ust prior to the Food Allergy Research and Education walk in mid-September, University of Cincinnati College of Medicine immunologist Fred Finkelman took the stage to discuss groundbreaking research on suppressing food allergies in mice.
While the therapeutic approach is, even optimistically, several years from human clinical trials, local FARE Walk organizer Heather Yee says she sees a glimmer of hope. Yee’s 7-year-old son Kai suffers from multiple life-threatening food allergies. She says finding a treatment would be life-changing.
“I can’t quite wrap my head around it yet, but it sounds wonderful,” Yee says. “My family chooses not to go out to restaurants due to Kai’s long list of severe food allergies. We could go to family dinners or a cookout that we’ve never been to before and feel more peaceful about it.”
During early September, Finkelman, who along with his colleagues is also sponsored by Cincinnati Children’s Hospital and Cincinnati Veterans Association, received grant dollars in excess of $700,000 from FARE and $1.3 million from the National Institute of Allergy and Infectious Disease to continue their research. The team recently successfully tested a monoclonal antibody that targets and deactivates cells that cause allergic reactions.
“Our aim is to develop a procedure that would allow us to completely suppress all allergies that are caused by IgE, which is a special type of antibody, and do this safely and do this within 24 hours,” Finkelman says. “This includes most food allergies, especially those types of food allergies where somebody rapidly develops a problem after eating, in particular.”
During an allergic reaction, molecules called IgE antibodies, which sit on histamine-filled mast cells, explode when the body is exposed to an allergen. During the study, researchers tested a laboratory-grown antibody that prohibits IgE molecules from attaching to receptors on the mast cells, essentially rendering them harmless. The IgE inhibiting antibodies were delivered to mice through a process called rapid desensitization, a longstanding practice that treats patients with drug allergies by giving them increased doses of the problem drug until their body tolerates it without effect.
“What we did in mice was to prove in fact that this did work,” Finkelman says. “We could treat mice first with a tiny dose of that antibody and then double that dose every hour until after about 12 hours we were giving them enough to remove all the IgE from the mast cells. So we could use this to block already existing allergies including a mouse model of food allergy.”
To increase safety, Finkelman says they used a “belt and suspenders” approach, building in redundancies to treatment including an allergy suppressing “drug cocktail” and an addition to the lab-engineered antibody which tells the mast cells signals not to react. He says the therapy would primarily work on food allergies or types of allergies that illicit an immediate reaction. He cautions the treatment is not a cure and those affected would need to receive additional treatment every few months, though rapid desensitization would only be necessary at the first treatment. Finkelman compares the process to treatment for autoimmune diseases such as rheumatoid arthritis or Crohn’s disease.
“One advantage of the approach we’re using, at least in theory, is it wouldn’t matter if you’re allergic to one food or allergic to multiple different types of food,” he says. “The same treatment would take care of allergies to all of them.”
According to FARE, food allergies affect more than 15 million people nationwide, including one in every 13 children. FARE Midwest Regional Director Dana Morris says the organization’s mission is to create awareness to the severity of food allergies, especially in children. The increase in children’s allergies has led to changes in school procedures.
In addition to tailoring lunches for children with food allergies, Morris says many classrooms are now peanut free, as even minimal exposure can lead to severe consequences for some. The group is advocating not only for permission for students to bring EpiPens (the self-injection for allergic shock) with them to school, but to also have undesignated EpiPens at all schools including colleges for students who might have allergic reactions.
“School districts are cracking down on tighter policies on what’s coming in, because it’s not just, ‘My child can’t be near it.’ It’s, ‘My child could die and I’d like him to come home from school today,’ ” she says.
To address the growing need, Morris says FARE is suggesting that restaurants have EpiPens on hand for diners who might go into anaphylaxis. When someone is diagnosed, they often feel overwhelmed, she says. For those who suffer from food allergies, Morris says FARE offers a surfeit of information and support on its website at foodallergy.org. She advises people to find a local support group and connect with other families dealing with similar issues.
“Because connecting with others who have been through it or are going through it are really the best resources in terms of trying to navigate through the world of living with food allergies,” she says.
At the age of 7 months, doctors diagnosed Yee’s son Kai with severe food allergies to dairy, wheat, eggs, peanuts and tree nuts. She says at the time they felt like they were being responsible, until a caretaker fed Kai a piece of toast that sent him into anaphylactic shock, resulting in 24 hours at Children’s Hospital.
“For me, personally, I was downward spiraling,” Yee says. “I couldn’t stop reading every article about every child dying from food allergies, so then I just had to channel that energy in a positive way.”
After her son’s diagnosis, Yee says she began looking at the world differently, carefully reading food labels at grocery stores and calling new food manufacturers to verify ingredients. Her family eschews restaurants, cookouts and other types of food-centric outings. She says it can be overwhelming at first, but she encourages people to network with other food allergy groups or search online to find information and resources.
When Yee discovered FARE walks in other cities, she says she decided to chair the event in Cincinnati to raise both funds and awareness.
“Over 500 people from Cincinnati showed up, and in the first two years we raised over $100,000,” Yee says, “which just shows how much it’s needed down here and how people like us are looking for other families who understand what you’re going through.”
When the press release for the study came out, Finkelman says parents started sharing their heartbreaking stories about how hard it is for their kids, especially those with multiple food allergies. While it may be three to five years before the mice study moves to clinical trials in humans, Finkelman says he hopes their research progresses to the next level.
“Remember, we can treat you right now if you’re a mouse,” he says.“Going from mouse to human, there are a lot of drugs that have worked well in mice and it turned out not to work too well in people. So we’re enthusiastic, but we’re cautiously enthusiastic.” ©