Food allergies are a major health problem in the US with an estimated 11 million Americans afflicted. Peanut allergy, which affects over 1.5 million Americans, is the single leading cause of severe and fatal food-induced allergic reactions. The prevalence of peanut allergy in children has doubled since the mid-1990's, and eosinophilic esophagitis (EE), largely food-related in children, has also markedly increased in prevalence. The current standard of care for managing food allergies consists of educating patients about food allergen avoidance and initiating therapy in case of an accidental ingestion. This approach is clearly inadequate since food allergic reactions are the leading single leading cause of anaphylaxis treated in US emergency departments, and dietary management of EE is extremely difficult and often ineffective. Recent oral immunotherapy trials suggest new approaches may alter the course of these disorders. A Consortium of investigators from five universities was formed to address this problem: Mount Sinai, Johns Hopkins, Duke, Arkansas, and National Jewish Health. The main objectives of this Consortium were to investigate the natural history of milk, egg and peanut allergy in infants, delineate underlying immunologic parameters associated with the natural course of milk and egg tolerance and peanut sensitization, and Identify biological markers that distinguish young children likely to develop symptomatic peanut allergy;and to test novel immunotherapies for the treatment of food allergy and delineate responsible mechanisms. The highly successful Consortium has recruited and retained a large cohort of children at high risk to develop peanut allergy, initiated three novel therapeutic trials, and been investigating immunologic mechanisms associated with the development and natural history of food allergy and immunotherapy. The Consortium proposed here will extend ongoing studies on the previous observational cohort and peanut SLIT trial, evaluate the efficacy of two novel immunotherapeutic approaches, and with the addition of a new site at Cincinatti Children's Hospital, initiate studies on the role of food allergy in EE, comparing and contrasting natural history and immunologic and genetic markers of EE with those of IgE-mediated food allergy.

Public Health Relevance

Food allergy and eosinophilic esophagitis, a food-related disorder, are affecting increasing numbers of Americans. Our five university consortium has effectively begun to address the underlying immunology of IgE-mediated food allergy and its treatment, and seeks to expand this effort by monitoring our well established cohort, evaluating other novel therapeutic strategies and investigating a growing and poorly understood food-related disorder, eosinophilic esophagitis.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Program--Cooperative Agreements (U19)
Project #
5U19AI066738-09
Application #
8505356
Study Section
Special Emphasis Panel (ZAI1-WFD-I (M3))
Program Officer
Minnicozzi, Michael
Project Start
2005-07-01
Project End
2015-06-30
Budget Start
2013-07-01
Budget End
2014-06-30
Support Year
9
Fiscal Year
2013
Total Cost
$4,291,494
Indirect Cost
$990,525
Name
Icahn School of Medicine at Mount Sinai
Department
Pediatrics
Type
Schools of Medicine
DUNS #
078861598
City
New York
State
NY
Country
United States
Zip Code
10029
Davis, Benjamin P; Rothenberg, Marc E (2016) Mechanisms of Disease of Eosinophilic Esophagitis. Annu Rev Pathol 11:365-93
Schoos, Ann-Marie M; Kattan, Jacob D; Gimenez, Gustavo et al. (2016) Sensitization phenotypes based on protein groups and associations to allergic diseases in children. J Allergy Clin Immunol 137:1277-80
Davis, Benjamin P; Epstein, Tolly; Kottyan, Leah et al. (2016) Association of eosinophilic esophagitis and hypertrophic cardiomyopathy. J Allergy Clin Immunol 137:934-936.e5
Bunyavanich, Supinda; Shen, Nan; Grishin, Alexander et al. (2016) Early-life gut microbiome composition and milk allergy resolution. J Allergy Clin Immunol 138:1122-1130
Sicherer, Scott H; Wood, Robert A; Vickery, Brian P et al. (2016) Impact of Allergic Reactions on Food-Specific IgE Concentrations and Skin Test Results. J Allergy Clin Immunol Pract 4:239-45.e4
Gupta, Jayanta; Johansson, Elisabet; Bernstein, Jonathan A et al. (2016) Resolving the etiology of atopic disorders by using genetic analysis of racial ancestry. J Allergy Clin Immunol 138:676-99
Jones, Stacie M; Burks, A Wesley; Keet, Corinne et al. (2016) Long-term treatment with egg oral immunotherapy enhances sustained unresponsiveness that persists after cessation of therapy. J Allergy Clin Immunol 137:1117-27.e1-10
Simons, F Estelle R; Sampson, Hugh A (2015) Anaphylaxis: Unique aspects of clinical diagnosis and management in infants (birth to age 2 years). J Allergy Clin Immunol 135:1125-31
Järvinen, Kirsi M; Westfall, Jennifer; De Jesus, Magdia et al. (2015) Role of Maternal Dietary Peanut Exposure in Development of Food Allergy and Oral Tolerance. PLoS One 10:e0143855
Travers, J; Rothenberg, M E (2015) Eosinophils in mucosal immune responses. Mucosal Immunol 8:464-75

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