Diagnostic markers of clinical allergy versus sensitisation to peanut

Lead Research Organisation: King's College London
Department Name: Asthma Allergy and Lung Biology

Abstract

Peanut allergy (PA) is particularly problematic since it is increasingly common in infants and
children, may be life-threatening, frequently persists through adulthood and has a significant impact
on children?s quality of life.
The diagnosis of PA is based on a combination of a history of allergic reaction(s) to peanut and
positive allergy tests. However, this is not reliable because many patients have positive allergy tests
and tolerate peanut whilst others have positive allergy tests and are peanut allergic. The only way to
clarify this is by giving the child peanuts in oral food challenges (OFC). However, OFC are expensive,
laborious and potentially dangerous, as they may induce allergic reactions.
Our proposed research project aims to provide fundamental insights into the mechanisms of
allergy and tolerance and also to distinguish between peanut allergic children and those who have
positive allergy tests but tolerate peanut without the need for OFC.
This project will improve allergy diagnosis, allowing for a more accurate distinction of allergic
children among children with positive allergy tests, not only to peanut but also to other allergens. By
understanding why some children with positive allergy tests react and others do not, we may
develop new definitive treatments for PA

Technical Summary

Background: In the United Kingdom, 2% of primary school children will develop peanut allergy but
10% will develop serum specific IgE to peanut. This poses diagnostic difficulties and dangerous oral
food challenges(OFC) are required. Why is it that some patients have high serum specific IgE levels
to peanut and tolerate it and others have low specific IgE levels and react violently?
Hypotheses:
Two separate hypotheses will be addressed:
1. Peanut specific IgE is functionally different in allergic and tolerant children;
2. The functionality of peanut specific IgE is similar and sensitized but tolerant children have an
inhibitor that blocks IgE function.
Objectives:
1) To understand the immunological differences that underpin sensitization and allergy;
2) To improve the diagnosis of peanut allergy while reducing the need for OFC.
Study design:
Four groups of children will be compared:
- Peanut allergic(PA) ? peanut IgE positive and peanut allergic(n=25);
- Peanut sensitized(PS) ? peanut IgE positive, never reacted to peanut and eat peanut(n=25);
- Peanut allergy resolved(PR) ? peanut IgE positive and have outgrown peanut allergy(n=25);
- Non-allergic(NA) ? peanut IgE negative and eat peanut(n=25).
PA, PS and PR groups will be matched for serum peanut specific IgE levels.
Methodology:
To test the first hypothesis, we will:
- perform basophil mediator release assays(histamine, IL-4 and IL-13), following pre-incubation
with sera and subsequent stimulation with peanut extract;
- purify IgE from sensitised but tolerant children(PS and PR) and assess whether it induces
basophil histamine release;
- analyse peanut specific IgE for specificity and clonality(peanut peptide and epitope recognition
of IgE, using ImmunoCAPTM and microarray immunoassays) and for affinity and avidity(using
surface plasmon resonance).
To test the second hypothesis, we will:
- pool sera from sensitised but tolerant with sera from allergic children and assess whether
basophil mediator release is inhibited;
- purify antibody isotypes other than IgE(e.g IgG4) from sensitised but tolerant children and
assess whether basophil mediator release is inhibited;
- assess basophil intracellular signalling protein activities, excitatory(Syk and p38-MAPK) and
inhibitory(SHIP), on western blotting, in case an inhibition is observed.
Scientific and medical opportunities:
This study will extend our knowledge about the mechanisms that determine clinical reactivity to
peanut in sensitized patients and define superior diagnostic markers for peanut allergy. The results
may be extended to other food and respiratory allergens. By understanding why some IgE react and
other do not, we may target therapeutical strategies to induce tolerance and provide definitive
treatment for allergy.

Publications

10 25 50

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Dhami S (2016) Allergen immunotherapy for the prevention of allergic disease: protocol for a systematic review. in Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology

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Santos AF (2014) Basophil activation test discriminates between allergy and tolerance in peanut-sensitized children. in The Journal of allergy and clinical immunology

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Santos AF (2016) Basophil activation test: food challenge in a test tube or specialist research tool? in Clinical and translational allergy

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Santos AF (2013) Commentary on 'glucocorticoids for the treatment of anaphylaxis'. in Evidence-based child health : a Cochrane review journal

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Du Toit G (2016) Effect of Avoidance on Peanut Allergy after Early Peanut Consumption. in The New England journal of medicine

 
Description EAACI Allergen-specific Immunotherapy Guidelines for Food Allergy
Geographic Reach Europe 
Policy Influence Type Membership of a guideline committee
 
Description EAACI Allergen-specific Immunotherapy Guidelines for Prevention of Allergic Disease
Geographic Reach Europe 
Policy Influence Type Membership of a guideline committee
 
Description EAACI Anaphylaxis Guidelines
Geographic Reach Asia 
Policy Influence Type Membership of a guidance committee
 
Description EAACI Food Allergy Guidelines
Geographic Reach Asia 
Policy Influence Type Membership of a guidance committee
 
Description EAACI Position paper about clinical utility of the basophil activation test
Geographic Reach Asia 
Policy Influence Type Influenced training of practitioners or researchers
 
Description EAACI Position paper establishing a new framework for the interpretation of IgE sensitisation tests
Geographic Reach Asia 
Policy Influence Type Influenced training of practitioners or researchers
 
Description EAACI Task Force on Allergen Thresholds
Geographic Reach Europe 
Policy Influence Type Membership of a guideline committee
 
Description EAACI Taskforce on the external quality assurance of the basophil activation test
Geographic Reach Europe 
Policy Influence Type Membership of a guideline committee
 
Description Guidelines for food allergy and weaning
Geographic Reach Multiple continents/international 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
 
Description Mast Cell, Basophil & Eosinophil expert group of NIAID Asthma and Allergy Network Summit meeting
Geographic Reach Multiple continents/international 
Policy Influence Type Membership of a guideline committee
 
Description Immune Tolerance Network/NIAID
Amount $320,420 (USD)
Organisation National Institute of Allergy and Infectious Diseases (NIAID) 
Sector Public
Country United States
Start 11/2012 
End 12/2014
 
Description MRC Centenary Early Career Award
Amount £55,000 (GBP)
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 04/2013 
End 07/2013
 
Description NIAID - Immune Tolerance Network
Amount £1,154,721 (GBP)
Organisation National Institute of Allergy and Infectious Diseases (NIAID) 
Sector Public
Country United States
Start 02/2016 
End 01/2019
 
Description Travel grant to attend the Annual Meeting of the British Society of Allergy and Clinical Immunology 2014
Amount £450 (GBP)
Organisation British Society of Allergy and Clinical Immunology 
Sector Charity/Non Profit
Country United Kingdom
Start 06/2014 
End 06/2014
 
Title Basophil activation test 
Description The whole blood basophil activation test is an in vitro assay where basophils in whole blood are stimulated with allergen and the expression of basophils' surface markers of activation are subsequently measured by flow cytometry. This assay was not previously performed in the host institution, was developed and optimised as part of the present research project and has proven to be very robust and to perform consistently. 
Type Of Material Technology assay or reagent 
Year Produced 2013 
Provided To Others? Yes  
Impact The basophil activation test (BAT) will be assessed as a tool for the diagnosis of food allergy and will be used in mechanistic experiments. BAT will be clinically validated and may be applied in the diagnosis of food allergy in clinical practice, reducing the need for oral food challenges and inherent costs and risks. BAT will also be used to unravel immunologic mechanisms of allergy versus tolerance, allowing us to understand why some children with IgE to foods react clinically whilst other children with equivalent levels of IgE do not. 
 
Title Mast cell activation and inhibition assays 
Description The mast cell activation assay is a flow-cytomety based assay where mast cells from a cell line are sensitised with patients' plasma and stimulated with allergens or controls. It is an in vitro surrogate of provocation tests where patients are exposed to the allergens in vivo. The inhibition assay is similar, where the mast cells are in the presence of plasma samples that are tested for their ability to suppress mast cell activation. It can be used as a marker for clinical improvement of allergic disease. 
Type Of Material Technology assay or reagent 
Year Produced 2015 
Provided To Others? Yes  
Impact MAT can be used to diagnose food allergy and as a biomarker for clinical improvement in clinical trials testing preventive or therapeutic strategies for food allergy. 
 
Title LEAP Study Database 
Description The data collected as part of the LEAP Study has been made public as it is being published. 
Type Of Material Database/Collection of data 
Year Produced 2015 
Provided To Others? Yes  
Impact Other researchers have been able to analyse the data themselves using Trialshare. 
URL https://www.itntrialshare.org/
 
Description Auto-anti-IgE project 
Organisation King's College London
Country United Kingdom 
Sector Academic/University 
PI Contribution I contributed with intellectual input into the project regarding basophil experiments and also performed some experiments as part of this collaboration.
Collaborator Contribution Professor Corrigan and his team recruited asthmatic and non-asthmatic subjects to the study and Professor Gould and her team performed experiments to detec the presence of anti-IgE and anti-FceRI and other auto antibodies in the serum of asthmatic and non-asthmatic subjects.
Impact Publication PMID: 25112697
Start Year 2011
 
Description Basophil activation test in the LEAP and LEAP-On studies 
Organisation National Institute of Allergy and Infectious Diseases (NIAID)
Country United States 
Sector Public 
PI Contribution Following successful development of basophil activation test to peanut, we have started to apply this technique to participants in the LEAP and LEAP-On studies.
Collaborator Contribution The NIAID and the Immune Tolerance Network are funding and monitoring the LEAP and LEAP-On trials.
Impact Publications are planned but for the time being we are still blinded for the
Start Year 2011
 
Description Basophil activation test in the PRONUTS Study 
Organisation King's College London
Country United Kingdom 
Sector Academic/University 
PI Contribution I have been performing the basophil activation test in participants in the Pronuts Study at the London site.
Collaborator Contribution This is a multicentre study, including the 3 centres indicated above. All centres have been recruiting study participants. At KCL, I collaborate with Dr Helen Brough (PI) and Professor Gideon Lack (CI).
Impact No outputs yet as the collaboration is ongoing and data will only be analysed at the end of the study.
Start Year 2013
 
Description Basophil activation test in the PRONUTS Study 
Organisation University of Geneva
Country Switzerland 
Sector Academic/University 
PI Contribution I have been performing the basophil activation test in participants in the Pronuts Study at the London site.
Collaborator Contribution This is a multicentre study, including the 3 centres indicated above. All centres have been recruiting study participants. At KCL, I collaborate with Dr Helen Brough (PI) and Professor Gideon Lack (CI).
Impact No outputs yet as the collaboration is ongoing and data will only be analysed at the end of the study.
Start Year 2013
 
Description Basophil activation test in the PRONUTS Study 
Organisation University of Valencia
Country Spain 
Sector Academic/University 
PI Contribution I have been performing the basophil activation test in participants in the Pronuts Study at the London site.
Collaborator Contribution This is a multicentre study, including the 3 centres indicated above. All centres have been recruiting study participants. At KCL, I collaborate with Dr Helen Brough (PI) and Professor Gideon Lack (CI).
Impact No outputs yet as the collaboration is ongoing and data will only be analysed at the end of the study.
Start Year 2013
 
Description Epitope IgE and IgG4 testing 
Organisation Benaroya Research Institute at Virginia Mason (BRI)
Country United States 
Sector Academic/University 
PI Contribution 1. We recruited patients who were being assessed for peanut allergy and designed the study in which we were assessing the hypothesis that differences in peanut epitope binding could explain differences in clinical reactivity (i.e. being allergic or not allergic) in children that had IgE to peanut. 2. We made contact with collaborators in New Orleans who tested IgE and IgG4 binding on a microarray containing peptides from all peanut allergens described to date. 3. We designed the analyses plan together with a computational biologist based in Oxford and Lisbon (now only in Lisbon) who performed the analyses of the microarray data. 4. We designed and performed functional assays to validate the findings using cellular tests in my laboratory. 5. We established a collaboration with Thermofisher to couple the peptides to a solid phase using ImmunoCAP technology, which enabled us to validate the microarray findings with quantitative method that could be come accessible to the clinical community. We tested all the samples in our laboratory using this technology. 6. ImmunoCAP and microarray data were analysed by statisticians at the BRI.
Collaborator Contribution - Collaborators from Southern Regional Research Centre performed microarray experiments - Collaborators from University of Lisbon helped analysing the microarray data - Collaborators from Thermofisher scientific coupled the peptides to the solid phase using the peptides we provided and sent the material to our lab to use for testing. - Collaborators from Benaroya Research Institute analysed the ImmunoCAP data - Collaborators from Queen Mary University of London contributed in an advisory capacity
Impact Abstract for meeting has been accepted as oral presentation to be presented at the annual congress of the European Academy of Allergy and Clinical Immunology. The manuscript is currently being reviewed by the editorial board of the Journal of Allergy and Clinical Immunology.
Start Year 2011
 
Description Epitope IgE and IgG4 testing 
Organisation Queen Mary University of London
Country United Kingdom 
Sector Academic/University 
PI Contribution 1. We recruited patients who were being assessed for peanut allergy and designed the study in which we were assessing the hypothesis that differences in peanut epitope binding could explain differences in clinical reactivity (i.e. being allergic or not allergic) in children that had IgE to peanut. 2. We made contact with collaborators in New Orleans who tested IgE and IgG4 binding on a microarray containing peptides from all peanut allergens described to date. 3. We designed the analyses plan together with a computational biologist based in Oxford and Lisbon (now only in Lisbon) who performed the analyses of the microarray data. 4. We designed and performed functional assays to validate the findings using cellular tests in my laboratory. 5. We established a collaboration with Thermofisher to couple the peptides to a solid phase using ImmunoCAP technology, which enabled us to validate the microarray findings with quantitative method that could be come accessible to the clinical community. We tested all the samples in our laboratory using this technology. 6. ImmunoCAP and microarray data were analysed by statisticians at the BRI.
Collaborator Contribution - Collaborators from Southern Regional Research Centre performed microarray experiments - Collaborators from University of Lisbon helped analysing the microarray data - Collaborators from Thermofisher scientific coupled the peptides to the solid phase using the peptides we provided and sent the material to our lab to use for testing. - Collaborators from Benaroya Research Institute analysed the ImmunoCAP data - Collaborators from Queen Mary University of London contributed in an advisory capacity
Impact Abstract for meeting has been accepted as oral presentation to be presented at the annual congress of the European Academy of Allergy and Clinical Immunology. The manuscript is currently being reviewed by the editorial board of the Journal of Allergy and Clinical Immunology.
Start Year 2011
 
Description Epitope IgE and IgG4 testing 
Organisation Thermo Fisher Scientific
Country United States 
Sector Private 
PI Contribution 1. We recruited patients who were being assessed for peanut allergy and designed the study in which we were assessing the hypothesis that differences in peanut epitope binding could explain differences in clinical reactivity (i.e. being allergic or not allergic) in children that had IgE to peanut. 2. We made contact with collaborators in New Orleans who tested IgE and IgG4 binding on a microarray containing peptides from all peanut allergens described to date. 3. We designed the analyses plan together with a computational biologist based in Oxford and Lisbon (now only in Lisbon) who performed the analyses of the microarray data. 4. We designed and performed functional assays to validate the findings using cellular tests in my laboratory. 5. We established a collaboration with Thermofisher to couple the peptides to a solid phase using ImmunoCAP technology, which enabled us to validate the microarray findings with quantitative method that could be come accessible to the clinical community. We tested all the samples in our laboratory using this technology. 6. ImmunoCAP and microarray data were analysed by statisticians at the BRI.
Collaborator Contribution - Collaborators from Southern Regional Research Centre performed microarray experiments - Collaborators from University of Lisbon helped analysing the microarray data - Collaborators from Thermofisher scientific coupled the peptides to the solid phase using the peptides we provided and sent the material to our lab to use for testing. - Collaborators from Benaroya Research Institute analysed the ImmunoCAP data - Collaborators from Queen Mary University of London contributed in an advisory capacity
Impact Abstract for meeting has been accepted as oral presentation to be presented at the annual congress of the European Academy of Allergy and Clinical Immunology. The manuscript is currently being reviewed by the editorial board of the Journal of Allergy and Clinical Immunology.
Start Year 2011
 
Description Epitope IgE and IgG4 testing 
Organisation U.S. Department of Agriculture USDA
Department Agricultural Research Service
Country United States 
Sector Public 
PI Contribution 1. We recruited patients who were being assessed for peanut allergy and designed the study in which we were assessing the hypothesis that differences in peanut epitope binding could explain differences in clinical reactivity (i.e. being allergic or not allergic) in children that had IgE to peanut. 2. We made contact with collaborators in New Orleans who tested IgE and IgG4 binding on a microarray containing peptides from all peanut allergens described to date. 3. We designed the analyses plan together with a computational biologist based in Oxford and Lisbon (now only in Lisbon) who performed the analyses of the microarray data. 4. We designed and performed functional assays to validate the findings using cellular tests in my laboratory. 5. We established a collaboration with Thermofisher to couple the peptides to a solid phase using ImmunoCAP technology, which enabled us to validate the microarray findings with quantitative method that could be come accessible to the clinical community. We tested all the samples in our laboratory using this technology. 6. ImmunoCAP and microarray data were analysed by statisticians at the BRI.
Collaborator Contribution - Collaborators from Southern Regional Research Centre performed microarray experiments - Collaborators from University of Lisbon helped analysing the microarray data - Collaborators from Thermofisher scientific coupled the peptides to the solid phase using the peptides we provided and sent the material to our lab to use for testing. - Collaborators from Benaroya Research Institute analysed the ImmunoCAP data - Collaborators from Queen Mary University of London contributed in an advisory capacity
Impact Abstract for meeting has been accepted as oral presentation to be presented at the annual congress of the European Academy of Allergy and Clinical Immunology. The manuscript is currently being reviewed by the editorial board of the Journal of Allergy and Clinical Immunology.
Start Year 2011
 
Description Epitope IgE and IgG4 testing 
Organisation University of Lisbon
Department Institute for Molecular Medicine
Country Portugal 
Sector Academic/University 
PI Contribution 1. We recruited patients who were being assessed for peanut allergy and designed the study in which we were assessing the hypothesis that differences in peanut epitope binding could explain differences in clinical reactivity (i.e. being allergic or not allergic) in children that had IgE to peanut. 2. We made contact with collaborators in New Orleans who tested IgE and IgG4 binding on a microarray containing peptides from all peanut allergens described to date. 3. We designed the analyses plan together with a computational biologist based in Oxford and Lisbon (now only in Lisbon) who performed the analyses of the microarray data. 4. We designed and performed functional assays to validate the findings using cellular tests in my laboratory. 5. We established a collaboration with Thermofisher to couple the peptides to a solid phase using ImmunoCAP technology, which enabled us to validate the microarray findings with quantitative method that could be come accessible to the clinical community. We tested all the samples in our laboratory using this technology. 6. ImmunoCAP and microarray data were analysed by statisticians at the BRI.
Collaborator Contribution - Collaborators from Southern Regional Research Centre performed microarray experiments - Collaborators from University of Lisbon helped analysing the microarray data - Collaborators from Thermofisher scientific coupled the peptides to the solid phase using the peptides we provided and sent the material to our lab to use for testing. - Collaborators from Benaroya Research Institute analysed the ImmunoCAP data - Collaborators from Queen Mary University of London contributed in an advisory capacity
Impact Abstract for meeting has been accepted as oral presentation to be presented at the annual congress of the European Academy of Allergy and Clinical Immunology. The manuscript is currently being reviewed by the editorial board of the Journal of Allergy and Clinical Immunology.
Start Year 2011
 
Title Basophil activation test to peanut 
Description The laboratory technique has been developed and validated for peanut allergy using samples from study ID 10020 in CRN Portfolio. Diagnostic performance and cut-off values have been determined and validated. It is currently being tested and validated to diagnose other food allergies, incluing milk, egg, sesame and cashew nut allergies. I would like to translate it to a clinical laboratory with the view of applying it to clinical practice. 
Type Diagnostic Tool - Non-Imaging
Current Stage Of Development Early clinical assessment
Year Development Stage Completed 2014
Development Status Under active development/distribution
Clinical Trial? Yes
UKCRN/ISCTN Identifier CRN Portfolio 10020
Impact This test will improve the accuracy of the diagnosis of peanut allergy and reduce the number of oral food challenges to peanut. 
URL https://clinicaltrials.gov/show/NCT03309488
 
Description Allergy UK Masterclass 2019 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact The patient organisation and Charity Allergy UK organised a one-day event targeting health care professionals and patient groups. Experts in different aspects of allergic diseases shared their knowledge and expertise and answered questions.
Year(s) Of Engagement Activity 2019
 
Description Asthma UK Event 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Supporters
Results and Impact 50 potential donors and members of the public attended this event, where PI and post-doctoral researchers presented about their research and showed them around the laboratories and research facilities. This event was very successful and significantly contributed for the funds needed for the renovation of the 5-year funding period of the centre.
Year(s) Of Engagement Activity 2015
 
Description Asthma UK Fundraising Event 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Patients, carers and/or patient groups
Results and Impact About 25 people who were either patients, relatives of patients or general public interested in asthma and allergy visited the department and the labs and had the opportunity to hear about recent research findings in asthma and allergy and had the opportunity to ask questions to the researchers and their teams. The event was organised by Asthma UK and raised interest and donations to this charity as a consequence.
Year(s) Of Engagement Activity 2012,2016,2017,2018
 
Description Asthma UK event 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? Yes
Type Of Presentation Poster Presentation
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact About 100 people attended, including Asthma UK's new and existing major supporters, special events committee members and attendees, celebrity contacts and pharmaceutical company contacts.

We showcased the work of the MRC & Asthma UK Centre for the Allergic Mechanisms of Asthma and the new Asthma UK Research strategy (incl. applied centre) and engaged the public, including people with asthma, with Asthma UK's research strategy.
Year(s) Of Engagement Activity 2012
 
Description Global Atlas of Allergy 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? Yes
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact I was an author of one of the chapters in this publication, which has been distributed to attendants of various scientific meetings organised by the European Academy of Allergy and Clinical Immunology.

After this book was published I have been contacted by other researchers interested in my research field and I have been invited to expert panels regarding other initiatives of similar scope.
Year(s) Of Engagement Activity 2014
URL http://www.eaaci.org/globalatlas/GlobalAtlasAllergy.pdf
 
Description Interviewed for Allergic Living magazine 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Patients, carers and/or patient groups
Results and Impact An interview for a magazine published for patients as the main target audience. The magazine is Canadian and has an international reach. It is published in print and also online, which allowed a wider reach, through not only the magazine's website but also social media.
Year(s) Of Engagement Activity 2018
URL https://www.allergicliving.com/2019/01/16/new-food-allergy-tests-hold-hope-of-reliable-results/
 
Description Invited to an International Patient Group event 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Patients, carers and/or patient groups
Results and Impact Invited to join expert panels in international days dedicated to food allergy organised by patient organisations and charities namely by the Food Allergy Research and Education (FARE) from the USA, to talk about the diagnostic tests that I have developed, namely BAT and MAT.
Year(s) Of Engagement Activity 2018
 
Description MRC Centenary Open Week Observation Point 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? Yes
Type Of Presentation Workshop Facilitator
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact About 100 members of the public visited the stations we had with information about the research developed at the MRC & Asthma UK Centre in Allergic Mechanisms of Asthma.

The members of the public were quite engaged with the activities we promoted on site, such as peak-flow measurements, models of molecules related to Allergy and a big inflatable lung with examples of diseases that can affect this organ.
Year(s) Of Engagement Activity 2013
 
Description Talk for FARE and iFAAA 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Patients, carers and/or patient groups
Results and Impact A group of experts, industry partners and patient organisation leads and individual patients got together in a one day event which consisted of presentations and Q&A sessions about food allergy and anaphylaxis.
Year(s) Of Engagement Activity 2019