Peanut allergy (PA) is a severe form of food allergy for which Improved treatments are needed. However, few Studies have been conducted to optimize the safety of oral immunotherapy (OIT) for PA, to tailor OIT protocols according to the needs of individual PA patients, or to identify the immunological mechanism(s) underlying any long-lasting effects of oral immunotherapy (OIT) in such subjects. Specifically, It is not yet clear what factors will determine, in individual subjects, whether OIT induces tolerance (in which no set dally use of that food alleroen is needed to allow for its safe consumption). To address these challenges, the Stanford Alliance for Food Allergy Research (SAFAR) plans to link the findings of the Phase 2 clinical study proposed here in Project 1 with the results of each of the other 3 projects of the U19 proposal focused on mechanistic studies (Projects 2, 3 &4), as well as with the results ofthe immune metrics assays carried out by Scientific Core B. Each of these projects and Core B will use patient samples from Project 1 collected at screening and longitudinally throughout the clinical study to Integrate all data. We propose 3 main goals of our research for Project 1:
Specific Aim 1 : Test whether treatment of PA patients with OIT allows tolerance to be achieved (i.e., allows the subject to stop maintenance ingestion of peanut [during an """"""""avoidance period""""""""] for 3 months or more but then still undergo a successful double-blind placebo-controlled food challenge [DBPCFC] with peanut).
Specific Aim 2 : Determine whether treatment with our OIT protocol is safe in children and adults with peanut allergy (PA).
Specific Aim 3 : Evaluate to what degree current laboratory and clinical testing methods are associated with safety and tolerance outcomes (as identified in Specific Aims 1 and 2) in subjects with PA. By pursuing these aims, we will both: 1) provide the clinical samples, and the clinical outcome data, that will permit the innovative immune monitoring and mechanistic studies proposed in this U19 application to be accomplished, and 2) determine whether performing such immune monitoring has the potential to permit Individualization and optimization of safe and efficacious OIT protocols for individual PA patients.

Public Health Relevance

Food allergy is an important disease of children and adults that is in need of improved therapy. We propose a Study to test whether adult and pediatric patients with one of the most dangerous food allergies, peanut allergy, can become tolerant to peanuts after an oral immunotherapy regimen so that they may be able to eat peanut safely.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Program--Cooperative Agreements (U19)
Project #
1U19AI104209-01
Application #
8468483
Study Section
Special Emphasis Panel (ZAI1-PA-I (J1))
Project Start
Project End
Budget Start
2013-02-01
Budget End
2014-01-31
Support Year
1
Fiscal Year
2013
Total Cost
$158,694
Indirect Cost
$57,615
Name
Stanford University
Department
Type
DUNS #
009214214
City
Stanford
State
CA
Country
United States
Zip Code
94305
Andorf, Sandra; Borres, Magnus P; Block, Whitney et al. (2017) Association of Clinical Reactivity with Sensitization to Allergen Components in Multifood-Allergic Children. J Allergy Clin Immunol Pract 5:1325-1334.e4
Balbino, Bianca; Sibilano, Riccardo; Starkl, Philipp et al. (2017) Pathways of immediate hypothermia and leukocyte infiltration in an adjuvant-free mouse model of anaphylaxis. J Allergy Clin Immunol 139:584-596.e10
Galli, Stephen J; Starkl, Philipp; Marichal, Thomas et al. (2017) Mast Cells and IgE can Enhance Survival During Innate and Acquired Host Responses to Venoms. Trans Am Clin Climatol Assoc 128:193-221
Mukai, Kaori; Gaudenzio, Nicolas; Gupta, Sheena et al. (2017) Assessing basophil activation by using flow cytometry and mass cytometry in blood stored 24 hours before analysis. J Allergy Clin Immunol 139:889-899.e11
Boyd, Scott Dexter; Hoh, Ramona Amy; Nadeau, Kari Christine et al. (2017) Immune monitoring for precision medicine in allergy and asthma. Curr Opin Immunol 48:82-91
Andorf, Sandra; Manohar, Monali; Dominguez, Tina et al. (2017) Observational long-term follow-up study of rapid food oral immunotherapy with omalizumab. Allergy Asthma Clin Immunol 13:51
MacGinnitie, Andrew J; Rachid, Rima; Gragg, Hana et al. (2017) Omalizumab facilitates rapid oral desensitization for peanut allergy. J Allergy Clin Immunol 139:873-881.e8
Reber, Laurent L; Sibilano, Riccardo; Starkl, Philipp et al. (2017) Imaging protective mast cells in living mice during severe contact hypersensitivity. JCI Insight 2:
Reber, Laurent L; Gillis, Caitlin M; Starkl, Philipp et al. (2017) Neutrophil myeloperoxidase diminishes the toxic effects and mortality induced by lipopolysaccharide. J Exp Med 214:1249-1258
Sampath, Vanitha; Tupa, Dana; Graham, Michelle Toft et al. (2017) Deciphering the black box of food allergy mechanisms. Ann Allergy Asthma Immunol 118:21-27

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