(Don't) get your peanuts! Research effort convened to tackle food allergy

There's but limited advice you can dispense to parents of your patients who have a potentially life-threatening food allergy: Avoid, avoid, avoid! Yet there's cause for optimism today among stymied clinicians and the four percent of Americans who have a food allergy—often to nuts or shellfish: a new Food Allergy Research Consortium convened at the end of June by the federal government, and led by a prominent pediatrician and food allergy expert, has been charged with, first, conducting basic, clinical, and epidemiologic studies aimed at developing therapies to treat and prevent food allergy and, second, developing educational programs aimed at parents, children, and healthcare providers.

The consortium is led by pediatrician Hugh Sampson, MD, professor of pediatrics and biomedical sciences and director of the Jaffe Food Allergy Institute at the Mount Sinai School of Medicine in New York City. It will be funded by approximately $17 million over five years from the National Institute of Allergy and Infectious Diseases (NIAID), arm of the National Institutes of Health. An additional five-year NIAID grant of approximately $5 million will fund a statistical center to support the consortium.

"The expertise of the Food Allergy Research Consortium provides a unique opportunity to investigate basic immunologic mechanisms associated with food allergy in animal models and humans, and, ultimately, to test novel therapies to treat food allergy," says Daniel Rotrosen, M.D., director of NIAID's Division of Allergy, Immunology and Transplantation.

The consortium's first project? A clinical study to evaluate a potential peanut allergy therapy that works in much the same fashion as traditional immunotherapy: administering increasing doses of an allergen to allergic individuals. Existing immunotherapeutic protocols can't be used for peanut allergy because those who are allergic are at risk of a life-threatening reaction to injection of even a minute amount of allergen. To overcome this obstacle, Dr. Sampson and pediatrician Wesley Burks, MD, of Duke University in Durham, N.C., developed modified versions of peanut allergens that are safe and effective in animal models. The consortium will evaluate the modified allergens in human clinical trials led by Robert Wood, M.D., of the Johns Hopkins University School of Medicine in Baltimore.

The second project is an observational study that will enroll 400 infants allergic to milk or eggs. Such children are at elevated risk of peanut allergy, but most lose their allergy to those foods as they grow. The study will follow the children for at least five years and study immunologic changes that accompany the loss of allergy to foods and the development of allergy to new foods. The study will be led by Scott Sicherer, MD, at Mount Sinai School of Medicine.

(Interested in participating in one of these clinical and observational studies? Call the Mount Sinai School of Medicine Pediatric Allergy Division at [212] 241-5548.)

The third project will be basic immunobiology research to determine the biological mechanisms of peanut allergy in mice-knowledge that's expected to provide insights into allergic mechanisms in humans and thus lead to the identification and development of potential strategies to treat and prevent food allergies in humans.

The consortium will also conduct a two-pronged educational program, teaching parents and children how to avoid food allergens and training pediatric clinicians to treat and prevent food allergy.

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