Oral Immunotherapy for Food Allergic Patients

Warmest regards from the Center for Allergy and Immunology at Yitzhak Shamir (Assaf Harofeh) Medical Center. The Corona pandemic is still raging, and Israel is in the midst of another lockdown. Fortunately however, we have benefitted from an extensive vaccination campaign, which will hopefully soon yield immunity in the broader population. Professor Arnon Elizur, the director of our Center, also serves on the board of the Israel Association of Allergy and Clinical Immunology, and co-wrote its position paper regarding vaccination for allergic patients. This guidance will facilitate safe and effective vaccination protocols for those with potential concerns. We are happy to report on several journal articles that have been published since our last update. First, in collaboration with our partners at the Bar Ilan University Faculty of Medicine in the Galilee, we have published a paper describing distinctive features of the stool microbiome population in food allergic patients. Some of these features also distinguished between different types of food allergies and were differentially associated with the presence of short chain fatty acids. We are continuing our work, examining whether stool microbiome features can also be tracked in patients as they progress through oral immunotherapy. And, we continue our bench research examining whether components of stool can mediate direct immune-related effects in cell culture. Secondly in the clinical arena, we report that subjective oral symptoms, such as tingling or itchiness, may not always reflect true allergic reactivity. Approximately 30% of the patients who complained of these symptoms during a food challenge, were able to successfully complete their challenge. This finding highlights a potential for false positive food allergy diagnoses, which can lead to unnecessary stress and hardships for patients. Our patients benefit from the experience and expertise of our clinical staff, who safely administer oral food challenges, yielding accurate diagnoses. At the same time, our research team continues to investigate alternative diagnostic approaches, with the goal of minimizing reliance on oral food challenges. We are very excited about our continued progress in these challenging times, and wish to express our gratitude to you-our donors and partners, in continuing to support our work. Best wishes for a happy and healthy 2021!

Links:

• Microbiome and food allergy
• Oral symptoms and association with food allergy

Greetings from the Center for Allergy and Immunology at Yitzhak Shamir (Assaf Harofeh) Medical Center. Considering how challenging this past year has been, the new year in Israel has arrived none too early. We hope that this update finds you safe and in good health. We are happy to share some recent developments here at the Center, starting off the year on the right foot.

First, breaking news! After an extensive peer review process, our prospective study concerning diagnostic algorithms for walnut and pecan allergy has been accepted to the journal JACI-In Practice. This article confirms our previous work demonstrating the capability of two diagnostic tests (skin prick and basophil activation tests), used in tandem, to accurately diagnose walnut and pecan allergies. As we have previously noted, the diagnoses of treenut allergies in particular are complicated due to their significant cross-reactivity which may or may not lead to coallergies between different treenuts. We believe and anticipate that our findings will be adapted to improve clinical accuracy in treenut allergy diagnosis. In the near future, we aim to study the potential of diagnostic tests for accurate diagnosis of allergy to other closely-related treenuts.

The laboratory research aspect of our program is also moving apace. In collaboration with our partners at the Bar Ilan University Faculty of Medicine in the Galilee, we are comparing the stool microbiomes of patients with and without persistent food allergies, and also between patients with different food allergies. In particular, we are examining whether derivatives of bacteria found in the stool can induce the development of regulatory immune cells (B cells and T cells), which are important players in the establishment of immune tolerance, and resolution of food allergy.

Despite the pandemic, our clinical programs in food allergy diagnosis and desensitization have continued at full strength. Over 325 patients are currently in active oral immunotherapy treatment, with up to 6 new patients joining every week. The success rate in achieving complete or partial allergic desensitization is over 85%, highlighting the importance and efficacy of our work. Especially in light of these challenging times, it behooves us to note the contributions of all those involved in making our programs successful. The physicians, nurses, dieticians, administrative staff, and laboratory workers in the center work diligently, while patients and their families routinely must overcome physical and psychological obstacles in attaining treatment success. And of course, we graciously note the contributions of you the donors, who have seen the value in our work, and have opened your hearts to facilitate our continuing and expanding upon it. Thank you, and best wishes for health in the year ahead!