brompton & Harefield NHS Foundation Trust
Clinical trials specialist (Paediatrics), Public Health England
Clinical Associate Professor in Paediatrics, University of Sydney, Australia

Dr. Nandinee Patel, MD
Section of Paediatrics
Imperial College London
London, United Kingdom
MRC & Asthma UK Centre in Allergic Mechanisms of Asthma
London, United Kingdom

MedicalResearch.com: What is the background for this study?

Response: Current desensitisation protocols for peanut allergy use defatted roasted peanut flour, which can be difficult to accurately measure in very low doses needed for desensitisation (and thus has resulted in the development of AR101 by Aimmune which is likely cost many thousands of dollars for a course of treatment).

We have previously observed that some children with food allergy to roasted peanut (such as peanut butter) are nonetheless able to tolerate boiled peanuts without reacting. We performed in vitro protein analysis studies which demonstrated that boiling peanuts resulted in around 50% of protein leaching out of the peanut into the cooking water. Furthermore, we found evidence for preferential leaching of allergen epitopes such as Ara h 2 as well aggregation of proteins resulting in a hypoallergenic peanut product.

We therefore sought to assess whether boiled peanuts could be as effective and safe to induce desensitisation.

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Overdiagnosis of Penicillin Allergy Can Lead To Unintended Side Effects

MedicalResearch.com Interview with:

ESS= Erica S. Shenoy, MD, PhD Harvard Medical School

Dr. Shenoy

ESS= Erica S. Shenoy, MD, PhD
Harvard Medical School
Division of Infectious Diseases, Department of Medicine
Massachusetts General Hospital, Boston

Kimberly G. Blumenthal MD, MSc Division of Rheumatology, Allergy and Immunology Department of Medicine, Massachusetts General Hospital, Boston

Dr. Blumenthal

KGB= Kimberly G. Blumenthal MD, MSc
Division of Rheumatology, Allergy and Immunology
Department of Medicine, Massachusetts General Hospital,Boston

 

EMM= Eric M. Macy MD, MS Department of Allergy Southern California Permanente Medical Group San Diego Medical Center

Dr. Macy

EMM= Eric M. Macy MD, MS
Department of Allergy
Southern California Permanente Medical Group
San Diego Medical Center

TR= Theresa Rowe, DO, MS General Internal Medicine and Geriatrics Feinberg School of Medicine Northwestern University, Chicago, Illinois

Dr. Rowe

TR= Theresa Rowe, DO, MS
General Internal Medicine and Geriatrics
Feinberg School of Medicine
Northwestern University, Chicago, Illinois

MedicalResearch.com: What is the background for this review?

ESS: A key component of reducing antimicrobial resistance is improving how antimicrobials are prescribed—both reducing inappropriate use (i.e., not prescribing when not needed) and favoring the use of narrow-spectrum agents that are less likely to contribute to the development of antimicrobial resistance.

KGB: Because unverified penicillin allergy labels are so prevalent with greater than 32 million Americans affected, and these labels lead to the use of alternative antibiotics that are often more broad-spectrum, we now know that penicillin allergy evaluations are an emerging important component of antibiotic stewardship.  When patients with a reported penicillin allergy are tested, more than 95% of them are not allergic, and thus could (and should) receive penicillins, and often related drugs, when appropriate.

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How Do Pregnant Women Decide Which Foods To Avoid To Prevent Food Allergies in Their Children?

MedicalResearch.com Interview with:

Dr-Karen Robbins

Dr. Robbins

 Karen Robbins, M.D.
Allergist at Children’s National Health System 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The background is that mothers are often concerned that something they did contributed to their children developing food allergies. Many will relate that they ate a lot of one specific food allergen while pregnant, and question how this could have impacted their unborn child. We realized that we hear a lot of anecdotal stories in clinic, but were not sure how frequently mothers try to alter their diet in the hopes of preventing food allergy in their children. We also were not sure where families get information or guidance on this topic. Continue reading

FDA Grants Orphan Drug Designation For Eosinophilic Granulomatosis with Polyangiitis

MedicalResearch.com Interview with:

Mr. Tosh Butt Vice President, Respiratory AstraZeneca

Mr. Butt


Mr. Tosh Butt

Vice President, Respiratory
AstraZeneca

Mr. Butt discusses the recent announcement that the FDA has granted Orphan Drug Designation for Fasenra for the treatment of Eosinophilic Granulomatosis with Polyangiitis. 


MedicalResearch.com:
What is the background for this announcement? Can you tell us a little more about Eosinophilic Granulomatosis with Polyangiitis/Churg Strauss? How does it differ/resemble severe eosinophilic asthma?

  • The US Food and Drug Administration (FDA) has granted Orphan Drug Designation (ODD) for FASENRA™ (benralizumab) for the treatment of Eosinophilic Granulomatosis with Polyangiitis (EGPA). The ODD application was based on epidemiology demonstrating the rarity of the disease (<200k US patients) and a scientific rationale that FASENRA may benefit patients with this condition. The core role of eosinophilia in EGPA and FASENRA’s demonstrated eosinophil-depleting properties provided this rationale and suggest it may deliver benefit to patients with EGPA.
  • EGPA is a rare autoimmune disease that can cause damage to multiple organs and tissues. EGPA is characterized by inflammation of blood vessels and the presence of elevated levels of eosinophils, a type of white blood cell. All patients with EGPA have very high levels of eosinophils at some point in their disease. FASENRA induces rapid and near-complete depletion of eosinophils in the blood and has proven efficacy in severe eosinophilic asthma, which suggest it may deliver benefit to patients with EGPA. 

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Asthma in Children Can Worsen From Allergy to Secondhand Marijuana

MedicalResearch.com Interview with:
"marijuana joint" by Torben Hansen is licensed under CC BY 2.0Bryce Hoffman, MD

Allergy & Immunology Fellow
National Jewish Health

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Secondhand marijuana exposure is expected to increase as personal cannabis use becomes legalized in more states and countries. Cannabis allergy from firsthand use has been reported in adults but allergy in young children exposed to secondhand smoke has not been previously reported. We present a case of a young child with difficult-to-control asthma who was found to have cannabis allergy after being exposed to secondhand marijuana smoke in his household. This child’s asthma improved after cannabis was removed from the environment.

MedicalResearch.com: What should readers take away from your report?

Response: Children exposed to secondhand marijuana smoke can become allergic to cannabis, which in turn may significantly worsen their asthma or allergy symptoms. This is particularly concerning as the cannabis may not be suspected as a cause. Parents and physicians should consider the possibility of cannabis allergy in any child with uncontrolled asthma who is being exposed to secondhand marijuana smoke. This includes any use of marijuana in the household where the patient lives. These children should be referred to an allergist for further work-up.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Further studies are needed to replicate these results with more patients in the future, and to optimize methods of testing for cannabis allergy. We need to better understand how secondhand allergy develops – is it from particles in the smoke, or plant particles left over in the environment? We also need to better characterize cannabis allergy and in particular its cross-reactivity with other plant foods and pollens. 

I have no disclosures.

Citation:Abstract MEETING American College of Allergy, Asthma and Immunology 2018 Annual Scientific Meeting

Abstract Title: Cannabis allergy in a young child with severe asthma exposed to secondhand marijuana smoke

Author: Bryce Hoffman, MD

Nov 18, 2018 @ 12:20 pm

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Omalizumab (XOLAIR) For Chronic Hives (Urticaria)

MedicalResearch.com Interview with:

Hives - Wikipedia image James Heilman, MD - Own work

Hives – Wikipedia image

Christopher S. Lee, PhD, RN, FAHA, FAAN, FHFSA
Professor and Associate Dean for Research
Boston College William F. Connell School of Nursing
Chestnut Hill, MA 02467

MedicalResearch.com: What is the background for this study?

Response: Although the efficacy of omalizumab (i.e. can it work?) in the treatment of chronic idiopathic (spontaneous) urticaria has been established in clinical trials, the effectiveness of omalziumab (i.e. does it work?) in the real-world management is less well established.

The purpose of this study was to synthesize what is known about the benefits and harms of omalizumab as used in real-world treatment of Chronic Idiopathic (Spontaneous) Urticaria.

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Could Sucking the Pacifier Clean Lower Your Baby’s Allergy Antibodies?

MedicalResearch.com Interview with:

Eliane Abou-Jaoude, MD  Allergy and Immunology Fellow Henry Ford Health System Detroit, MichiganEliane Abou-Jaoude, MD 
Allergy and Immunology Fellow
Henry Ford Health System
Detroit, Michigan

MedicalResearch.com: What is the background for this study?

Response: Early life exposure to diverse types of microbes is necessary for healthy immune development and may impact the risk for developing allergic disorders.

Theoretically the transfer of parental microbes to their offspring during infancy can influence a child’s developing gut microbiome and subsequent immune response patterns.

We wished to investigate whether parental pacifier cleaning methods, reported at 6-months of age, were associated with altered serum IgE trajectory over the first 18 months of life. 

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Are Some Dogs Really ‘Allergy Friendly’?

MedicalResearch.com Interview with:
"Dogs and Kids Mix Well" by Tony Alter is licensed under CC BY 2.0Catarina Almqvist Malmros MD, PhD
Professor | Consultant Pediatrician
Dept of Medical Epidemiology and Biostatistics | Karolinska Institutet
Lung and Allergy Unit | Astrid Lindgren Children’s Hospital
Stockholm, Sweden

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We have previously shown an association between growing up with dogs and a lower risk of childhood asthma (doi: 10.1001/jamapediatrics.2015.3219) but it has been unknown whether this link is modified by characteristics of the dog. Sex of the dog may have an effect on expressed allergens, and uncastrated male dogs release more of a certain allergen than castrated male dogs and female dogs. Some breeds are also described as ‘hypoallergenic’, but there is no scientific evidence whether they are more suitable for people with allergies.

We examined how variables such as sex, breed, number of dogs or size of dog are associated with the risk of asthma and allergy among children with a dog in their home during the first year of life. We included all Swedish children born between January 2001 and December 2004 whose parents had a registered dog in a dog-owner register and linked the data to the Swedish population- and health data registers.

Main findings are that children raised with only female dogs at home had a 16 per cent lower risk of asthma than those with male dogs, and that children living with two or more dogs had a 21 per cent lower risk of asthma than those with only one dog. Importantly, families with parental asthma or allergies had ‘hypoallergenic’ breeds more often than children whose parents did not have asthma or allergies; 11.7% compared to 7.6 . Exposure to these breeds was associated with a 27 per cent higher risk of allergy and no decreased risk of asthma.  Continue reading

Pediatric Allergist Discusses New Insights into Pediatric Food Allergies

MedicalResearch.com Interview with:

David Stukus, MD Associate Professor of Pediatrics Associate Director, Pediatric Allergy & Immunology Fellowship Program Director of Quality Improvement, Division of Allergy and Immunology Nationwide Children's Hospital and The Ohio State University College of Medicine Columbus Ohio 43205

Dr. Stukus

David Stukus, MD
Associate Professor of Pediatrics
Associate Director, Pediatric Allergy & Immunology Fellowship Program
Director of Quality Improvement, Division of Allergy and Immunology
Nationwide Children’s Hospital and The Ohio State University College of Medicine
Columbus Ohio 43205

Dr. David Stukus discusses the emerging science behind food allergy prevention.

MedicalResearch.com: How many US children are affected by food allergies? 

Response: Food allergies affect roughly 5-8% of all U.S. children, which is approximately 6 million children. This translates to about 1 in every 13 children, or an average of two children in every classroom. 

MedicalResearch.com: Are food allergies becoming more common?

Response: Yes, we know that the prevalence of food allergies have doubled over the past two decades. Unfortunately, there is no single or definitive answer as to why this increase has occurred.

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Babies Born During Peak Pollen Season Have IgE in Cord Blood

MedicalResearch.com Interview with:
“Pollen” by John S. Quarterman is licensed under CC BY 2.0Bircan Erbas, Associate Professor
Reader/Associate Professor, Department of Public Health
School of Psychology & Public Health
La Trobe University 

MedicalResearch.com: What is the background for this study?

Response: Around the world allergic respiratory diseases especially in children is a major problem. Studies have already shown that cord blood IgE can be used to identify children at risk for allergic diseases. Our previous research showed that exposure to high levels of outdoor pollen, especially grass, in the first couple of months after birth increased risk of allergic respiratory diseases. Based on this, we suspected that exposure to high grass pollen during pregnancy could be also important. Continue reading

Antibiotics Leading Cause of Pediatric Adverse Drug Events in ER

MedicalResearch.com Interview with:
Maribeth C. Lovegrove, MPH
Division of Healthcare Quality Promotion
Centers for Disease Control and Prevention
Atlanta, GA 30333).

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There has been a lot of recent attention on reducing unnecessary antibiotic prescribing in order to reduce antibiotic resistance (a longer-term harm).  However, antibiotic use also can lead to shorter-term harms like allergic reactions and other side effects.  With this analysis, we wanted to focus on the acute harms to individual pediatric patients from antibiotic use in order to help target prevention efforts.  Specifically, we used data from two national data sources to identify the antibiotics with the highest numbers of emergency department visits for adverse drug events and the highest rates of emergency department visits for adverse drug events (accounting for amount of antibiotic prescriptions dispensed) and to identify the pediatric patients with the highest risks.

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Severe Skin Reactions TEN/SJS: Children Generally Do Better Than Adults

MedicalResearch.com Interview with:
CDC imageJames W. Antoon, MD, PhD

Pediatric Primary Care
University of Illinois Hospital

MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis?

Response: Stevens Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are potentially fatal skin conditions, most commonly caused by medications and infections. Early symptoms include fever, blistering and peeling of the skin and mucus membranes and can affect any organ system including the eyes, lungs, kidneys and intestines. While rare, the conditions often result in life-long effects. The rarity and severity of these diseases have made it a challenge for researchers and clinicians to study, especially in a pediatric population. As a result, much of the information used to drive our care for children is derived from adult studies.

MedicalResearch.com: What are the main findings? 

Response: Using the Pediatric Health Information System, a large pediatric database containing information from 45 U.S. children’s hospitals, we studied the treatment and outcomes of SJS and TEN in children. This is one of the first large-scale to benchmark clinical outcomes the conditions in children. We characterized outcomes such as cost of hospital care, length of hospital stay, mortality, recurrence, hospital readmission as well as short-term complications like kidney failure, respiratory failure and sepsis.

Overall, we found that these outcomes in children were better than in adults. We also found that children with SJS and TEN received different kinds of treatment and that treatment strategies varied by region of the country. Expensive or combination treatments did not necessarily result in better outcomes.

MedicalResearch.com: What should readers take away from your report?

Response: Overall, these findings suggest we can be cautiously optimistic about SJS and TEN outcomes in children. Mortality and short-term morbidity in children with SJS and TEN is lower than in adults. Our results also suggest we can potentially reduce the cost of care for families by selecting lower-cost treatments to achieve the same outcomes. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: We identified a large variation in the treatment kids with SJS and TEN received, yet outcomes did not differ between treatments. This usually indicates an area for improvement in the quality of care doctors provide. Further research focusing on strategies that reduce complications, hospital stays and the cost of care would help provide physicians with better evidence on how to treat these conditions. 

MedicalResearch.com: Is there anything else you would like to add?

Response: The study was performed in collaboration with Drs. Jennifer Goldman and Brian Lee of Children’s Mercy Hospital and Clinic in Kansas City, Missouri, and Dr. Samir Shah of Cincinnati Children’s Hospital Medical Center. Dr. Goldman’s work was supported in part by a grant (KL2TR000119) from the National Center for Advancing Translational Sciences, part of the National Institutes of Health.

Citation:

J Allergy Clin Immunol Pract. 2018 May 30. pii: S2213-2198(18)30346-5. doi: 10.1016/j.jaip.2018.05.024. [Epub ahead of print]
A Retrospective Cohort Study of the Management and Outcomes of Children Hospitalized with Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis.
Antoon JW1, Goldman JL2, Shah SS3, Lee B4. 

Jul 16, 2018 @ 8:24 pm

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Not All Tomatoes Are Equally Allergenic

MedicalResearch.com Interview with:
“TOMATOES” by RubyGoes is licensed under CC BY 2.0Prof. Dr. rer. nat. Wilfried Schwab

Technical University of Munich
Center of Life and Food Science Weihenstephan
Biotechnology of Natural Products
Freising, Germany

MedicalResearch.com: What is the background for this study?

Response: The prevalence of food allergy is an increasing health problem. Although tomatoes are one of the most consumed vegetables worldwide and have health beneficial effects lowering the risk of cancer and cardiovascular diseases, patients suffering from birch pollen allergy can develop cross-reactivity after consumption of fresh tomatoes.

The aim of this study was to develop an analytical method for the quantification of the birch-pollen homologous allergen Sola l 4 in various tomatoes cultivars. Furthermore, the effect of conventional or organic cultivation as well as processing techniques on Sola l 4 content was investigated. Continue reading

Red Meat Allergy Caused by Lone Star Tick Linked to Coronary Artery Disease

MedicalResearch.com Interview with:
“Lone Star Tick” by Katja Schulz is licensed under CC BY 2.0Jeffrey Wilson, MD, PhD

Research Fellow, Allergy & Immunology
University of Virginia 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Galactose-α-1,3-galactose (α-Gal) represents an oligosaccharide that is present in mammalian products and is the causal allergen in a syndrome of delayed red meat allergy (commonly called α-Gal syndrome). Sensitization to this allergen has been linked to tick bites, specifically the lone star tick in the United States.

Thus, sensitization to α-Gal (and the prevalence of subjects with symptomatic red meat allergy) is relatively common where the lone star tick is common, i.e- the southeast.

For a variety of reasons we hypothesized that specific immune sensitization (which relates to IgE antibody production) to α-Gal would be a risk factor for coronary artery disease. To address this possibility we measured IgE specific to α-Gal in 118 adults subjects from central Virginia who had undergone advanced cardiac imaging with a technique called intravascular ultrasound. Out of the cohort 26% of the subjects in the study had the sensitivity to α-Gal.

The main finding was that subjects with the IgE sensitization to α-Gal had greater amounts of atherosclerosis, as well as atherosclerotic plaques with more unstable characteristics. This association was significant when controlled for traditional cardiovascular risk factors such as hypertension, diabetes and lipids levels.

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Food Allergies More Common in Children With ASD

MedicalResearch.com Interview with:

Wei Bao, MD, PhD Assistant Professor, Epidemiology College of Public Health University of Iowa

Dr. Wei Bao

Wei Bao, MD, PhD
Assistant Professor, Epidemiology
College of Public Health
University of Iowa

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Previous studies indicated a possible link between immunologic dysfunction and autism. The current study, based on nationally representative large-scale surveys, showed that food allergy, respiratory allergy, and skin allergy, all relevant to immunological dysfunction, were associated with autism spectrum disorder among US children.

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Allergic Rhinitis Can Impair Adolescent Sleep and School Performance

MedicalResearch.com Interview with:

Michael S. Blaiss, MD, FACAAI Executive Medical Director American College of Allergy, Asthma & Immunology Arlington Heights, IL 60005

Dr. Blaiss

Michael S. Blaiss, MD, FACAAI
Executive Medical Director
American College of Allergy, Asthma & Immunology
Arlington Heights, IL 60005

MedicalResearch.com: Is this research important? Why or why not?

Response: There has not been a comprehensive review of how allergic rhinitis impacts the adolescent population. Most studies put adolescents in with children and yet we know that how disease affects adolescents may be dramatically different than children. Adolescents is a difficult enough time with a chronic condition

MedicalResearch.com: What is the key take-home message?

Response: The symptoms associated with nasal and eye allergies can be different in adolescents compared with adults and children and lead to poor quality of life and impair learning in school. Adolescents with AR/ARC may experience difficulties falling asleep, night waking, and snoring, and generally have poorer sleep. Therefore health care providers need to aggressively control the adolescent’s allergic rhinitis.  Continue reading

Inflammatory Cells That Suppress Skin Allergic Reactions Identified

MedicalResearch.com Interview with:
elstarNidhi Malhotra PhD

Boston Children’s Hospital
Division of Allergy and Immunology
Senior Scientist at Elstar Therapeutics Inc.

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Allergies such as Atopic Dermatitis (AD) are rampant in the industrialized nations. Why are we more predisposed to developing hypersensitive reactions to innocuous proteins (allergens) is not well understood. To gain better understanding and to develop better therapies, we need to first delve deeper into how our immune system regulates homeostasis in tissues such as skin. The main cell types that thwart inflammatory reactions are known as regulatory T cells. These cells are generated in thymus and reside in secondary lymphoid tissues but they are also prominent at tissue sites such as in dermal layer of skin. In this study, I focused on understanding how Tregs resident in skin are distinct from the Tregs in secondary lymphoid organs such as lymph nodes (LNs). I uncovered that functioning of Tregs in skin is underpinned by a distinct set of genes. One main gene that I found to be highly expressed in skin Tregs but not in LN Tregs is Rora, which encodes for the transcription factor ROR alpha (RORa).

This observation was intriguing as previous studies had elucidated the requirement of RORa in the development of inflammatory type-2 innate lymphoid cells (ILC2s) and it has been considered the antagonizing RORa functioning would curb allergic responses. However, I observed that Tregs require RORa to suppress allergic responses. In particular, RORa regulates the expression of a TNF receptor family member DR3, which binds to the cytokine TL1A. TL1A has a role in enhancing suppressive activity of Tregs while also enhancing type-2 cytokine production from ILC2s. Hence, in the absence of DR3 in Tregs, we believe more TL1A is available to ILC2s resulting in unrestrained allergic responses.  Continue reading

Synthetic Folic Acid Metabolites May Be Associated With Food Allergy in Children

MedicalResearch.com Interview with:
Emily Clarke McGowan, MD

Assistant Professor, Allergy/Clinical Immunology
Charlottesville, VA 22908-1355

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Folate (vitamin B9) is available in either the natural or synthetic forms and has been shown to reduce the risk of neural tube defects, like spina bifida, in newborns.  Folic acid, the synthetic form of folate, is widely consumed in the United States in infant formula, supplements, vitamins, and fortified grains.  When folic acid is consumed in high quantities, some of this folic acid does not undergo further metabolism and circulates in the blood as “unmetabolized folic acid” (UMFA).

In this study, we measured total folate, UMFA, and 5-methyltetrahydrofolate (5-MTHF), the main folate metabolite involved in biochemical processes in the body, in a subset of children from the Boston Birth Cohort.

While mean levels of total folate at birth were lower among those who developed food allergy, mean levels of the synthetic folic acid derivative, UMFA, were higher.  There was no association between total folate, 5-MTHF, or UMFA levels in early life and the development of food allergy.  Continue reading

Tick Bites Plus Blood Type Predispose to Red Meat Allergy

MedicalResearch.com Interview with:

Brestoff-Parker

Dr. Brestoff-Parker

Jonathan R. Brestoff-Parker, MD, PhD
PSTP Resident, Clinical Pathology
Department of Pathology & Immunology
Washington University School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Red meat allergy is a recently recognized food allergy in which people experience a delayed allergic response about 3-6 hours after eating red meats that contain the allergen alpha-gal.

Red meat allergy is thought to be caused by tick bites which expose humans to alpha-gal, however other factors that contribute to disease risk are not well described. Alpha-gal looks a lot like the B antigen, which is one of the factors that determines blood type. So we wondered whether people with blood types B or AB are protected from getting red meat allergy. We were amazed when we found that patients who make the B antigen (blood types B or AB) are 5 times less likely to have red meat allergy than patients who do not make the B antigen (blood types O or A).  Continue reading

AI Trained Computer Program Can Monitor Health Forums To Detect Adverse Drug Reactions

MedicalResearch.com Interview with:

Kavita Sarin, M.D., Ph.D.

Dr. Sarin

Kavita Sarin, M.D., Ph.D.
Assistant Professor of Dermatology
Stanford University Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Drug reactions occur in the majority of patients undergoing cancer therapies. Half of serious drug reactions are detected after market approval which can result in painful complications and interruption in therapy. Post-market drug surveillance platforms such as FDA monitoring rely on medical publications and physician reporting and take time to identify trends. We sought to determine if we could identify trends in patient discussions in internet health forums to more rapidly identify chemotherapeutic drug reactions. We chose skin reactions as a proof-of-principle because patients can more easily describe what they see on their skin.

Julia Ransohoff, a medical student, and Azadeh Nikfarham, an informatics postdoctoral fellow trained a computer to recognize when a patient undergoing anti-cancer treatment with PD-1 antagonists or EGFR-inhibitors described a drug reaction in their internet forum posts.

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Can Probiotics and Fish Oil Supplements During Pregnancy Reduce Childhood Allergies?

MedicalResearch.com Interview with:
Dr Robert Boyle, 
Reader in Paediatric Allergy
Department of Medicine
Imperial College London

MedicalResearch.com: What is the background for this study?

Response: Diet in early life may influence whether or not an infant develops allergies or autoimmune disease. We undertook a project for the UK Food Standards Agency to evaluate the evidence for this.

MedicalResearch.com: What are the main findings? 

Response: We found that a probiotic supplement during the last 2-4 weeks of pregnancy and during breastfeeding may reduce an infant’s chances of developing eczema; and that omega-3 fatty acid supplements taken from the middle of pregnancy (20 weeks gestation) through the first few months of breastfeeding may reduce an infant’s chances of developing food allergy. We also found links between longer duration of breastfeeding and improved infant health, but for most other variations in diet during pregnancy or infancy we did not find evidence for a link with allergies or autoimmune disease.

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Oral Immunotherapy With Omalizmuab Resulted in Faster Food Desensitization

MedicalResearch.com Interview with:

Sandra Andorf PhD Kim and Ping Li Director of Computational Biology Sean N. Parker Center for Allergy and Asthma Research at Stanford University Instructor, Nadeau Lab Department of Medicine, Division of Pulmonary & Critical Care Medicine Stanford University School of Medicine

Dr. Andorf

Sandra Andorf PhD
Kim and Ping Li Director of Computational Biology
Sean N. Parker Center for Allergy and Asthma Research at Stanford University
Instructor, Nadeau Lab
Department of Medicine, Division of Pulmonary & Critical Care Medicine
Stanford University School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Food allergies are on the rise in the world. Approximately 15 million Americans have food allergies, which includes around 6 million children. Of people with food allergies, 30-40% are allergic to more than one food and therefore these people have a greater risk for an accidental ingestion resulting in an allergic reaction or anaphylaxis.

Currently there is no FDA approved treatment for food allergies but oral immunotherapy, a treatment in which the patient eats small but slowly increasing doses of their allergen until they can tolerate a specified dose, was shown in research settings to be safe in children and adults for up to 5 foods in parallel.

In this trial, we studied the efficacy and safety of Omalizmuab (an anti-IgE drug) treatment with oral immunotherapy in multifood allergic participants versus placebo with oral immunotherapy for a total of 9 months. We found that 83% of the participants who received Omalizumab could tolerate at least 2 g of at least two different food allergens at the end of the trial compared to 33% of those who received placebo. The participants that received Omalizumab were also desensitized faster, meaning they were on average able to eat 2 g of each of their allergic foods earlier in the treatment. Furthermore, we could show that the use of Omalizumab and the fast updosing is safe.

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