BIOMARKERS AND MECHANISMS OF FOOD ALLERGY AND ORAL TOLERANCE IN IgE-SENSITISED CHILDREN
Lead Research Organisation:
King's College London
Department Name: Asthma Allergy and Lung Biology
Abstract
The symptoms of food allergy (FA) result from the release of certain substances by cells of the immune system, called mast cells and basophils, triggered by the interaction between allergy antibodies and food allergens. FA is often diagnosed using skin prick test or by detecting IgE (allergy antibodies) in the blood. However, more common than being food allergic is to have a positive allergy test to that food. For example, only 1 out of 5 children with a positive allergy test to peanut in the United Kingdom has peanut allergy. In the equivocal cases (more than 50% of patients), an oral food challenge (OFC) is required. OFC consists in giving the patient the suspected food in a controlled environment to see whether the patient develops an allergic reaction. OFC are quite expensive, time-consuming and place the patient at risk of a potentially severe reaction, but this is currently the gold-standard for the diagnosis of FA. In my MRC-funded PhD project, I developed a new blood test called the basophil activation test (BAT) that works like an OFC in a test tube. BAT to peanut showed 97% accuracy in the diagnosis of peanut allergy and reduced the need for OFC by two thirds. In this project, I will develop similar diagnostic tests for cow's milk and egg allergies, which are the most common food allergies in childhood, and for sesame and cashew, which are two of the foods that most commonly require OFC as conventional allergy tests fail to diagnose allergy correctly. I anticipate that BAT will lead to a significant improvement of care for allergic patients and will reduce the costs and anxiety associated with OFC.
BAT requires the use of fresh blood cells. As part of an MRC Award, I developed a test similar to BAT using a cell line that is grown in the laboratory and thus is readily available. I will test various samples of peanut allergic and non allergic patients to validate this assay as a biomarker of peanut allergy. I have developed a similar assay to test the ability of antibodies in the blood of non allergic patients to block IgE - this is the inhibition of mast cell activation test (IMAT), that I will validate as a biomarker of food tolerance. These assays could be used in future studies to test samples collected far from the laboratory or to test in parallel samples that have been collected at different time points, in relation to allergy or tolerance.
To understand why some patients have a positive allergy test and are not allergic, I will determine which specific part of the allergen the antibodies of allergic patients and non allergic individuals recognise. It is possible that allergic and tolerant patients recognise different parts of the allergen that may or may not be able to trigger allergic symptoms, respectively. It is also possible that allergic and tolerant patients recognise the same parts of the allergen molecule but tolerant individuals generate antibodies of a different type that are able to block IgE. In collaboration with Professors Brian Sutton and Hannah Gould, artificial antibodies will be generated based on the antibodies of a peanut allergic patient and a crystal formed by these antibodies and by peanut allergens will help to investigate which part of the allergen is recognised by the IgE allergy antibodies. Mutant allergens will be generated by changing the allergen at specific sites. I will be testing these mutant allergens alongside with naturally occurring peanut allergens regarding their ability to cause allergic symptoms in the MAT. Blocking antibodies directed at the same part of the peanut allergens will be generated and its blocking activity tested on the IMAT.
Understanding precisely what is happening when a patient is allergic and when a patient is not allergic despite the presence of IgE antibodies will help us to find ways to treat patients with FA and to prevent the development of FA by modifying the way the immune system responds to peanut or other food allergens.
BAT requires the use of fresh blood cells. As part of an MRC Award, I developed a test similar to BAT using a cell line that is grown in the laboratory and thus is readily available. I will test various samples of peanut allergic and non allergic patients to validate this assay as a biomarker of peanut allergy. I have developed a similar assay to test the ability of antibodies in the blood of non allergic patients to block IgE - this is the inhibition of mast cell activation test (IMAT), that I will validate as a biomarker of food tolerance. These assays could be used in future studies to test samples collected far from the laboratory or to test in parallel samples that have been collected at different time points, in relation to allergy or tolerance.
To understand why some patients have a positive allergy test and are not allergic, I will determine which specific part of the allergen the antibodies of allergic patients and non allergic individuals recognise. It is possible that allergic and tolerant patients recognise different parts of the allergen that may or may not be able to trigger allergic symptoms, respectively. It is also possible that allergic and tolerant patients recognise the same parts of the allergen molecule but tolerant individuals generate antibodies of a different type that are able to block IgE. In collaboration with Professors Brian Sutton and Hannah Gould, artificial antibodies will be generated based on the antibodies of a peanut allergic patient and a crystal formed by these antibodies and by peanut allergens will help to investigate which part of the allergen is recognised by the IgE allergy antibodies. Mutant allergens will be generated by changing the allergen at specific sites. I will be testing these mutant allergens alongside with naturally occurring peanut allergens regarding their ability to cause allergic symptoms in the MAT. Blocking antibodies directed at the same part of the peanut allergens will be generated and its blocking activity tested on the IMAT.
Understanding precisely what is happening when a patient is allergic and when a patient is not allergic despite the presence of IgE antibodies will help us to find ways to treat patients with FA and to prevent the development of FA by modifying the way the immune system responds to peanut or other food allergens.
Technical Summary
The majority of children with food-specific IgE do not have food allergy (FA). In equivocal cases, oral food challenges (OFC) are required. However, these are expensive, time-consuming and not without risk.
Aims:
1. To improve the diagnosis of food allergy using the basophil activation test (BAT)
2. To validate the mast cell activation test (MAT) and the inhibition of MAT (IMAT) as novel biomarkers of food allergy and food tolerance
3. To understand the mechanisms underpinning FA and tolerance in IgE-sensitised children
Methodology:
Following the success of BAT in accurately diagnosing peanut allergy (PA) and reducing the need for oral food challenges (OFC), I will create a new BAT to diagnose cow's milk, egg, sesame and cashew nut allergies. I will validate MAT and IMAT as biomarkers of PA and peanut tolerance, respectively. In order to understand the discrepancy between clinical allergy (and tolerance) and the levels of IgE (and IgG4) to peanut allergens, I will test the following hypotheses:
1.The location, number and combination of IgE epitopes in the allergen molecules play a role in the ability of allergen-IgE complexes to trigger effector cell activation;
2.Relative titres and matching of epitope-specific antibodies between IgE and IgG4 contribute to the overall effector cell activation or inhibition.
IgE and IgG4 binding to peanut allergen peptides will be performed. IgE and IgG4 epitopes will be identified on the allergen structure and compared between allergic and tolerant patients. The crystal structure of IgE-allergen complexes will allow identifying critical epitopes for IgE binding and their relevance will be assessed on MAT using wild-type and allergens mutated to remove specific epitopes. The blocking effect of IgG4 and Fab fragments with the same specificity as IgE will be tested in the IMAT.
Scientific and medical opportunities: This study will improve FA diagnosis and may identify targets for definitive treatment and prevention of FA.
Aims:
1. To improve the diagnosis of food allergy using the basophil activation test (BAT)
2. To validate the mast cell activation test (MAT) and the inhibition of MAT (IMAT) as novel biomarkers of food allergy and food tolerance
3. To understand the mechanisms underpinning FA and tolerance in IgE-sensitised children
Methodology:
Following the success of BAT in accurately diagnosing peanut allergy (PA) and reducing the need for oral food challenges (OFC), I will create a new BAT to diagnose cow's milk, egg, sesame and cashew nut allergies. I will validate MAT and IMAT as biomarkers of PA and peanut tolerance, respectively. In order to understand the discrepancy between clinical allergy (and tolerance) and the levels of IgE (and IgG4) to peanut allergens, I will test the following hypotheses:
1.The location, number and combination of IgE epitopes in the allergen molecules play a role in the ability of allergen-IgE complexes to trigger effector cell activation;
2.Relative titres and matching of epitope-specific antibodies between IgE and IgG4 contribute to the overall effector cell activation or inhibition.
IgE and IgG4 binding to peanut allergen peptides will be performed. IgE and IgG4 epitopes will be identified on the allergen structure and compared between allergic and tolerant patients. The crystal structure of IgE-allergen complexes will allow identifying critical epitopes for IgE binding and their relevance will be assessed on MAT using wild-type and allergens mutated to remove specific epitopes. The blocking effect of IgG4 and Fab fragments with the same specificity as IgE will be tested in the IMAT.
Scientific and medical opportunities: This study will improve FA diagnosis and may identify targets for definitive treatment and prevention of FA.
Planned Impact
The proposed research aims to improve the diagnosis of food allergy (FA) by using a very accurate newly developed blood test, to validate novel biomarkers of food allergy and tolerance and to improve our understanding of the mechanism that mediate food allergy and tolerance. The ultimate goals of this project are to create an accurate safe non-invasive diagnostic test for food allergy eliminating the need for oral food challenge (OFC) and to identify key targets for future interventions to treat and prevent allergic disease.
FA affects 8% of children and 2% of adults in Western countries. FA has become a significant public health concern; an increased prevalence resulted in an increased incidence in anaphylaxis, which can be fatal. There is no curative treatment for FA and the mainstay of management remains allergen avoidance and the use of rescue treatment for accidental reactions. FA affects the quality of life of allergic children and their families due to dietary and social restrictions and to anxiety related to the life-threatening nature of FA.
The majority of patients with a positive allergy test are not allergic. In equivocal cases, which constitute about 50% of patients seen in an Allergy clinic, OFC are required to diagnose FA. However, OFC are laborious and expensive procedures that place the patient at risk of a potentially severe allergic reaction. In my previous research, the basophil activation test (BAT) proved to be very accurate (97%), with 98% sensitivity and 96% specificity, and was superior to other diagnostic tests in discriminating between peanut allergy and tolerance. BAT reduced the need for oral food challenges by two thirds. I now propose to expand the use of BAT to the diagnosis of other food allergies.
The key beneficiaries from this research include:
1. The immediate and wider science communities
(see Academic Beneficiaries)
2. The health care system and society
I anticipate that the validation of a more accurate diagnostic test (BAT) for various foods allergies will substantially improve the care for patients with suspected FA, not only by improving the diagnostic accuracy but mainly by reducing the number of OFC required. The reduction in the number of OFC will have direct and indirect economic implications for the health care system: the costs of BAT are lower than those of OFC, BAT is less time-consuming and does not require a multidisciplinary highly-trained clinical team and eliminates the anxiety and risk associated with OFC.
3. The food industry
Determination of thresholds is useful for the Public Health Authorities and for the Food Industry to establish regulatory measures to protect food allergic patients and to institute allergen control measures and labelling policies. However, this requires the performance of graded OFC in patients known to be allergic. In my previous work, BAT informed about threshold of allergic reactions to peanut. The same could be determined for other foods.
4. Patient organisations and patients
(see Pathways to Impact)
5. Key established and new industry partners who can develop new paradigms for drug testing based on our mechanistic findings
My work will also open new potential research areas for exploitation. The discovery of new mechanisms underlying FA and tolerance will have significant potential to build on existing collaborations with industry and develop new industry collaborations. The same applies to the standardisation of BAT as a diagnostic tool in FA and making this test commercially available to multiple foods. All these possibilities will be of interest to industry especially for testing new therapies based on the immunological discovery of new targets. Furthermore, the close collaboration between clinicians and scientists fostered by my project will benefit both parties and create stronger links for further collaboration and translational activity.
FA affects 8% of children and 2% of adults in Western countries. FA has become a significant public health concern; an increased prevalence resulted in an increased incidence in anaphylaxis, which can be fatal. There is no curative treatment for FA and the mainstay of management remains allergen avoidance and the use of rescue treatment for accidental reactions. FA affects the quality of life of allergic children and their families due to dietary and social restrictions and to anxiety related to the life-threatening nature of FA.
The majority of patients with a positive allergy test are not allergic. In equivocal cases, which constitute about 50% of patients seen in an Allergy clinic, OFC are required to diagnose FA. However, OFC are laborious and expensive procedures that place the patient at risk of a potentially severe allergic reaction. In my previous research, the basophil activation test (BAT) proved to be very accurate (97%), with 98% sensitivity and 96% specificity, and was superior to other diagnostic tests in discriminating between peanut allergy and tolerance. BAT reduced the need for oral food challenges by two thirds. I now propose to expand the use of BAT to the diagnosis of other food allergies.
The key beneficiaries from this research include:
1. The immediate and wider science communities
(see Academic Beneficiaries)
2. The health care system and society
I anticipate that the validation of a more accurate diagnostic test (BAT) for various foods allergies will substantially improve the care for patients with suspected FA, not only by improving the diagnostic accuracy but mainly by reducing the number of OFC required. The reduction in the number of OFC will have direct and indirect economic implications for the health care system: the costs of BAT are lower than those of OFC, BAT is less time-consuming and does not require a multidisciplinary highly-trained clinical team and eliminates the anxiety and risk associated with OFC.
3. The food industry
Determination of thresholds is useful for the Public Health Authorities and for the Food Industry to establish regulatory measures to protect food allergic patients and to institute allergen control measures and labelling policies. However, this requires the performance of graded OFC in patients known to be allergic. In my previous work, BAT informed about threshold of allergic reactions to peanut. The same could be determined for other foods.
4. Patient organisations and patients
(see Pathways to Impact)
5. Key established and new industry partners who can develop new paradigms for drug testing based on our mechanistic findings
My work will also open new potential research areas for exploitation. The discovery of new mechanisms underlying FA and tolerance will have significant potential to build on existing collaborations with industry and develop new industry collaborations. The same applies to the standardisation of BAT as a diagnostic tool in FA and making this test commercially available to multiple foods. All these possibilities will be of interest to industry especially for testing new therapies based on the immunological discovery of new targets. Furthermore, the close collaboration between clinicians and scientists fostered by my project will benefit both parties and create stronger links for further collaboration and translational activity.
Organisations
- King's College London (Fellow, Lead Research Organisation)
- Viapath (Collaboration)
- National Jewish Medical and Research Center, USA (Collaboration)
- Technical University of Munich (Collaboration)
- Karolinska Institute (Collaboration)
- Federal University of São Paulo (Collaboration)
- August Pi i Sunyer Biomedical Research Institute (Collaboration)
- Southampton Hospital (Collaboration)
- Utrecht University (Collaboration)
- Benaroya Research Institute (Collaboration)
- SANDWELL AND WEST BIRMINGHAM HOSPITALS NHS TRUST (Collaboration)
- QUEEN MARY UNIVERSITY OF LONDON (Collaboration)
- University of Geneva (Collaboration)
- Danaher Corporation (Collaboration)
- U.S. Department of Agriculture USDA (Collaboration)
- University College Hospital (Collaboration)
- Murdoch Children's Research Institute (Collaboration)
- Massachusetts General Hospital (Collaboration)
- Spanish National Research Council (CSIC) (Collaboration)
- ASTON UNIVERSITY (Collaboration)
- Stanford University (Collaboration)
- Guy's and St Thomas' NHS Foundation Trust (Collaboration)
- University of Helsinki (Collaboration)
- University of Malaga (Collaboration)
- University of Valencia (Collaboration)
- Addenbrooke's Hospital (Collaboration)
- Thermofisher - Uppsala (Collaboration)
- Curie Institute Paris (Institut Curie) (Collaboration)
- Charité - University of Medicine Berlin (Collaboration)
- Aarhus University (Collaboration)
- Sheffield Children's Hospital (Collaboration)
- King's College Hospital (Collaboration)
- University of Chicago (Collaboration)
- University of Lisbon (Collaboration)
- Thermo Fisher Scientific (United Kingdom) (Collaboration)
- UNIVERSITY HOSPITALS OF LEICESTER NHS TRUST (Collaboration)
- Royal Manchester Children's Hospital (Collaboration)
- IMPERIAL COLLEGE LONDON (Collaboration)
- NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST (Collaboration)
- Immune Tolerance Network (Collaboration)
- UNIVERSITY OF EDINBURGH (Collaboration)
- National Institutes of Health (NIH) (Collaboration)
- University of Bonn (Collaboration)
- KING'S COLLEGE LONDON (Collaboration)
- Antwerp University Hospital (Collaboration)
Publications
Barber D
(2021)
Molecular allergology and its impact in specific allergy diagnosis and therapy.
in Allergy
Brough HA
(2022)
Early intervention and prevention of allergic diseases.
in Allergy
Brough HA
(2020)
Reply.
in The Journal of allergy and clinical immunology
Brough HA
(2020)
Defining challenge-proven coexistent nut and sesame seed allergy: A prospective multicenter European study.
in The Journal of allergy and clinical immunology
Buyuktiryaki B
(2020)
Food allergy severity predictions based on cellular in vitro tests
in Expert Review of Molecular Diagnostics
Caminati M
(2019)
The EAACI-AAAAI-WAO Junior Members' joint survey: A worldwide snapshot of Allergy and Clinical Immunology specialty
in Allergy
Carboni E
(2020)
Les tests de provocation alimentaire dans 4 pays européens : France, Espagne, Italie et Royaume-Uni
in Revue Française d'Allergologie
De Boer R
(2020)
Specific IgE as the best predictor of the outcome of challenges to baked milk and baked egg.
in The journal of allergy and clinical immunology. In practice
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
Dhami S
(2016)
Allergen immunotherapy for IgE-mediated food allergy: protocol for a systematic review.
in Clinical and translational allergy
| Description | Chair of the Research and Outreach Committee Food Allergy Group of the European Academy of Allergy and Clinical Immunology |
| Geographic Reach | Multiple continents/international |
| Policy Influence Type | Participation in a guidance/advisory committee |
| Description | Changes in guidelines for prevention of peanut allergy |
| Geographic Reach | North America |
| Policy Influence Type | Implementation circular/rapid advice/letter to e.g. Ministry of Health |
| 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 Food Allergy Guidelines (Chair) |
| Geographic Reach | Europe |
| Policy Influence Type | Participation in a guidance/advisory committee |
| Description | EAACI Task Force on Allergen Thresholds |
| Geographic Reach | Europe |
| Policy Influence Type | Membership of a guideline committee |
| Description | EAACI Task Force on the impact of food processing on food allergy |
| Geographic Reach | Europe |
| Policy Influence Type | Membership of a guideline committee |
| Description | EAACI Task-Force on allergic diseases in adolescents and young people, towards better patient-centred care |
| 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 | WHO IUIS Allergen Nomenclature Committee Member |
| Geographic Reach | Multiple continents/international |
| Policy Influence Type | Membership of a guideline committee |
| Description | "Intestinal organoid platform to facilitate multidisciplinary multidisease studies" - King's Together Multi- and Interdisciplinary Research Fund |
| Amount | £100,000 (GBP) |
| Organisation | King's College London |
| Sector | Academic/University |
| Country | United Kingdom |
| Start | 10/2019 |
| End | 09/2020 |
| Description | ERA-HDHL Call for Joint Transnational Research Proposals: "Addressing adverse and beneficial effects of food ingredients and food processing on hypersensitivities to food" (FOOD_HYPERSENS) |
| Amount | £1,000,000 (GBP) |
| Funding ID | BB/X002519/1 |
| Organisation | King's College London |
| Sector | Academic/University |
| Country | United Kingdom |
| Start | 04/2022 |
| End | 03/2025 |
| Description | Food Allergy Research and Education |
| Amount | $500,000 (USD) |
| Organisation | Food Allergy Research and Education (FARE) |
| Sector | Charity/Non Profit |
| Country | United States |
| Start | 04/2021 |
| End | 04/2024 |
| Description | King's College London Confidence in Concept 2018 |
| Amount | £1,000,000 (GBP) |
| Funding ID | MC_PC_18052 |
| Organisation | Medical Research Council (MRC) |
| Sector | Public |
| Country | United Kingdom |
| Start | 07/2019 |
| End | 03/2021 |
| Description | MRC Transition Support CSF Alexandra Santos |
| Amount | £700,773 (GBP) |
| Organisation | Medical Research Council (MRC) |
| Sector | Public |
| Country | United Kingdom |
| Start | 08/2020 |
| End | 07/2022 |
| Description | MRC-DTP PhD Programme |
| Amount | £82,227 (GBP) |
| Organisation | King's College London |
| Sector | Academic/University |
| Country | United Kingdom |
| Start | 09/2021 |
| End | 08/2024 |
| Description | Mast cell activation in the EAT and EAT-On Study |
| Amount | £10,000 (GBP) |
| Organisation | National Institute for Health Research |
| Sector | Public |
| Country | United Kingdom |
| Start | 01/2021 |
| End | 03/2022 |
| 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 | National Institutes of Health (NIH) |
| Amount | £40,985 (GBP) |
| Organisation | National Institutes of Health (NIH) |
| Sector | Public |
| Country | United States |
| Start | 04/2021 |
| End | 12/2021 |
| Description | The Asthma UK Centre Allergy Mechanisms in Asthma |
| Amount | £953,495 (GBP) |
| Organisation | Asthma + Lung UK |
| Sector | Charity/Non Profit |
| Country | United Kingdom |
| Start | 08/2016 |
| End | 08/2021 |
| Description | Understanding how environmental cutaneous exposure to peanut protein might cause food allergy in early life |
| Amount | £95,000 (GBP) |
| Organisation | Rosetrees Trust |
| Sector | Charity/Non Profit |
| Country | United Kingdom |
| Start | 04/2023 |
| End | 01/2026 |
| Description | Wellcome Trust PhD Programme on Neuroimmunology |
| Amount | £205,252 (GBP) |
| Organisation | King's College London |
| Sector | Academic/University |
| Country | United Kingdom |
| Start | 10/2021 |
| End | 09/2025 |
| 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/ |
| Title | Predicting Allergic Reactions During Oral Peanut Challenges |
| Description | his prediction tool calculates the reaction severity based on a published model developed from the LEAP, LEAP-On, and PAS studies. This tool uses the basophil activation test (BAT), skin prick test (SPT) size (mm), and the level of Ara h 2-specific IgE (kU/L) to predict reaction severity defined as no reaction, moderate reaction, or a severe reaction. The values of these biomarkers are combined to give the predicted probabilities of falling into each of the severity categories. This tool may be useful for clinicians when assessing the risk of conducting oral food challenges to diagnose peanut allergy. All study details and modeling are outlined in "Santos AF, et al., Biomarkers of severity and threshold of allergic reactions during oral peanut challenges. J Allergy Clin Immunol. 2020 Aug;146(2):344-355. PMID: 32311390." |
| Type Of Material | Computer model/algorithm |
| Year Produced | 2021 |
| Provided To Others? | Yes |
| Impact | This tool has been useful for clinical teams to determine the likelihood of patients to react during peanut challenges. |
| URL | https://benaroyaresearch.shinyapps.io/peanutallergytool/ |
| Description | BAT to clinic |
| Organisation | Danaher Corporation |
| Department | Beckmann Coulter |
| Country | United States |
| Sector | Private |
| PI Contribution | We designed the study, the experiments, recruited the patients, generated and analysed the data and interpreted the results. We secured the fundings required to provide the necessary equipment and reagents for the project. |
| Collaborator Contribution | Viapath provided some time from their employees to support the project. Beckman Coulter provided the reagents for the trials runs before the start of the project. |
| Impact | Funding from the MRC Confidence in Concept Scheme through the KHP Challenge Fund. |
| Start Year | 2019 |
| Description | BAT to clinic |
| Organisation | Viapath |
| Country | United Kingdom |
| Sector | Private |
| PI Contribution | We designed the study, the experiments, recruited the patients, generated and analysed the data and interpreted the results. We secured the fundings required to provide the necessary equipment and reagents for the project. |
| Collaborator Contribution | Viapath provided some time from their employees to support the project. Beckman Coulter provided the reagents for the trials runs before the start of the project. |
| Impact | Funding from the MRC Confidence in Concept Scheme through the KHP Challenge Fund. |
| Start Year | 2019 |
| Description | Basophil activation test in the LEAP and LEAP-On studies |
| Organisation | National Institutes of Health (NIH) |
| 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 | Basophil activation test in the TREAT study |
| Organisation | Murdoch Children's Research Institute |
| Country | Australia |
| Sector | Academic/University |
| PI Contribution | I have provided my expert advise and intellectual input in the design of experiments to assess basophil activation to tree nuts in children recruited into the Treeat Trial. |
| Collaborator Contribution | Treeat is an interventional randomised controlled study to find out if the introduction of multiple tree nuts in a hospital oral food challenge is better for prevention of tree nut allergy and is easier for families, than standard care. |
| Impact | None |
| Start Year | 2021 |
| Description | Basophil activation test to diagnose cow's milk allergy in Brazil |
| Organisation | Federal University of São Paulo |
| Country | Brazil |
| Sector | Academic/University |
| PI Contribution | I have provided expert advice on the study design and experimental set up of a study on the utility of the basophil activation test to diagnose cow's milk allergy in Sao Paulo. I have trained the PI of the study on the basophil activation test in my lab during a Sabbatical visit in 2020. |
| Collaborator Contribution | My collaborator is setting up and leading the study in Brazil. |
| Impact | Not yet. |
| Start Year | 2020 |
| Description | Epitope IgE and IgG4 testing |
| Organisation | Benaroya Research Institute |
| 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 |
| Description | Epitope IgE testing |
| Organisation | Thermo Fisher Scientific |
| Country | United States |
| Sector | Private |
| PI Contribution | We identified key epitope-containing peptides in peanut allergens and provided the peptides to our collaborator, who couple them to a solid phase using the ImmunoCAP technology to enable us to measure IgE and IgG4 to the peptides. With this, we validated our findings and found a clinical application given that these peptides had diagnostic value. |
| Collaborator Contribution | Our collaborator couple the peptides of interest to a solid phase using the ImmunoCAP technology. |
| Impact | Examples of outputs that resulted from this collaboration were posters and oral abstracts presented at internal and extrenal conferences and one peer-reviewed publication. More are in preparation. |
| Start Year | 2018 |
| Description | Epitope IgE testing |
| Organisation | Thermofisher - Uppsala |
| Country | Sweden |
| Sector | Private |
| PI Contribution | We identified key epitope-containing peptides in peanut allergens and provided the peptides to our collaborator, who couple them to a solid phase using the ImmunoCAP technology to enable us to measure IgE and IgG4 to the peptides. With this, we validated our findings and found a clinical application given that these peptides had diagnostic value. |
| Collaborator Contribution | Our collaborator couple the peptides of interest to a solid phase using the ImmunoCAP technology. |
| Impact | Examples of outputs that resulted from this collaboration were posters and oral abstracts presented at internal and extrenal conferences and one peer-reviewed publication. More are in preparation. |
| Start Year | 2018 |
| Description | ISAC model |
| Organisation | Guy's and St Thomas' NHS Foundation Trust |
| Country | United Kingdom |
| Sector | Public |
| PI Contribution | Me and my team designed the study, recruited the patients, tested the patients' samples on the ISAC chip, planned and critically reviewed the analyses performed by the bioinformaticians. |
| Collaborator Contribution | - Thermofisher scientific provided the reagents to test patients' samples. - Bioinformaticians at the NIHR Biomedical Research Center, Guy's and St Thomas' NHS Foundation Trust performed the data analyses. |
| Impact | An abstract to be presented at a conference and the respective paper are in preparation. Disciplines involves are: Medicine (Allergy), Immunology, Bioinformatics. |
| Start Year | 2018 |
| Description | ISAC model |
| Organisation | Thermo Fisher Scientific |
| Country | United States |
| Sector | Private |
| PI Contribution | Me and my team designed the study, recruited the patients, tested the patients' samples on the ISAC chip, planned and critically reviewed the analyses performed by the bioinformaticians. |
| Collaborator Contribution | - Thermofisher scientific provided the reagents to test patients' samples. - Bioinformaticians at the NIHR Biomedical Research Center, Guy's and St Thomas' NHS Foundation Trust performed the data analyses. |
| Impact | An abstract to be presented at a conference and the respective paper are in preparation. Disciplines involves are: Medicine (Allergy), Immunology, Bioinformatics. |
| Start Year | 2018 |
| Description | Immune-gut interactions in food allergy and oral tolerance |
| Organisation | King's College London |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | This is an MRC-funded PhD studentship, part of the MRC-DTP Programme at KCL, where I am PhD Supervisor, co-supervising the student with Dr Joana Neves from KCL. Me and my team contribute at least 50% of the resources needed for the project, including expertise, intellectual input, training of PhD student and access to data, equipment and lab facilities. |
| Collaborator Contribution | Dr Joana Neves and I co-supervise the student and the Neves Lab contributes with the other 50% of the resources needed for the project. |
| Impact | This collaboration is multidisciplinary as it involves Allergy, Immunology, stem cell biology and gut organoid platform. The direct output from this collaboration was a conference abstract presented at the Immunology Winter School of the European Academy of Allergy and Clinical Immunology. |
| Start Year | 2021 |
| Description | Investigating the impact of food allergic reactions on children's mental health and the underlying neurobiological mechanisms |
| Organisation | King's College London |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | This is a PhD studentship funded by the Wellcome Trust via the Wellcome Trust PhD Programme on Neuroimmunology. I am PhD Supervisor together with Prof Sandrine Thuret. In this model the co-supervision each supervisor and the respective team contribute equally to the project, thus this would be 50%, and includes expertise, intellectual input and training of PhD student, as well as access to data, equipment and lab facilities. Specifically, the student spends 50% of their time in my lab and in the clinical trials unit, recruiting and assessing patients, whose blood samples the student is testing in my lab on the mast cell activation test to cow's milk and other food allergens. The student will use the mast cell line to explore the immune mechanisms of the interaction between the allergic mediators of mast cells and the neurons from the hippocampus which could explain the modifications of neurogenesis underlying anxiety and changes in mood and cognition induced by allergic reactions and anaphylaxis. |
| Collaborator Contribution | Prof Thuret and the Thuret Lab contribute with 50% of the resources required for the project. The student will spend time in the Thuret Lab testing samples from allergic and non-allergic children in the hippocampal neurogenesis assay and exploring the biologic mechanisms underlying anxiety and changes in mood and cognition induced by allergic reactions to food and anaphylaxis. |
| Impact | This collaboration is interdisciplinary and involves Allergy and Immunology and Neuroscience and Psychology. |
| Start Year | 2020 |
| Description | Mast cell activation test as biomarker of resolution of food allergy |
| Organisation | King's College London |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | My lab has provided training of a PhD student on the mast cell activation and has provided the equipment and reagents to enable this test. |
| Collaborator Contribution | The EAT study team is providing plasma samples to be tested on the mast cell activation test. |
| Impact | No outputs yet. |
| Start Year | 2018 |
| Description | Milk and egg allergy study |
| Organisation | Spanish National Research Council (CSIC) |
| Country | Spain |
| Sector | Public |
| PI Contribution | Me and my team designed the study, collected the data and interpreted the results. |
| Collaborator Contribution | The statistician based at the Spanish Council for Scientific Research performed the statistical analyses. |
| Impact | We have written a manuscript which is almost ready for submission |
| Start Year | 2016 |
| Description | Modification of antibody function with early peanut consumption |
| Organisation | Immune Tolerance Network |
| Country | United States |
| Sector | Charity/Non Profit |
| PI Contribution | My research team will be testing samples of participants in the LEAP, LEAP-On and PAS studies on the mast cell activation test. |
| Collaborator Contribution | ITN will be sending plasma samples from participants in the LEAP, LEAP-On and PAS studies alongside with funding to support the experimental work. |
| Impact | No outputs yet. |
| Start Year | 2020 |
| Description | Monoclonal antibodies to Ara h 2 |
| Organisation | Massachusetts General Hospital |
| Country | United States |
| Sector | Hospitals |
| PI Contribution | My PhD student is expressing monoclonal antibodies using the sequence provided by my collaborator, which was generated from peanut allergic patients' samples. Once expressed, we will use the mAbs to test on our functional assays to explore their function in the context of the mechanisms of peanut allergy and potential treatments. |
| Collaborator Contribution | Our partner has provided the sequences of Ara h 2- specific antibodies generated from B cells isolated from peanut allergic patients. |
| Impact | This collaboration is multidisciplinary and also involves another collaborator based at QMUL. |
| Start Year | 2019 |
| Description | Natural history of food allergy in the EAT cohort |
| Organisation | King's College London |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | I have provided my expertie in antibody responses and mast cell activation to allergens in food allergy and spontaneous resolution of food allergy. I have supervised a KCL Clinical PhD student doing experimental work testing samples from the EAT study over time. This is a study funded by the MRC and Action Medical Research. I have provided intellectual input, training of the PhD student and access to equipment and facilities. |
| Collaborator Contribution | The collaborators have provided clinical information about the study participants. |
| Impact | Foong RX, Santos AF*. Biomarkers of diagnosis and resolution of food allergy. Pediatr Allergy Immunol 2021; 32: 223-233. *Corresponding author |
| Start Year | 2019 |
| Description | Neuroimmunology in food allergy |
| Organisation | King's College London |
| Department | Institute of Psychiatry, Psychology & Neuroscience |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | Collaboration with Dr Sandrine Thuret to test the biological basis of the impact of food allergic reactions in children's anxiety and cognitive function. |
| Collaborator Contribution | Thuret's lab is testing serum samples of participants in the BAT 2 study in their in vitro model of hypothalamic stem cell differentiation. We are testing the same samples on the mast cell activation test. |
| Impact | Multidisciplinary: Allergy & Immunology, Psychology & Neurosciences We have been awarded pilot funding from KCL to test our hypothesis and have been accepted as supervisors for PhD within the Wellcome Trust Programme on Neuroimmunology at KCL. |
| Start Year | 2019 |
| Description | Physo-social impact of food allergy |
| Organisation | Aston University |
| Department | Department of Psychology |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | Our aim is to improve food allergy patient outcomes by ensuring that patients' psychosocial needs are met via three objectives: 1) assessing the availability and uptake of mental health resources and professionals at food allergy clinics globally, focusing on the United Kingdom, mainland Europe, Australia and Canada, via an online survey and comparing the data with that already collected in the United States, 2) exploring the psychosocial needs and experiences with mental health care in these countries by patients with food allergy and their families via online survey and interviews, and 3) piloting a psychological intervention developed using a person-centered approach, based on the data gathered in objective two. We have assembled an expert team of food allergy and mental health researchers and clinicians who are well positioned to achieve the proposed project, including psychologists with expertise in food allergy impact and management. |
| Collaborator Contribution | The key collaborator will be supervising the research assistant working on the questionnaires to gather data about the mental health needs of patients with food allergy and their uptake of mental health services, and the availability of mental health services at food allergy clinics. Guided by these data, we intend to pursue completion of two follow up projects: 1) in depth interviews with food allergy patients and/or their caregivers, exploring their psychosocial needs and experiences with mental health care; and 2) development and pilot testing of a person-centred psychological intervention for patients with food allergy and their caregivers. |
| Impact | Novartis grant and task-force budget from the European Academy of Allergy and Clinical Immunology |
| Start Year | 2019 |
| Description | Preventing peanut allergy through improved understanding of the transcutaneous sensitisation route, novel food processing and skin care adaptations (TRANS-FOODS) |
| Organisation | Charité - University of Medicine Berlin |
| Department | Paediatric Endocrinology Charité |
| Country | Germany |
| Sector | Academic/University |
| PI Contribution | As part of this consortium, I provide expertise on food allergy and risk factors for sensitisation and allergic reactions and also about peanut allergens, their allergenicity and effect of their modification. In my laboratory at King's College London, my team will test the samples of interstitial fluid retrieved from the skin of adults participating in the clinical study planned as part of WP4 to assess the ability of peanut proteins contained in the interstitial skin fluid to interact with immune cells. Specifically, I plan is to use these samples to stimulate basophils in whole blood collected from peanut allergic donors, alongside the relevant controls, and assess basophil activation by flow cytometry. The basophil activation assay to peanut is well established in my laboratory. I have previously shown that it has 97% accuracy with 98% sensitivity and 96% specificity to diagnose peanut allergy with basophil activation being detectable below 1ng/ml of peanut protein. The basophil activation test is therefore a very sensitive and specific method to detect the presence and the allergenicity of peanut proteins. The basophil activation test can be very informative to demonstrate retained allergenicity and immunogenicity of peanut proteins that have crossed the skin barrier in adults, with or without atopic eczema, who have applied different peanut-containing preparations on to the skin. The evidence that sensitisation to food allergens can occur through the skin and the demonstration of the mechanisms by which this happens can potentially identify ways to reduce allergen exposure and to prevent the development of peanut and other food allergies in infants and children and possibly later in the life course. |
| Collaborator Contribution | Background: Allergic diseases, including atopic dermatitis (AD) and food allergies (FA), affect over a quarter of all children across Europe. The immune responses to oral food allergens are well-established and controlled oral allergen exposure methods in early life have been developed that can prevent FA. However, it is not easy to comply with the repeated oral allergen exposure required to induce tolerance and additional approaches are therefore needed. There is mounting evidence that early life cutaneous exposure to foods causes sensitisation, especially in the presence of dry skin and AD. Despite this, very little is known about how the cutaneous sensitisation to FA occurs. Aims: This project aims to reduce the risk of peanut allergy development through the transcutaneous route by 1) understanding the mechanisms through which this occurs, and 2) designing and testing novel prevention approaches, such as modification in the peanut manufacturing processes and the adaptation of skin care practices. Workplan: These ambitious, but achievable aims are addressed in integrated workpackages, taken forward by leaders in their respective fields from the UK, Germany, and France: WP1 addresses the effects of food processing upon the solubility of peanut protein and its components in oil and how this relates to the cutaneous exposure to peanut protein. WP2 examines the effect of peanut protein skin contamination and skin appendage trapping. WP3 studies the immune system activation induced by massage and cutaneous peanut exposure. WP4 uses an intervention study approach with skin massage to study the immune responses to peanut allergen in those with a skin barrier defect. WP5 examines the cutaneous immune responses to peanut allergen in those suffering of peanut allergy, and, WP6 translates our findings through working with an industrial peanut processing partner, patients and consumers. Impact of expected results: We will work with the food industry, Allergy UK, the Natasha Allergy Research Foundation, as well as national and international food standards agencies to ensure stakeholder awareness and that the findings of our work are translated into improved public health measures. |
| Impact | Not yet |
| Start Year | 2021 |
| Description | Preventing peanut allergy through improved understanding of the transcutaneous sensitisation route, novel food processing and skin care adaptations (TRANS-FOODS) |
| Organisation | Curie Institute Paris (Institut Curie) |
| Department | BioPhenics Platform |
| Country | France |
| Sector | Public |
| PI Contribution | As part of this consortium, I provide expertise on food allergy and risk factors for sensitisation and allergic reactions and also about peanut allergens, their allergenicity and effect of their modification. In my laboratory at King's College London, my team will test the samples of interstitial fluid retrieved from the skin of adults participating in the clinical study planned as part of WP4 to assess the ability of peanut proteins contained in the interstitial skin fluid to interact with immune cells. Specifically, I plan is to use these samples to stimulate basophils in whole blood collected from peanut allergic donors, alongside the relevant controls, and assess basophil activation by flow cytometry. The basophil activation assay to peanut is well established in my laboratory. I have previously shown that it has 97% accuracy with 98% sensitivity and 96% specificity to diagnose peanut allergy with basophil activation being detectable below 1ng/ml of peanut protein. The basophil activation test is therefore a very sensitive and specific method to detect the presence and the allergenicity of peanut proteins. The basophil activation test can be very informative to demonstrate retained allergenicity and immunogenicity of peanut proteins that have crossed the skin barrier in adults, with or without atopic eczema, who have applied different peanut-containing preparations on to the skin. The evidence that sensitisation to food allergens can occur through the skin and the demonstration of the mechanisms by which this happens can potentially identify ways to reduce allergen exposure and to prevent the development of peanut and other food allergies in infants and children and possibly later in the life course. |
| Collaborator Contribution | Background: Allergic diseases, including atopic dermatitis (AD) and food allergies (FA), affect over a quarter of all children across Europe. The immune responses to oral food allergens are well-established and controlled oral allergen exposure methods in early life have been developed that can prevent FA. However, it is not easy to comply with the repeated oral allergen exposure required to induce tolerance and additional approaches are therefore needed. There is mounting evidence that early life cutaneous exposure to foods causes sensitisation, especially in the presence of dry skin and AD. Despite this, very little is known about how the cutaneous sensitisation to FA occurs. Aims: This project aims to reduce the risk of peanut allergy development through the transcutaneous route by 1) understanding the mechanisms through which this occurs, and 2) designing and testing novel prevention approaches, such as modification in the peanut manufacturing processes and the adaptation of skin care practices. Workplan: These ambitious, but achievable aims are addressed in integrated workpackages, taken forward by leaders in their respective fields from the UK, Germany, and France: WP1 addresses the effects of food processing upon the solubility of peanut protein and its components in oil and how this relates to the cutaneous exposure to peanut protein. WP2 examines the effect of peanut protein skin contamination and skin appendage trapping. WP3 studies the immune system activation induced by massage and cutaneous peanut exposure. WP4 uses an intervention study approach with skin massage to study the immune responses to peanut allergen in those with a skin barrier defect. WP5 examines the cutaneous immune responses to peanut allergen in those suffering of peanut allergy, and, WP6 translates our findings through working with an industrial peanut processing partner, patients and consumers. Impact of expected results: We will work with the food industry, Allergy UK, the Natasha Allergy Research Foundation, as well as national and international food standards agencies to ensure stakeholder awareness and that the findings of our work are translated into improved public health measures. |
| Impact | Not yet |
| Start Year | 2021 |
| Description | Preventing peanut allergy through improved understanding of the transcutaneous sensitisation route, novel food processing and skin care adaptations (TRANS-FOODS) |
| Organisation | King's College London |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | As part of this consortium, I provide expertise on food allergy and risk factors for sensitisation and allergic reactions and also about peanut allergens, their allergenicity and effect of their modification. In my laboratory at King's College London, my team will test the samples of interstitial fluid retrieved from the skin of adults participating in the clinical study planned as part of WP4 to assess the ability of peanut proteins contained in the interstitial skin fluid to interact with immune cells. Specifically, I plan is to use these samples to stimulate basophils in whole blood collected from peanut allergic donors, alongside the relevant controls, and assess basophil activation by flow cytometry. The basophil activation assay to peanut is well established in my laboratory. I have previously shown that it has 97% accuracy with 98% sensitivity and 96% specificity to diagnose peanut allergy with basophil activation being detectable below 1ng/ml of peanut protein. The basophil activation test is therefore a very sensitive and specific method to detect the presence and the allergenicity of peanut proteins. The basophil activation test can be very informative to demonstrate retained allergenicity and immunogenicity of peanut proteins that have crossed the skin barrier in adults, with or without atopic eczema, who have applied different peanut-containing preparations on to the skin. The evidence that sensitisation to food allergens can occur through the skin and the demonstration of the mechanisms by which this happens can potentially identify ways to reduce allergen exposure and to prevent the development of peanut and other food allergies in infants and children and possibly later in the life course. |
| Collaborator Contribution | Background: Allergic diseases, including atopic dermatitis (AD) and food allergies (FA), affect over a quarter of all children across Europe. The immune responses to oral food allergens are well-established and controlled oral allergen exposure methods in early life have been developed that can prevent FA. However, it is not easy to comply with the repeated oral allergen exposure required to induce tolerance and additional approaches are therefore needed. There is mounting evidence that early life cutaneous exposure to foods causes sensitisation, especially in the presence of dry skin and AD. Despite this, very little is known about how the cutaneous sensitisation to FA occurs. Aims: This project aims to reduce the risk of peanut allergy development through the transcutaneous route by 1) understanding the mechanisms through which this occurs, and 2) designing and testing novel prevention approaches, such as modification in the peanut manufacturing processes and the adaptation of skin care practices. Workplan: These ambitious, but achievable aims are addressed in integrated workpackages, taken forward by leaders in their respective fields from the UK, Germany, and France: WP1 addresses the effects of food processing upon the solubility of peanut protein and its components in oil and how this relates to the cutaneous exposure to peanut protein. WP2 examines the effect of peanut protein skin contamination and skin appendage trapping. WP3 studies the immune system activation induced by massage and cutaneous peanut exposure. WP4 uses an intervention study approach with skin massage to study the immune responses to peanut allergen in those with a skin barrier defect. WP5 examines the cutaneous immune responses to peanut allergen in those suffering of peanut allergy, and, WP6 translates our findings through working with an industrial peanut processing partner, patients and consumers. Impact of expected results: We will work with the food industry, Allergy UK, the Natasha Allergy Research Foundation, as well as national and international food standards agencies to ensure stakeholder awareness and that the findings of our work are translated into improved public health measures. |
| Impact | Not yet |
| Start Year | 2021 |
| Description | Preventing peanut allergy through improved understanding of the transcutaneous sensitisation route, novel food processing and skin care adaptations (TRANS-FOODS) |
| Organisation | University of Bonn |
| Country | Germany |
| Sector | Academic/University |
| PI Contribution | As part of this consortium, I provide expertise on food allergy and risk factors for sensitisation and allergic reactions and also about peanut allergens, their allergenicity and effect of their modification. In my laboratory at King's College London, my team will test the samples of interstitial fluid retrieved from the skin of adults participating in the clinical study planned as part of WP4 to assess the ability of peanut proteins contained in the interstitial skin fluid to interact with immune cells. Specifically, I plan is to use these samples to stimulate basophils in whole blood collected from peanut allergic donors, alongside the relevant controls, and assess basophil activation by flow cytometry. The basophil activation assay to peanut is well established in my laboratory. I have previously shown that it has 97% accuracy with 98% sensitivity and 96% specificity to diagnose peanut allergy with basophil activation being detectable below 1ng/ml of peanut protein. The basophil activation test is therefore a very sensitive and specific method to detect the presence and the allergenicity of peanut proteins. The basophil activation test can be very informative to demonstrate retained allergenicity and immunogenicity of peanut proteins that have crossed the skin barrier in adults, with or without atopic eczema, who have applied different peanut-containing preparations on to the skin. The evidence that sensitisation to food allergens can occur through the skin and the demonstration of the mechanisms by which this happens can potentially identify ways to reduce allergen exposure and to prevent the development of peanut and other food allergies in infants and children and possibly later in the life course. |
| Collaborator Contribution | Background: Allergic diseases, including atopic dermatitis (AD) and food allergies (FA), affect over a quarter of all children across Europe. The immune responses to oral food allergens are well-established and controlled oral allergen exposure methods in early life have been developed that can prevent FA. However, it is not easy to comply with the repeated oral allergen exposure required to induce tolerance and additional approaches are therefore needed. There is mounting evidence that early life cutaneous exposure to foods causes sensitisation, especially in the presence of dry skin and AD. Despite this, very little is known about how the cutaneous sensitisation to FA occurs. Aims: This project aims to reduce the risk of peanut allergy development through the transcutaneous route by 1) understanding the mechanisms through which this occurs, and 2) designing and testing novel prevention approaches, such as modification in the peanut manufacturing processes and the adaptation of skin care practices. Workplan: These ambitious, but achievable aims are addressed in integrated workpackages, taken forward by leaders in their respective fields from the UK, Germany, and France: WP1 addresses the effects of food processing upon the solubility of peanut protein and its components in oil and how this relates to the cutaneous exposure to peanut protein. WP2 examines the effect of peanut protein skin contamination and skin appendage trapping. WP3 studies the immune system activation induced by massage and cutaneous peanut exposure. WP4 uses an intervention study approach with skin massage to study the immune responses to peanut allergen in those with a skin barrier defect. WP5 examines the cutaneous immune responses to peanut allergen in those suffering of peanut allergy, and, WP6 translates our findings through working with an industrial peanut processing partner, patients and consumers. Impact of expected results: We will work with the food industry, Allergy UK, the Natasha Allergy Research Foundation, as well as national and international food standards agencies to ensure stakeholder awareness and that the findings of our work are translated into improved public health measures. |
| Impact | Not yet |
| Start Year | 2021 |
| Description | STOPPING ECZEMA AND ALLERGY (SEAL) STUDY: PREVENT THE ALLERGIC MARCH BY ENHANCING THE SKIN BARRIER |
| Organisation | Benaroya Research Institute |
| Country | United States |
| Sector | Academic/University |
| PI Contribution | I have contributed to this collaboration with my expertise on basophil and mast cell responses to food allergens in high risk children and using in vitro assays. My team in my laboratory will be testing samples from children recruited into the Seal study on the mast cell activation test that I have established in my lab. |
| Collaborator Contribution | Stanford, Chicago, Denver and London will be the clinical sites recruiting patients for the Seal Study. Immune mechanistic work will also be undertaken at the sites, namely: skin barrier (Denver), microbiome (Chicago), T cells (Stanford) and mast cells (London). |
| Impact | Brough HA, Lanser BJ, Sindher SB, Teng JMC, Leung DYM, Venter C, Chan SM, Santos AF, Bahnson HT, Guttman-Yassky E, Gupta RS, Lack G, Ciaccio CE, Sampath V, Nadeau KC, Nagler CR. Early intervention and prevention of allergic diseases. Allergy 2021; doi: 10.1111/all.15006. |
| Start Year | 2020 |
| Description | STOPPING ECZEMA AND ALLERGY (SEAL) STUDY: PREVENT THE ALLERGIC MARCH BY ENHANCING THE SKIN BARRIER |
| Organisation | National Jewish Medical and Research Center, USA |
| Country | United States |
| Sector | Academic/University |
| PI Contribution | I have contributed to this collaboration with my expertise on basophil and mast cell responses to food allergens in high risk children and using in vitro assays. My team in my laboratory will be testing samples from children recruited into the Seal study on the mast cell activation test that I have established in my lab. |
| Collaborator Contribution | Stanford, Chicago, Denver and London will be the clinical sites recruiting patients for the Seal Study. Immune mechanistic work will also be undertaken at the sites, namely: skin barrier (Denver), microbiome (Chicago), T cells (Stanford) and mast cells (London). |
| Impact | Brough HA, Lanser BJ, Sindher SB, Teng JMC, Leung DYM, Venter C, Chan SM, Santos AF, Bahnson HT, Guttman-Yassky E, Gupta RS, Lack G, Ciaccio CE, Sampath V, Nadeau KC, Nagler CR. Early intervention and prevention of allergic diseases. Allergy 2021; doi: 10.1111/all.15006. |
| Start Year | 2020 |
| Description | STOPPING ECZEMA AND ALLERGY (SEAL) STUDY: PREVENT THE ALLERGIC MARCH BY ENHANCING THE SKIN BARRIER |
| Organisation | Stanford University |
| Country | United States |
| Sector | Academic/University |
| PI Contribution | I have contributed to this collaboration with my expertise on basophil and mast cell responses to food allergens in high risk children and using in vitro assays. My team in my laboratory will be testing samples from children recruited into the Seal study on the mast cell activation test that I have established in my lab. |
| Collaborator Contribution | Stanford, Chicago, Denver and London will be the clinical sites recruiting patients for the Seal Study. Immune mechanistic work will also be undertaken at the sites, namely: skin barrier (Denver), microbiome (Chicago), T cells (Stanford) and mast cells (London). |
| Impact | Brough HA, Lanser BJ, Sindher SB, Teng JMC, Leung DYM, Venter C, Chan SM, Santos AF, Bahnson HT, Guttman-Yassky E, Gupta RS, Lack G, Ciaccio CE, Sampath V, Nadeau KC, Nagler CR. Early intervention and prevention of allergic diseases. Allergy 2021; doi: 10.1111/all.15006. |
| Start Year | 2020 |
| Description | STOPPING ECZEMA AND ALLERGY (SEAL) STUDY: PREVENT THE ALLERGIC MARCH BY ENHANCING THE SKIN BARRIER |
| Organisation | University of Chicago |
| Country | United States |
| Sector | Academic/University |
| PI Contribution | I have contributed to this collaboration with my expertise on basophil and mast cell responses to food allergens in high risk children and using in vitro assays. My team in my laboratory will be testing samples from children recruited into the Seal study on the mast cell activation test that I have established in my lab. |
| Collaborator Contribution | Stanford, Chicago, Denver and London will be the clinical sites recruiting patients for the Seal Study. Immune mechanistic work will also be undertaken at the sites, namely: skin barrier (Denver), microbiome (Chicago), T cells (Stanford) and mast cells (London). |
| Impact | Brough HA, Lanser BJ, Sindher SB, Teng JMC, Leung DYM, Venter C, Chan SM, Santos AF, Bahnson HT, Guttman-Yassky E, Gupta RS, Lack G, Ciaccio CE, Sampath V, Nadeau KC, Nagler CR. Early intervention and prevention of allergic diseases. Allergy 2021; doi: 10.1111/all.15006. |
| Start Year | 2020 |
| Description | Task-force for the external quality assurance of the basophil activation test |
| Organisation | Aarhus University |
| Country | Denmark |
| Sector | Academic/University |
| PI Contribution | I have planned the task force and contributed with ideas for the best way forward in the standardisation and quality assurance of the basophil activation test across different centres in Europe. Me and my team have also tested samples that were sent around the various laboratories and provided the results to the group. I have critically analysed the results and interpreted them as we are preparing the manuscript for submission. |
| Collaborator Contribution | The partners in this collaboration have provided data and input from their own centres. |
| Impact | We are now preparing a manuscript for publication and setting up a system with a central european laboratory for quality assurance of the BAT. |
| Start Year | 2017 |
| Description | Task-force for the external quality assurance of the basophil activation test |
| Organisation | Antwerp University Hospital |
| Country | Belgium |
| Sector | Hospitals |
| PI Contribution | I have planned the task force and contributed with ideas for the best way forward in the standardisation and quality assurance of the basophil activation test across different centres in Europe. Me and my team have also tested samples that were sent around the various laboratories and provided the results to the group. I have critically analysed the results and interpreted them as we are preparing the manuscript for submission. |
| Collaborator Contribution | The partners in this collaboration have provided data and input from their own centres. |
| Impact | We are now preparing a manuscript for publication and setting up a system with a central european laboratory for quality assurance of the BAT. |
| Start Year | 2017 |
| Description | Task-force for the external quality assurance of the basophil activation test |
| Organisation | August Pi i Sunyer Biomedical Research Institute |
| Department | Hospital Clinic of Barcelona |
| Country | Spain |
| Sector | Hospitals |
| PI Contribution | I have planned the task force and contributed with ideas for the best way forward in the standardisation and quality assurance of the basophil activation test across different centres in Europe. Me and my team have also tested samples that were sent around the various laboratories and provided the results to the group. I have critically analysed the results and interpreted them as we are preparing the manuscript for submission. |
| Collaborator Contribution | The partners in this collaboration have provided data and input from their own centres. |
| Impact | We are now preparing a manuscript for publication and setting up a system with a central european laboratory for quality assurance of the BAT. |
| Start Year | 2017 |
| Description | Task-force for the external quality assurance of the basophil activation test |
| Organisation | Imperial College London |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | I have planned the task force and contributed with ideas for the best way forward in the standardisation and quality assurance of the basophil activation test across different centres in Europe. Me and my team have also tested samples that were sent around the various laboratories and provided the results to the group. I have critically analysed the results and interpreted them as we are preparing the manuscript for submission. |
| Collaborator Contribution | The partners in this collaboration have provided data and input from their own centres. |
| Impact | We are now preparing a manuscript for publication and setting up a system with a central european laboratory for quality assurance of the BAT. |
| Start Year | 2017 |
| Description | Task-force for the external quality assurance of the basophil activation test |
| Organisation | Karolinska Institute |
| Country | Sweden |
| Sector | Academic/University |
| PI Contribution | I have planned the task force and contributed with ideas for the best way forward in the standardisation and quality assurance of the basophil activation test across different centres in Europe. Me and my team have also tested samples that were sent around the various laboratories and provided the results to the group. I have critically analysed the results and interpreted them as we are preparing the manuscript for submission. |
| Collaborator Contribution | The partners in this collaboration have provided data and input from their own centres. |
| Impact | We are now preparing a manuscript for publication and setting up a system with a central european laboratory for quality assurance of the BAT. |
| Start Year | 2017 |
| Description | Task-force for the external quality assurance of the basophil activation test |
| Organisation | Technical University of Munich |
| Country | Germany |
| Sector | Academic/University |
| PI Contribution | I have planned the task force and contributed with ideas for the best way forward in the standardisation and quality assurance of the basophil activation test across different centres in Europe. Me and my team have also tested samples that were sent around the various laboratories and provided the results to the group. I have critically analysed the results and interpreted them as we are preparing the manuscript for submission. |
| Collaborator Contribution | The partners in this collaboration have provided data and input from their own centres. |
| Impact | We are now preparing a manuscript for publication and setting up a system with a central european laboratory for quality assurance of the BAT. |
| Start Year | 2017 |
| Description | Task-force for the external quality assurance of the basophil activation test |
| Organisation | University of Bonn |
| Country | Germany |
| Sector | Academic/University |
| PI Contribution | I have planned the task force and contributed with ideas for the best way forward in the standardisation and quality assurance of the basophil activation test across different centres in Europe. Me and my team have also tested samples that were sent around the various laboratories and provided the results to the group. I have critically analysed the results and interpreted them as we are preparing the manuscript for submission. |
| Collaborator Contribution | The partners in this collaboration have provided data and input from their own centres. |
| Impact | We are now preparing a manuscript for publication and setting up a system with a central european laboratory for quality assurance of the BAT. |
| Start Year | 2017 |
| Description | Task-force for the external quality assurance of the basophil activation test |
| Organisation | University of Helsinki |
| Country | Finland |
| Sector | Academic/University |
| PI Contribution | I have planned the task force and contributed with ideas for the best way forward in the standardisation and quality assurance of the basophil activation test across different centres in Europe. Me and my team have also tested samples that were sent around the various laboratories and provided the results to the group. I have critically analysed the results and interpreted them as we are preparing the manuscript for submission. |
| Collaborator Contribution | The partners in this collaboration have provided data and input from their own centres. |
| Impact | We are now preparing a manuscript for publication and setting up a system with a central european laboratory for quality assurance of the BAT. |
| Start Year | 2017 |
| Description | Task-force for the external quality assurance of the basophil activation test |
| Organisation | University of Malaga |
| Country | Spain |
| Sector | Academic/University |
| PI Contribution | I have planned the task force and contributed with ideas for the best way forward in the standardisation and quality assurance of the basophil activation test across different centres in Europe. Me and my team have also tested samples that were sent around the various laboratories and provided the results to the group. I have critically analysed the results and interpreted them as we are preparing the manuscript for submission. |
| Collaborator Contribution | The partners in this collaboration have provided data and input from their own centres. |
| Impact | We are now preparing a manuscript for publication and setting up a system with a central european laboratory for quality assurance of the BAT. |
| Start Year | 2017 |
| Description | Task-force for the external quality assurance of the basophil activation test |
| Organisation | Utrecht University |
| Country | Netherlands |
| Sector | Academic/University |
| PI Contribution | I have planned the task force and contributed with ideas for the best way forward in the standardisation and quality assurance of the basophil activation test across different centres in Europe. Me and my team have also tested samples that were sent around the various laboratories and provided the results to the group. I have critically analysed the results and interpreted them as we are preparing the manuscript for submission. |
| Collaborator Contribution | The partners in this collaboration have provided data and input from their own centres. |
| Impact | We are now preparing a manuscript for publication and setting up a system with a central european laboratory for quality assurance of the BAT. |
| Start Year | 2017 |
| Description | UK Multicentre biomarker-led randomised-controlled trial of the basophil and mast cell activation tests in food allergy |
| Organisation | Addenbrooke's Hospital |
| Country | United Kingdom |
| Sector | Hospitals |
| PI Contribution | We have designed the study and will be distributing electronic clinical questionnaires as well as centralising the blood samples to perform the basophil and mast cell activation studies to the various allergens. |
| Collaborator Contribution | The various partners will be consenting participants and send their anonymised clinical information as well as blood samples to KCL. |
| Impact | No outputs yet. |
| Start Year | 2020 |
| Description | UK Multicentre biomarker-led randomised-controlled trial of the basophil and mast cell activation tests in food allergy |
| Organisation | King's College Hospital |
| Country | United Kingdom |
| Sector | Hospitals |
| PI Contribution | We have designed the study and will be distributing electronic clinical questionnaires as well as centralising the blood samples to perform the basophil and mast cell activation studies to the various allergens. |
| Collaborator Contribution | The various partners will be consenting participants and send their anonymised clinical information as well as blood samples to KCL. |
| Impact | No outputs yet. |
| Start Year | 2020 |
| Description | UK Multicentre biomarker-led randomised-controlled trial of the basophil and mast cell activation tests in food allergy |
| Organisation | King's College London |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | We have designed the study and will be distributing electronic clinical questionnaires as well as centralising the blood samples to perform the basophil and mast cell activation studies to the various allergens. |
| Collaborator Contribution | The various partners will be consenting participants and send their anonymised clinical information as well as blood samples to KCL. |
| Impact | No outputs yet. |
| Start Year | 2020 |
| Description | UK Multicentre biomarker-led randomised-controlled trial of the basophil and mast cell activation tests in food allergy |
| Organisation | Newcastle upon Tyne Hospitals NHS Foundation Trust |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | We have designed the study and will be distributing electronic clinical questionnaires as well as centralising the blood samples to perform the basophil and mast cell activation studies to the various allergens. |
| Collaborator Contribution | The various partners will be consenting participants and send their anonymised clinical information as well as blood samples to KCL. |
| Impact | No outputs yet. |
| Start Year | 2020 |
| Description | UK Multicentre biomarker-led randomised-controlled trial of the basophil and mast cell activation tests in food allergy |
| Organisation | Royal Manchester Children's Hospital |
| Country | United Kingdom |
| Sector | Hospitals |
| PI Contribution | We have designed the study and will be distributing electronic clinical questionnaires as well as centralising the blood samples to perform the basophil and mast cell activation studies to the various allergens. |
| Collaborator Contribution | The various partners will be consenting participants and send their anonymised clinical information as well as blood samples to KCL. |
| Impact | No outputs yet. |
| Start Year | 2020 |
| Description | UK Multicentre biomarker-led randomised-controlled trial of the basophil and mast cell activation tests in food allergy |
| Organisation | Sandwell and West Birmingham Hospitals NHS Trust |
| Department | Rheumatology Sandwell and West Birmingham |
| Country | United Kingdom |
| Sector | Public |
| PI Contribution | We have designed the study and will be distributing electronic clinical questionnaires as well as centralising the blood samples to perform the basophil and mast cell activation studies to the various allergens. |
| Collaborator Contribution | The various partners will be consenting participants and send their anonymised clinical information as well as blood samples to KCL. |
| Impact | No outputs yet. |
| Start Year | 2020 |
| Description | UK Multicentre biomarker-led randomised-controlled trial of the basophil and mast cell activation tests in food allergy |
| Organisation | Sheffield Children's Hospital |
| Country | United Kingdom |
| Sector | Hospitals |
| PI Contribution | We have designed the study and will be distributing electronic clinical questionnaires as well as centralising the blood samples to perform the basophil and mast cell activation studies to the various allergens. |
| Collaborator Contribution | The various partners will be consenting participants and send their anonymised clinical information as well as blood samples to KCL. |
| Impact | No outputs yet. |
| Start Year | 2020 |
| Description | UK Multicentre biomarker-led randomised-controlled trial of the basophil and mast cell activation tests in food allergy |
| Organisation | Southampton Hospital |
| Country | United States |
| Sector | Hospitals |
| PI Contribution | We have designed the study and will be distributing electronic clinical questionnaires as well as centralising the blood samples to perform the basophil and mast cell activation studies to the various allergens. |
| Collaborator Contribution | The various partners will be consenting participants and send their anonymised clinical information as well as blood samples to KCL. |
| Impact | No outputs yet. |
| Start Year | 2020 |
| Description | UK Multicentre biomarker-led randomised-controlled trial of the basophil and mast cell activation tests in food allergy |
| Organisation | University College Hospital |
| Country | United Kingdom |
| Sector | Hospitals |
| PI Contribution | We have designed the study and will be distributing electronic clinical questionnaires as well as centralising the blood samples to perform the basophil and mast cell activation studies to the various allergens. |
| Collaborator Contribution | The various partners will be consenting participants and send their anonymised clinical information as well as blood samples to KCL. |
| Impact | No outputs yet. |
| Start Year | 2020 |
| Description | UK Multicentre biomarker-led randomised-controlled trial of the basophil and mast cell activation tests in food allergy |
| Organisation | University Hospitals of Leicester NHS Trust |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | We have designed the study and will be distributing electronic clinical questionnaires as well as centralising the blood samples to perform the basophil and mast cell activation studies to the various allergens. |
| Collaborator Contribution | The various partners will be consenting participants and send their anonymised clinical information as well as blood samples to KCL. |
| Impact | No outputs yet. |
| Start Year | 2020 |
| Description | UK Multicentre biomarker-led randomised-controlled trial of the basophil and mast cell activation tests in food allergy |
| Organisation | University of Edinburgh |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | We have designed the study and will be distributing electronic clinical questionnaires as well as centralising the blood samples to perform the basophil and mast cell activation studies to the various allergens. |
| Collaborator Contribution | The various partners will be consenting participants and send their anonymised clinical information as well as blood samples to KCL. |
| Impact | No outputs yet. |
| Start Year | 2020 |
| 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 |
| Title | Mast cell activation test |
| Description | The mast cell activation test (MAT) uses a mast cell line that is sensitised with patients' plasma to replicate the patients' own mast cells before stimulating with allergen extracts to see whether or not the mast cells react in vitro, as a surrogate of allergen challenge in which patients are exposed to the allergen to diagnose or exclude allergy. The MAT showed to be very specific to diagnose peanut allergy (98%) and could reduce the number of children that we need to refer for allergen challenge. The MAT is currently being tested and validated for the diagnosis of other food allergies in my lab at KCL. |
| Type | Diagnostic Tool - Non-Imaging |
| Current Stage Of Development | Early clinical assessment |
| Year Development Stage Completed | 2018 |
| Development Status | Under active development/distribution |
| Clinical Trial? | Yes |
| UKCRN/ISCTN Identifier | CRN Portfolio 10020 (samples tested for peanut allergy) |
| Impact | The MAT has much better specificity in the diagnosis of peanut allergy than existing tests and could complement these nicely by enabling the reduction of patients requiring allergen challenge, which involve the risk of an allergic reaction that is potentially severe. The reduction in allergen challenges would not only enhance patient safety and comfort but also reduce the waiting lists and timely access for service, particularly in the case of young children for whom a timely diagnosis and introduction of food in the diet can be critical in terms of later development of an allergy. |
| 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 | Article on BBC Expert Network |
| 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 | Public/other audiences |
| Results and Impact | Article for the BBC Expert Network about the recent increase in food allergy and possible explanations for this. |
| Year(s) Of Engagement Activity | 2018 |
| URL | https://www.bbc.com/news/health-46302780?fbclid=IwAR0KdB97TFPdhxl_-oZ4hceUlV4VsOLcjA8csUxua9FnxLUkx9... |
| 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 | FARE Online Research Retreat 2023 |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Patients, carers and/or patient groups |
| Results and Impact | Online event organised by the largest patient group in the USA with an international reach. The purpose was to update patients and the general public about recent developments in food allergy research. My talk was entitled "Basophil and mast cell activation as biomarkers of food allergy and oral tolerance". |
| Year(s) Of Engagement Activity | 2015,2022 |
| URL | https://www.foodallergy.org/take-action/contains-courage-research-retreat |
| Description | FARE Research Retreat for patients and public |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Patients, carers and/or patient groups |
| Results and Impact | • FARE Research Retreat for patients - lecture and Q&A about "Ex-vivo cellular activation assays in the diagnosis and monitoring of food allergy - online event, 21/09/2020 |
| Year(s) Of Engagement Activity | 2020 |
| 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 | Invited to give an interview for the iTV programme "This Morning" |
| 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 | Public/other audiences |
| Results and Impact | Following news regarding a few fatal cases of food allergic children and teenagers, I was invited to give an interview at ITV for the widely watched programme "This morning", in which I commented on a fatal allergic reaction to sesame that had been on the news as well as on the case of a real patient also interviewed who suffered irreversible brain damage following a severe nut allergic reaction. |
| Year(s) Of Engagement Activity | 2018 |
| URL | http://www.itv.com/thismorning/hot-topics/fighting-for-the-rights-of-allergy-sufferers |
| Description | MRC Asthma UK Centre Advisory Board Meeting |
| 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 | About 60 people attended the MRC & Asthma UK Centre Advisory Board Meeting where selected Principal Investigators, Post-doctoral researchers and PhD students presented their research to the Advisory Board members and the general audience. This was an opportunity to show case the research and collaborations within the Centre and beyond. |
| Year(s) Of Engagement Activity | 2014,2018 |
| Description | Media attention following publication of original paper |
| 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 | Public/other audiences |
| Results and Impact | My research into diagnostic tests for food allergy has gathered the attention from the press and the general public. I engaged in TV and radio interviews as well as with newspapers and online press, around the globe. Below are some links to these publications: https://www.reuters.com/article/health-allergy-peanut/scientists-devise-new-more-accurate-peanut-allergy-test-idUSL8N1S91QE https://www.theguardian.com/society/2018/may/03/identifying-peanut-allergies-cheaper-and-easier-with-new-test http://www.bbc.co.uk/news/health-43962236 https://www.thesun.co.uk/news/6198595/groundbreaking-blood-test-for-peanut-allergy/ http://www.dailymail.co.uk/wires/pa/article-5686607/New-blood-test-developed-spot-peanut-allergy.html http://www.alphr.com/bioscience/1009263/simple-test-peanut-allergy http://www.newsweek.com/new-peanut-allergy-test-safer-current-method-according-scientists-908495 http://home.bt.com/news/science-news/new-blood-test-developed-to-spot-peanut-allergy-11364268385007 https://www.express.co.uk/life-style/health/954734/peanut-allergy-test-with-no-reactions-created https://www.theglobeandmail.com/life/article-scientists-devise-new-more-accurate-test-for-peanut-allergies/?cmpid=rss https://www.telegraph.co.uk/science/2018/05/03/peanut-allergy-test-could-prevent-huge-over-diagnosis-condition/ https://www.thetimes.co.uk/article/new-nut-allergy-test-may-be-cheaper-and-more-accurate-7wdkjn73c https://www.healio.com/pediatrics/allergy-asthma-immunology/news/online/%7Bee49a7ab-2018-4112-80f6-af1c5e8f6588%7D/new-test-shows-high-specificity-in-diagnosing-peanut-allergy?fbclid=IwAR1hzGMuDj2h4g7Q20IKrUr7ImzwrTD5kXvgtYCgQtvIG9bhUI79mKNL8cY https://sicnoticias.sapo.pt/pais/2018-05-18-Investigadora-portuguesa-desenvolve-novo-teste-sanguineo-para-detetar-alergias-alimentares?fbclid=IwAR1VgXK0nYd7BntwIDKUpLZjba4QqooARtMQnOaZAIfBzOcDN3xVZruWxCE https://www.sabado.pt/ciencia---saude/detalhe/investigadora-portuguesa-cria-teste-de-alergia-ao-amendoim-inovador?fbclid=IwAR1WezrozB1NLvWTc22pKO2nGbMxati1BhVWRPFj3JPyVmH3ZWQX9khPBMg |
| Year(s) Of Engagement Activity | 2018 |
| URL | https://www.reuters.com/article/health-allergy-peanut/scientists-devise-new-more-accurate-peanut-all... |
| 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 |
| Description | Virtual Food Allergy Fund Summit 2020 |
| Form Of Engagement Activity | Participation in an activity, workshop or similar |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Patients, carers and/or patient groups |
| Results and Impact | Online Lecture "New approaches to the diagnosis of peanut allergy" at the Virtual Food Allergy Fund Summit 2020, 14th May 2020 |
| Year(s) Of Engagement Activity | 2020 |