Mechanisms underlying the physiological and cellular response to food allergen challenge in human subjects with peanut allergy

Lead Research Organisation: Imperial College London
Department Name: Dept of Medicine

Abstract

Food allergy affects up to 2% of adults and 8% of children in the UK, and can cause life-threatening reactions (anaphylaxis) in some but not all individuals. The mainstay of management remains dietary avoidance. There is no effective treatment for preventing allergic reactions, which can be fatal even when rescue medication is given in a timely manner.

Allergic reactions to food are mediated through the Immunoglobulin E (IgE) antibody. The binding of allergenic proteins in food to IgE causes the release of different chemical mediators, including histamine. Much of our knowledge of the mechanism is derived from animal models, but this may not be representative of the situation in man. Antihistamines can prevent fatality in animal models of anaphylaxis but are much less effective in man, possibly because humans are 1000-fold more sensitive to the effects of histamine than, for example, mice. Furthermore, anaphylaxis in peanut-allergic humans can be triggered by tiny amounts of protein (under 10mg or 1/30 of a single peanut). By comparison, very high levels are required to cause anaphylaxis by the oral route in mouse models, equivalent to a person eating over 1000 peanuts. These examples demonstrate the difficulties of extrapolating data from animal models to man.

The diagnosis of food allergy can be confirmed by the detection of specific IgE to the trigger food, either by blood or skin testing. Unfortunately, while levels of specific IgE predict the likelihood of reaction after exposure, they do not predict the severity of reaction. While some risk factors have been identified for anaphylaxis (e.g. asthma, underlying heart disease, previous anaphylaxis), the majority of patients do not have a risk factor. Health professionals are therefore unable to determine who is at risk of anaphylaxis, resulting in widespread prescribing of adrenaline auto-injector pens for emergency rescue treatment. The prescription of these devices has increased over the past decade, from 74,600 devices in England in 2000 to over 230,000 devices in 2010, at a cost of £12.5m. The vast majority of these devices are never used, and their prescription is a significant cost to the health service. Any data facilitating improved risk stratification of allergic individuals would assist health professionals in providing reassurance to patients and parents alike, as well as delivering economic savings.

Given the importance of dietary avoidance in the management of food allergies, the Food Standards Agency (FSA) is commissioning a study to determine the amount of peanut which needs to be consumed to trigger a reaction. This threshold varies significantly between individuals, but also within the same person, depending on a number of poorly understood factors including exercise. The aim is to define a safe level of potential food contamination below which peanut-allergic individuals will not react, thus informing the food industry and better protecting the allergic population. The study will recruit 100 peanut-allergic volunteers, each undergoing controlled exposure to peanut or placebo under medical supervision on different occasions.

The FSA study provides a unique opportunity to assess the mechanism of food allergic reactions, and determine the extent to which data from animal models are applicable to man. We propose to monitor the effects of food allergic reactions on:
- the absorption of food proteins in the mouth, to see if this changes as the reaction progresses
- the release of different chemical mediators in blood, saliva and urine.
- changes in blood flow, both at the site of reaction and beyond, using non-invasive techniques

Our data will provide valuable insight into the mechanisms underlying food allergic reactions in man, highlighting new targets for future diagnostic tests and therapies. We further plan to develop new strategies to improve risk stratification, in order to improve management of peanut allergic individuals.

Technical Summary

AIMS
1) To investigate the pathophysiology of acute allergic reactions to peanut, and how this relates to severity of clinical symptoms, by assessing mucosal absorption of allergen, cellular activation and vascular physiology.
2) To understand the process by which exercise may alter the character of food allergic reactions.

METHODS
This fellowship will capitalize on a recently funded trial involving repeated double-blind placebo-controlled food challenge (DBPCFC) of peanut-allergic adults under controlled conditions. We will assess mechanisms of the acute reaction to a food allergen through:
- assays for biomarkers (blood, saliva, urine) including kinins, complement, leukotrienes and mast cell proteases. Leukocyte activation will be determined by poylchromatic flow cytometry
- Assessment of local and systemic changes in vascular flow and permeability, using established non-invasive techniques
- the above techniques will be repeated with DBPCFC after exercise

SCIENTIFIC AND MEDICAL OPPORTUNITIES
1) Investigate how the pathophysiology of acute allergic reactions to food differs from that of non-food triggers, which are not often associated with systemic effects. This will highlight new targets for future therapeutic interventions, as well as facilitate risk stratification of peanut allergic individuals
2) Determine the extent to which animal models of food allergy are applicable to man.
3) Allow for characterisation of peanut allergic individuals in terms of peanut-specific antibody production (IgE, IgG, IgG4, IgA, free Ig light chain) and how this relates to reaction severity
4) Validation of novel salivary markers of allergic reactions, improving diagnostic opportunities in patients in whom diagnosis is unclear
5) Synergistic collaborations with the pan-European project on Integrated Approaches to Food Allergen and Allergy Risk Management (iFAAM), which will investigate intrinsic and extrinsic factors affecting the severity of reactions to foods.

Planned Impact

1. Health and Social Outputs : Individuals

Study participants: will benefit directly from an awareness of their symptoms and the amount of food allergen needed to trigger this. Previous studies have demonstrated that patients undergoing diagnostic food challenges report an improvement in quality of life measures within a short timeframe (months), even where the challenge is 'positive'.

Patients and their families: Up to 8% of children and 2% of adults in the UK have food allergies; this has a high impact on a patient's quality of life, along with their carers (e.g. parents of affected children). This study will complement the results from the threshold-determining study, by providing additional data relating to the allergic reaction, and whether levels of exposure around the threshold cause reproducible reactions in terms of symptom severity. This will inform policy relating to allergen labelling of foods in terms of potential cross-contamination, resulting in benefits to the wider food-allergic population in the UK. It is hoped that this will take place within 3-5 years. Longer-term, the study will highlight future therapeutic targets which may be useful in the future management of severe reactions.

Health professionals: will be better able to offer reassurance to those affected by food allergies, on the basis of a greater understanding of mechanisms involved and improved tools to determine who is at risk of severe symptoms. The validation of diagnostic techniques for food allergic reactions (e.g. salivary testing) will be of particular utility for professionals in the emergency services and A&E departments. These benefits should commence within the period of this grant, once results have been published in peer-reviewed journals.

2. Health and Social Outputs : Public Services and Health Policy

UK & Europe Policy makers: The results will be used to inform data relating to Minimal Eliciting Doses for the food-allergic population and the required safety factor, in order to inform industry and with a view to protecting the allergic population. This has been determined to be a priority by the Food Standards Agency (FSA). Through my proposed collaboration in the EU-funded project on Integrated Approaches to Food Allergen and Allergy Risk Management (iFAAM), there will also be significant benefits to EU policy makers.

Health policy: Improved risk stratification of peanut-allergic individuals will allow a more targeted provision of education and rescue medications (such as adrenaline autoinjector devices), with associated cost benefits.

Voluntary sector: A number of support groups and charities have been established to support food-allergic patients and their families. Food allergy has a high impact on quality of life measures. By providing information relating to risk assessment and allergen avoidance, the study will empower these groups to provide more comprehensive information to allergic individuals in the UK, within a timeframe similar to that of the publication of the study results (as described above).

3. Economic benefits : National and Global

Food allergy is increasing throughout the world, and is now a global issue, particularly with the export of foods from one country to another. Some countries (e.g. Australia) have already attempted to rationalise allergen labelling of foods in order to provide clearer information to consumers, though the success of this initiative is debatable. Europe, and in particular the FSA, are taking a more quantitative, evidence-based approach. In conjunction with good manufacturing practice, this initiative can be expected to provide a competitive advantage in the provision of foods with appropriate labelling for allergy sufferers. European researchers are leading the world in advancing this important area of investigation.

Publications

10 25 50

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Anagnostou K (2019) Myths, facts and controversies in the diagnosis and management of anaphylaxis. in Archives of disease in childhood

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Bahri R (2018) Mast cell activation test in the diagnosis of allergic disease and anaphylaxis. in The Journal of allergy and clinical immunology

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Brough HA (2015) Dietary management of peanut and tree nut allergy: what exactly should patients avoid? in Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology

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Bulfone-Paus S (2018) Reply. in The Journal of allergy and clinical immunology

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Chong KW (2019) Food allergy desensitisation: a hard nut to crack? in Archives of disease in childhood

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Duca B (2019) GRADE-ing the Benefit/Risk Equation in Food Immunotherapy. in Current allergy and asthma reports

 
Description AAAAI Taskforce on adrenaline autoinjector devices
Geographic Reach Multiple continents/international 
Policy Influence Type Influenced training of practitioners or researchers
 
Description Allergen management on aircraft
Geographic Reach Multiple continents/international 
Policy Influence Type Gave evidence to a government review
 
Description COT
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
Impact Invited to be expert member to the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT), an independent scientific committee that provides advice to the Food Standards Agency, the Department of Health and other Government Departments and Agencies on matters concerning the toxicity of chemicals. Remit relates to a review by COT of strategies which might affect atopic outcomes in pregnancy/children/adulthood.
 
Description European Allergen Immunotherapy taskforce
Geographic Reach Europe 
Policy Influence Type Participation in a advisory committee
 
Description FSA
Geographic Reach National 
Policy Influence Type Participation in advisory committee
Impact Involved in a UK Food Standards Agency review programme for allergen management in industry
 
Description FSA Science Council - Member
Geographic Reach Europe 
Policy Influence Type Participation in a advisory committee
Impact I was successful in applying to be a member of UK Food Standards Agency (FSA) Science Council, where our remit is to provide high-level, expert strategic insight, challenge and advice to the FSA's Chief Scientific Adviser and to the Board and executive of the FSA on the FSA's use of science to deliver FSA objectives in its role as the official government regulator for food safety.
URL https://science-council.food.gov.uk/
 
Description FSA/DEFRA labelling
Geographic Reach Multiple continents/international 
Policy Influence Type Gave evidence to a government review
Impact Asked to provide ongoing expert input into a government (FSA/DEFRA) consultatation on improving allergen labelling relating to PPDS food products.
 
Description Generic AAI
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
Impact Member of steering group which has worked and lobbied DoH and MHRA for a change in UK legislation to allow generic adrenaline autoinjectors in schools and other educational settings. This MHRA have agreed to a change in legislation and we are working with a variety of stakeholder groups including DH and D.Ed. to provide national guidance to schools in the management of allergic reactions and the use of the generic adrenaline.
URL http://www.anaphylaxis.org.uk/campaigning/generic-pen-campaign/
 
Description Green Book guidance - asthma and influenza vaccination
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
Impact Advised the Joint Committee on Vaccination and Immunisation (JCVI) which advises UK health departments on immunisation relating to influenza in chidlren with asthma, and redrafted official government guidance on vaccination
URL https://www.gov.uk/government/publications/influenza-the-green-book-chapter-19
 
Description JCVI / Dept of Health
Geographic Reach Multiple continents/international 
Policy Influence Type Participation in a advisory committee
Impact Asked to advise the Joint Committee on Vaccination and Immunisation (JCVI) which advises UK health departments on immunisation relating to influenza.
URL https://www.gov.uk/government/publications/influenza-the-green-book-chapter-19
 
Description NICE Diagnostic Assessment
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Membership of a guideline committee
 
Description Public Health England / Dept Health
Geographic Reach National 
Policy Influence Type Participation in advisory committee
Impact Asked to advise DoH re National Vaccination Policy with respect to influenza vaccination. Data from research on which I have led has been used to inform UK guideliness.
URL https://www.gov.uk/government/publications/influenza-the-green-book-chapter-19
 
Description SACN/COT committee on infant feeding
Geographic Reach Multiple continents/international 
Policy Influence Type Gave evidence to a government review
Impact Invited to be member of DoH expert committee (SACN/COT) on drafting Government guidelines on infant feeding
URL https://cot.food.gov.uk/committee/committee-on-toxicity/cotwg/joint-sacn/cot-working-group-on-the-ti...
 
Description UCT Paediatric Allergy/PICU meeting
Geographic Reach Africa 
Policy Influence Type Influenced training of practitioners or researchers
Impact Guest speaker/trainer at National Paediatric Training meeting in S. Africa, which attracted HCPs from across Africa as well as from South Africa. I gave 3 sessions on diagnosis/management of anaphylaxis, with a number of approaches afterwards to discuss improvements in the clinical management of anaphylaxis.
 
Description WAO Anaphylaxis Committee
Geographic Reach Multiple continents/international 
Policy Influence Type Membership of a guideline committee
 
Description BRC Funding
Amount £153,000 (GBP)
Organisation National Institute for Health Research 
Department NIHR Imperial Biomedical Research Centre
Sector Academic/University
Country United Kingdom
Start 07/2014 
End 03/2016
 
Description Department of Health Policy Research Programme
Amount £2,061,500 (GBP)
Funding ID PR-R17-0916-22001 
Organisation Government of Wales 
Department Department of Health
Sector Public
Country United Kingdom
Start 09/2017 
End 08/2020
 
Description FP7 iFAAM collaboration
Amount € 130,000 (EUR)
Funding ID 312147 
Organisation European Commission 
Sector Public
Country European Union (EU)
Start 09/2015 
End 02/2017
 
Description MRC Confidence in Concepts Award
Amount £55,400 (GBP)
Funding ID ICL P50832 
Organisation Medical Research Council (MRC) 
Department MRC Confidence in Concept Scheme
Sector Academic/University
Country United Kingdom
Start 08/2014 
End 04/2015
 
Description MRC Confidence in Concepts Award
Amount £55,426 (GBP)
Funding ID ICL PS2531_WMNP and PS2563_WMNP 
Organisation Medical Research Council (MRC) 
Department MRC Confidence in Concept Scheme
Sector Academic/University
Country United Kingdom
Start 07/2015 
End 03/2016
 
Description MRC DPFS
Amount £1,031,452 (GBP)
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
Start 07/2019 
End 06/2022
 
Description NIHR EME
Amount £1,742,727 (GBP)
Organisation NIHR Evaluation, Trials and Studies Coordinating Centre (NETSCC) 
Sector Academic/University
Country United Kingdom
Start 01/2020 
End 12/2023
 
Description National Vaccine Evaluation Consortium, Department of Health
Amount £60,000 (GBP)
Funding ID 039/0031 
Organisation Public Health England 
Sector Public
Country United Kingdom
Start 09/2015 
End 07/2016
 
Description National Vaccine Evaluation Consortium, Department of Health
Amount £245,000 (GBP)
Funding ID 039/0031 
Organisation Public Health England 
Sector Public
Country United Kingdom
Start 09/2013 
End 02/2015
 
Description Research Grant
Amount $180,050 (USD)
Organisation End Allergies Together 
Sector Charity/Non Profit
Country United States
Start 05/2016 
End 12/2017
 
Description SOCMA Study
Amount £295,407 (GBP)
Organisation J P Moulton Charitable Foundation 
Sector Charity/Non Profit
Country United Kingdom
Start 03/2018 
End 03/2020
 
Title Mast cell activation test 
Description Together with our collaboration partners in Manchester, we have successfully developed the mast cell activation test as a tool in allergy diagnostics, and in the assessment of the relative contributions of mast cells to IgE-mediated pathologies. 
Type Of Material Model of mechanisms or symptoms - in vitro 
Year Produced 2018 
Provided To Others? Yes  
Impact Further grant submissions 
 
Title Anaphylaxis registry 
Description UK National Register of Fatal Anaphylaxis 
Type Of Material Database/Collection of data 
Provided To Others? No  
Impact Publications highlighting risk factors for severe food allergic reactions. Pilot data for case-control study to identify risk factors of severity in food allergy. 
 
Description Anaphylaxis Registry 
Organisation Manchester University NHS Foundation Trust
Country United Kingdom 
Sector Public 
PI Contribution Review and cleaning of existing UK fatal anaphylaxis data, collection of prospective data
Collaborator Contribution Review and cleaning of existing UK fatal anaphylaxis data, collection of prospective data
Impact Publication pending
Start Year 2013
 
Description CHOP 
Organisation Children's Hospital of Philadelphia
Department Division of Allergy
Country United States 
Sector Hospitals 
PI Contribution Successful award of a grant from the EAT foundation (USA) to look at transcriptomics during peanut-induced allergic reactions: provision of blood samples, clinical data and analysis
Collaborator Contribution Successful award of a grant from the EAT foundation (USA) to look at transcriptomics during peanut-induced allergic reactions: analysis of blood samples.
Impact nil to date - collaboration only just commenced
Start Year 2016
 
Description Epitope mapping 
Organisation Allergenis
PI Contribution Supplied clinical data and patient samples for analysis
Collaborator Contribution Epitope analysis to include in our data science approach to predict phenotypes relating to peanut allergy
Impact Submitted abstract to EAACI 2019
Start Year 2018
 
Description ICNARC 
Organisation ICNARC Case Mix Programme
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution Joint funding application to analysis ICU admissions due to anaphylaxis in England and Wales
Collaborator Contribution Joint funding application to analysis ICU admissions due to anaphylaxis in England and Wales
Impact Funding application (submitted)
Start Year 2015
 
Description INRA 
Organisation French National Institute of Agricultural Research
Country France 
Sector Public 
PI Contribution Supply of biologicial samples for laboratory analysis
Collaborator Contribution Laboratory analysis of food proteins in biological samples
Impact Pilot data
Start Year 2014
 
Description Influenza collaboration 
Organisation Imperial College London
Country United Kingdom 
Sector Academic/University 
PI Contribution Designing and executing a clinical trial assessing efficacy and immunological response to nasal influenza vaccination in children.
Collaborator Contribution Funding pilot work for an MRC application to assess immunological responses to nasal influenza vaccination, resulting in biological samples to be available for assay
Impact MRC Grant application (through to final round)
Start Year 2017
 
Description Influenza collaboration 
Organisation Public Health England
Country United Kingdom 
Sector Public 
PI Contribution Designing and executing a clinical trial assessing efficacy and immunological response to nasal influenza vaccination in children.
Collaborator Contribution Funding pilot work for an MRC application to assess immunological responses to nasal influenza vaccination, resulting in biological samples to be available for assay
Impact MRC Grant application (through to final round)
Start Year 2017
 
Description PHE 
Organisation Public Health England
Country United Kingdom 
Sector Public 
PI Contribution Head of collaboration for multicentre CTIMP assessing safety of egg-containing vaccine in egg-allergic children including those with history of severe allergic reactions
Collaborator Contribution Funding and statistical support
Impact Report to MHRA x 2. 4 conference abstracts. Change in UK vaccination policy achieved. Further study funded. 3 x papers published.
Start Year 2013
 
Description Pero Korosec, Slovenia 
Organisation University Clinic Golnik
Country Slovenia 
Sector Academic/University 
PI Contribution Provision of samples and data from food challenges to peanut, to determine pathophysiological changes during allergic reactions
Collaborator Contribution Provision of samples and data from patients undergoing acute allergic reactions to venom, presenting to the emergency department, to determine pathophysiological changes during allergic reactions
Impact 1 Accepted manuscript to J. Allergy Clin Immunol., to date.
Start Year 2016
 
Description TNO 
Organisation Netherlands Organization for Applied Scientific Research (TNO)
Country Netherlands 
Sector Public 
PI Contribution Contributed with data and methodology towards risk assessment methodology for food industry with respect to food allergens. Negotiations are underway to fund a 2 year MD project at Imperial College London.
Collaborator Contribution TNO have provided analysis for data relating to food allergen thresholds and the effect of food processing on these.
Impact Conference abstract. Paper in submission.
Start Year 2015
 
Description TRACE 
Organisation University of Cambridge
Country United Kingdom 
Sector Academic/University 
PI Contribution Mechanistic investigations to food allergic reactions
Collaborator Contribution Resources in order to fund and excecute DBPCFC food challenges in allergic adults
Impact nil to date
Start Year 2013
 
Description TRACE 
Organisation University of Manchester
Department Institute of Inflammation and Repair
Country United Kingdom 
Sector Academic/University 
PI Contribution Mechanistic investigations to food allergic reactions
Collaborator Contribution Resources in order to fund and excecute DBPCFC food challenges in allergic adults
Impact nil to date
Start Year 2013
 
Description UCC 
Organisation University College Cork
Country Ireland 
Sector Academic/University 
PI Contribution Data relating to reaction thresholds, interpretation of food allergen labels, research methodology, survey.
Collaborator Contribution Data relating to reaction thresholds, interpretation of food allergen labels, research methodology, data analysis
Impact Plans for a pan-European survey to assess consumer approaches to allergen labelling interpretation
Start Year 2015
 
Description UNSW 
Organisation University of New South Wales
Department Faculty of Engineering
Country Australia 
Sector Academic/University 
PI Contribution Provision of samples and clinical data relating to peanut-allergic individuals, to assess IgE-immunoblot changes during desensitisation in peanut allergy
Collaborator Contribution IgE-immunoblot changes during desensitisation in peanut allergy
Impact Nil to date - collaboration only just commenced
Start Year 2016
 
Description USyd 
Organisation University of Sydney
Country Australia 
Sector Academic/University 
PI Contribution Joint clinical study: pilot study being performed in London, UK with analysis of samples and future 2 centre study involving UK and Australia
Collaborator Contribution Intellectual input, provision of IMP equivalent, lab analysis
Impact pending
Start Year 2013
 
Description iFAAM 
Organisation University of Manchester
Department Institute of Inflammation and Repair
Country United Kingdom 
Sector Academic/University 
PI Contribution 1) Development of a severity score system for food-induced allergic reactions 2) Strategic approaches to 'may contain' precautionary statements on food labels
Collaborator Contribution Synergies with regards to severity score
Impact 2 review articles (one published to date, one under review)
Start Year 2013
 
Title BOPI 
Description Phase 2/3 RCT to evaluate use of modified peanut allergen in oral immunotherapy for peanut allergy 
Type Therapeutic Intervention - Drug
Current Stage Of Development Late clinical evaluation
Year Development Stage Completed 2016
Development Status Under active development/distribution
Clinical Trial? Yes
Impact The pilot data has led to a AUD$1.6million award from NHMRC for a follow-on study, on which I am a co-I. 
URL https://clinicaltrials.gov/ct2/show/NCT02149719
 
Title Fluenz (LAIV) 
Description Efficacy and safety of Fluenz (intranasal influenza vaccine) in atopic children 
Type Therapeutic Intervention - Vaccines
Current Stage Of Development Market authorisation
Year Development Stage Completed 2015
Development Status Under active development/distribution
Clinical Trial? Yes
Impact Data has supported change in national vaccine policy 
URL https://clinicaltrials.gov/ct2/show/NCT02549365
 
Title Fluenz (LAIV) 
Description Safety of Fluenz (intranasal influenza vaccine in children with egg allergy +/- asthma 
Type Therapeutic Intervention - Vaccines
Current Stage Of Development Late clinical evaluation
Year Development Stage Completed 2014
Development Status Under active development/distribution
Clinical Trial? Yes
Impact change in UK public vaccination policy 
URL http://clinicaltrials.gov/show/NCT02111512
 
Title Fluenz Tetra (LAIV) 
Description SNIFFLE-4 Study is a nationwide, multicentre study assessing the safety of Fluenz Tetra in children with moderate-severe asthma. The vaccine is currently available in UK and is part of the national childhood immunisation schedule. However, it's use in asthma is a relative contra-indication. I am the national CI on the study. 
Type Therapeutic Intervention - Vaccines
Current Stage Of Development Wide-scale adoption
Year Development Stage Completed 2017
Development Status Under active development/distribution
Clinical Trial? Yes
Impact The study results will feed directly in PHE guidance for influenza vaccination. 
URL https://clinicaltrials.gov/show/NCT02866942
 
Title SNIFFLE Study 
Description Assessing safety of Fluenz LAIV immunisation in egg-allergic children; DoH funded. 
Type Therapeutic Intervention - Vaccines
Current Stage Of Development Market authorisation
Year Development Stage Completed 2013
Development Status Under active development/distribution
Clinical Trial? Yes
Impact Demonstration of safety of Fluenz vaccination in egg-allergic children, facilitating nationwide roll-out of universal flu vaccination in children improving streamlined delivery of vaccination programme. 
URL http://clinicaltrials.gov/show/NCT01859039
 
Title SOCMA study 
Description Phase 2b/3 clinical trial evaluating combination approach to milk allergy desensitisation 
Type Therapeutic Intervention - Complementary
Current Stage Of Development Refinement. Clinical
Year Development Stage Completed 2018
Development Status Actively seeking support
Clinical Trial? Yes
Impact Study due to report early 2020 
URL https://clinicaltrials.gov/show/NCT02216175
 
Description Airline company 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Industry/Business
Results and Impact Advisory panel to a major international airline on medical procedures in-flight with respect to anaphylaxis emergencies
Year(s) Of Engagement Activity 2019
 
Description Akademie Fresenius 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Industry/Business
Results and Impact 2 day workshop / expert panel on improving allergen risk management in food industry
Year(s) Of Engagement Activity 2015
URL https://www.akademie-fresenius.com/company/press/news-details/eliminationsdiaet-bei-lebensmittelalle...
 
Description Anaphylaxis Campaign support group 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? Yes
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact 15 parents of food allergic children

Follow up from 2 parents seeking further information
Year(s) Of Engagement Activity 2013,2014,2015
 
Description BBC 4 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact Filming for a BBC documentary on blood and allergy

Film yet to be aired
Year(s) Of Engagement Activity 2014
 
Description EAACI Severity meeting 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? Yes
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Invovled in European working group on anaphylaxis diagnosis and management

pending
Year(s) Of Engagement Activity 2014
 
Description FSA Adult allergy 
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 Scoping group to define research strategy for Food Standards Agency
Year(s) Of Engagement Activity 2016
 
Description Food Matters 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Food Matters Live meeting at Excel - presentation on allergy labelling to general public with Q&A afterwards
Year(s) Of Engagement Activity 2015
 
Description Generic adrenaline autoinjectors / MHRA 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Working group to work with DoH/MHRA to facilitate change in UK legislation allowing generic adrenaline autoinjectors into schools
Year(s) Of Engagement Activity 2015,2016,2017
 
Description Generic adrenaline pens in schools 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Schools
Results and Impact Led project/working group including patient representatives to develop DoH-funded resources including website to support changes in legislation allowing "spare" adrenaline auto-injectors in schools.
Year(s) Of Engagement Activity 2017,2018
URL http://www.sparepensinschools.uk
 
Description ILSI Severity 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact Ongoing ILSI expert group on assessing relationship between exposure dose and severity of resulting allergic reactions, to inform allergen risk management
Year(s) Of Engagement Activity 2015,2016
URL http://www.ilsi.org/Europe/Pages/Food-Allergy-Expert-Groups.aspx
 
Description ITV regional news 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? Yes
Geographic Reach Regional
Primary Audience Media (as a channel to the public)
Results and Impact Filmed for brief slot on allergy awareness week for ITV regional news

none specific
Year(s) Of Engagement Activity 2014
URL https://www.youtube.com/watch?v=d86SRfBk1s4
 
Description Infant Feeding Advice - working group 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Led a working group of healthcare professionals (doctors, nurses, dietitians, health visitors) to write national guidance on the introduction of allergenic foods into the infant diet, with input from parents/public/patient rep groups
Year(s) Of Engagement Activity 2017,2018
 
Description NRP Radio interview 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Radio interview with NRP Washington to discuss management of anaphylaxis, and in particular, use of adrenaline autoinjectors
Year(s) Of Engagement Activity 2016
 
Description Sunday Times article 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Interviewed for Sunday Times magazine central feature on food allergy
Year(s) Of Engagement Activity 2019
 
Description Updated info sheets: Anaphylaxis Campaign 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Patients, carers and/or patient groups
Results and Impact Edited information sheet (online) for Anaphylaxis Campaign
Year(s) Of Engagement Activity 2016
 
Description Working group: FPIES 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact International guidelines on the management of FPIES
Year(s) Of Engagement Activity 2015,2016,2017
URL http://www.jacionline.org/article/S0091-6749(17)30153-7/fulltext
 
Description iFAAM Food labelling 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Industry/Business
Results and Impact 80 stakeholders attended a 1 day iFAAM/ILSI workshop on improving allergen food labelling. Feedback useful in determining ongoing activities.
Year(s) Of Engagement Activity 2015