The mucosal immune systems has evolved to become incredibly flexible. On the one hand it is the first line of defense against pathogens from the external environment and must react quickly to prevent infection. Interestingly the predominant tone of the GI tract is one of suppression or down-regulation of immune responses. This is an active process whose mechanisms have just started to be elucidated. The hallmark of this suppressed state of phenomenon of oral tolerance. This involves the active suppression of systemic immune responses following the initial (ans possibly subsequent) administration of antigen via the oral route. In food allergic patients the presence of hypersensitivity reactions to food antigens, suggests that this tolerant state may have ben altered. Since several components go into the development of tolerance (nature of the antigen, dose of the antigen, genetics, co-administered adjuvants, etc.), any alteration in this process may result in priming and a failure to tolerize. Such may the case in the development of food allergy. It is the goal of this proposal to identify whether oral tolerance exists in patients with various forms of food allergy and, if so, what mechanisms govern the altered responses to food antigens. This will be addressed in three specific aims: #1. Does oral tolerance exist to soluble protein antigens in milk allergic children? #2. What is the nature of the cytokine profile of antigen activated T cells following oral administration of antigen in milk allergic children? #3, Does the presence or absence of oral tolerance correlate with intestinal permeability defects? The results of such studies should provide a basis for a better understanding of the nature of food allergy and potentially provide useful information that will allow us to develop approaches to therapy.

Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Mount Sinai School of Medicine
New York
United States
Zip Code
Nowak-W?grzyn, Anna; Lawson, Kaitie; Masilamani, Madhan et al. (2018) Increased Tolerance to Less Extensively Heat-Denatured (Baked) Milk Products in Milk-Allergic Children. J Allergy Clin Immunol Pract 6:486-495.e5
Frischmeyer-Guerrerio, Pamela A; Masilamani, Madhan; Gu, Wenjuan et al. (2017) Mechanistic correlates of clinical responses to omalizumab in the setting of oral immunotherapy for milk allergy. J Allergy Clin Immunol 140:1043-1053.e8
Wood, Robert A; Kim, Jennifer S; Lindblad, Robert et al. (2016) A randomized, double-blind, placebo-controlled study of omalizumab combined with oral immunotherapy for the treatment of cow's milk allergy. J Allergy Clin Immunol 137:1103-1110.e11
Järvinen, Kirsi M; Suárez-Fariñas, Mayte; Savilahti, Erkki et al. (2015) Immune factors in breast milk related to infant milk allergy are independent of maternal atopy. J Allergy Clin Immunol 135:1390-3.e1-6
Lee, Tricia D; Gimenez, Gustavo; Grishina, Galina et al. (2015) Profile of a milk-allergic patient who tolerated partially hydrolyzed whey formula. J Allergy Clin Immunol Pract 3:116-8
Roda, G; Jianyu, X; Park, M S et al. (2014) Characterizing CEACAM5 interaction with CD8? and CD1d in intestinal homeostasis. Mucosal Immunol 7:615-24
Järvinen, K M; Westfall, J E; Seppo, M S et al. (2014) Role of maternal elimination diets and human milk IgA in the development of cow's milk allergy in the infants. Clin Exp Allergy 44:69-78
Caubet, Jean-Christoph; Masilamani, Madhan; Rivers, Neisha A et al. (2014) Potential non-T cells source of interleukin-4 in food allergy. Pediatr Allergy Immunol 25:243-9
Tordesillas, Leticia; Goswami, Ritobrata; Benedé, Sara et al. (2014) Skin exposure promotes a Th2-dependent sensitization to peanut allergens. J Clin Invest 124:4965-75
Järvinen, Kirsi M; Konstantinou, George N; Pilapil, Mariecel et al. (2013) Intestinal permeability in children with food allergy on specific elimination diets. Pediatr Allergy Immunol 24:589-95

Showing the most recent 10 out of 78 publications