Oral Immunotherapy for Food Allergic Patients

Hello and welcome to another update from the Center for Allergy at Assaf Harofeh (Yitzhak Shamir) Medical Center. This time of year is always busy at the Center. With Passover approaching, the staff here is working diligently to make sure that the food doses are properly prepared in sufficient quantities, so that patients can continue their oral immunotherapy (OIT) programs throughout the holiday. Additionally, during Passover, many observe traditional dietary restrictions, which can be somewhat challenging for those with food allergies. The physicians, nurses, and dieticians on staff at the Center can guide patients and their families to ensure that they are able to have a safe and enjoyable holiday.

Research is also continuing apace in our laboratory. One area of current interest is that of allergen identification. While food allergy is often thought to relate to a food as a whole, in reality, allergy is driven by IgE-antibody reactivity to particular components in the food. The identification of these components, known as allergens, is important, because reactivity to particular components may help to better categorize an allergy in terms of its severity, or co-incidence with other food allergies. In a joint effort with scientists at ThermoFisher, we have identified some allergens whose IgE-antibody reactivity is associated with pecan allergy, in comparison with walnut allergy. We have found that pecan allergy always manifests with walnut allergy, while walnut allergy can manifest without pecan allergy. Thus, reactivity to the allergens in question may indicate a more severe allergic state. Importantly, in a recently-accepted manuscript, we report that IgE-antibody reactivity to some of these allergens is lower after successful completion of OIT, whereas IgG4-antibody reactivity (associated with protection from allergic reactions) is higher after OIT. In future work, we hope to identify allergens that are specific for other treenuts, ultimately using these identifications to develop accurate methods for treenut allergy diagnosis.

With your support, we continue these and other projects, with the goal of understanding and effectively treating food allergy. Thank you!

Greetings from Assaf Harofeh! As we get ready to close the books on 2018, we at the Center for Food Allergy are proud to point to a number of highlights from the outgoing year:

- A new state of the art facility, allowing for treatment of up to 240 new patients per year

- Publication of eight articles relating to methods for diagnosis of food allergy, as well as its clinical management

- Oral and poster presentations regarding our clinical and research work at an international allergy meeting held in Jerusalem (Israel Allergy, Asthma and Clinical Allergy meeting)

-Collaborative efforts to characterize biomarkers predictive of, and related to food allergy

We are gearing up for an even better 2019. One specific focus is that of our microbiome project. In recent years, there has been much research investigating links between resident microbes of the human gut and various health conditions. Food allergy develops in part, due to a deficiency in immune tolerance-inducing mechanisms that are normally present in the gut. Many molecules produced by gut microbes can affect immune cell orientation, and we are therefore interested in determining whether microbial products found in stool samples from different patients differentially affect immune cell orientation. We have already obtained some preliminary data which we hope to build on in time for the American Academy of Allergy Asthma & Immunology meeting in February. Your support will enable us to continue this work in trying to better understand the underpinnings of food allergy development, and develop better strategies in its treatment via oral immunotherapy.

Thank you for your support. Looking forward to our continued partnership in 2019!

All the best for a wonderful and successful new year.