The National Peanut Board (NPB) is committed to being part of the solution for food allergies. To that end, America’s peanut farmers, through NPB, have provided more than $21 million in resources to support education, outreach, and research. NPB provides www.peanutallergyfacts.org as a resource on peanut allergies; maintains a Food Allergy Education Advisory Council (FAEAC), made up of experts from a variety of stakeholder organizations; funds groundbreaking research; and connects with experts at conferences as exhibitor, presenter, and attendee. In April, NPB representatives JJ Levenstein, MD and chair of the FAEAC, and registered dietitians Sherry Coleman Collins and Caroline Bearden Young attended the Food Allergy Research and Education (FARE) National Food Allergy Conference on behalf of the National Peanut Board. FARE is an organization that seeks to support people with food allergies by funding initiatives that further research in the field, and by providing education and advocacy for its members. In this two-part series, Levenstein and Coleman Collins share some key takeaways from this year’s event.
The annual conference for FARE is a great place to witness the hope and hunger within the food allergy community. They are hopeful for a cure and hungry for information – this year’s event did not disappoint in either area. Experts attending and speaking this year included allergists/immunologists, PhD researchers, clinical psychologists, registered nurses, dietitians, food safety consultants, and advocates from many corners of the food allergy world. Exhibitors showcased new products, ranging from apps to promote safety while eating out, to lunchboxes that help reduce risk, to personalized kits to hold medications.
The education sessions were broken down into those focused toward parents and adults, and those targeted to youth. Parents were not allowed in the youth sessions in order to create a place where the adolescents and teens could open up about their fears, questions, and have open discussion. Adult-focused sessions included high-level science overviews, very practical sessions on management – and everything in between. In this post, we’ll tackle some key points from the high-level topics and share the practical takeaways next time around.
Food Allergy Update: Prevention, Diagnosis and Treatment
Dr. Scott Sicherer, renowned food allergy researcher and pediatric allergist at Mount Sinai Health System, spoke first to provide an encouraging opening for attendees. In the area of prevention, Dr. Sicherer provided an overview of the LEAP study and how its findings have changed the way we introduce foods to babies. He reiterated the importance of early introduction of peanuts to prevent peanut allergy. Moreover, he suggested that a varied diet that includes potentially allergenic foods should be encouraged.
Diagnosis remains an important area of research and Dr. Sicherer emphasized that food allergy diagnosis is based on a combination of information that includes the patient’s history, laboratory tests (e.g. skin prick testing results, serum IgE testing) and oral food challenges. According to Dr. Sicherer, component testing (foods contain many different types of proteins – component testing involves testing for antibodies to single proteins, rather than all of the proteins in a food at one time) may enhance diagnosis. He mentioned basophil activation testing (BAT), ratios of IgE to IgG, use of epitopes, and computer assisted prediction as tools currently being studied for use in diagnosis.
Finally, for those already managing food allergies (the majority in the audience), Sicherer discussed some of the emerging treatments and research, including OIT (oral immunotherapy), SLIT (sublingual immunotherapy), epicutaneous immunotherapy (EPIT/patch), and combinations of immunotherapy and drug therapies. Dr. Sicherer also briefly touched on anti-IgE medications, probiotics, and Chinese herbal therapies as areas of exciting research. While we may not yet have a cure, researchers are definitely making great strides to reduce risk, induce tolerance, and learn more about predicting and preventing severe reactions.
Speaking of exciting areas of research, Cathy Nagler, PhD and researcher at The University of Chicago, spoke about the human microbiome and its impact on health. The human microbiome is made up of trillions of microbes (such as bacteria, yeast, and viruses) that live outside and inside our bodies. These microbes are responsible for protecting us, digesting our food, and serving other functions such as vitamin synthesis and supporting our immune systems. Most are helpful or benign, but some (called pathogens) can cause illness. Nagler’s research, along with others, suggests that there are a variety of contributing factors responsible for disrupting the body’s microbiome – potentially contributing to the development of a variety of diseases, including allergic disease.
Dr. Nagler suggested that over use of antibacterial soaps and other antibacterial personal care items disrupts the microbiome, so we should use those less. She also says that caregivers should carefully consider the administration of antibiotics in infancy and childhood, using only when necessary. In addition, she shared how increasing dietary fiber in your diet supports a healthy gut mucosa (the lining of the gastrointestinal tract), which is protective. Learn more about Dr. Nagler’s work at The University of Chicago’s Cathryn Nagler Lab.
Clearly there are exciting things happening in the research of food allergies. NPB will continue to work to share valuable information for those who want to learn more about these exciting areas of study. For more on food allergy diagnosis and management, and the recommendations for early introduction to prevent food allergies, visit the NIAID Guidelines for Clinicians and Patients for Diagnosis and Management of Food Allergy in the United States.