Skip to main content

Dr. Burks' Presentation at AAAAI: Related Tweets

So for those of you who are not obsessed with research, this weekend is the annual AAAAI meeting down in San Antonio. A number of immunologists and allergists tweet during the presentations to give those of us who are not lucky enough to attend a glimpse of the presentations.

This morning was Dr. Wesley Burks' highly anticipated talk: Immune Tolerance and Allergy: Can We Produce True Tolerance? Here's what the various tweeters had to say:
Several studies now indicate that food allergy is related to defective T regulatory response” Anne Ellis, M.D ‏@DrAnneEllis
Some studies suggest that when peanut tolerance develops, existing cells do not change, but rather, new populations of cells arise. Peripheral t cell tolerance is key.  Children who have outgrown non IgE-mediated milk allergy demonstrate detectable T regulatory activity. Sakina Bajowala, M.D @allergistmommy
So these are things I've touched on in other columns. Somehow, a child's immune system gets off track when they're first born and develops an immune response that's similar to what the body uses to react to parasites (T2) rather than one that see proteins as harmless (T1).

The $64,000 question is: what, exactly, are these OIT trials (and, by extension, my son's FAHF-2 trial) actually doing? Are they changing the way the body responds? Or are they simply "stretching the balloon" as far as possible, but leaving the maladaptive underlying response intact?

This is important because, if the immune system is really not being changed, then it may be that desensitization and not true tolerance is the best we can hope for.
Allergic individuals form peanut-specific IgE, non-allergic form peanut specific IgG - IgG is a Normal response to a foreign protein. True Peanut allergic patients - their peanut specific IgE continues to rise with ongoing avoidance. Anne Ellis, M.D ‏@DrAnneEllis
Peanut OIT changes antigen specific Tregs and suppresses Th2 response to peanut. Sakina Bajowala, M.D ‏@allergistmommy

So it does appear that these studies are doing something to really change the immune system. That's positive, as there's more hope for true tolerance. It's also important to note that this idea of waiting for IgE levels to fall may not really be the signal for tolerance, as levels generally continue to rise as long as peanut is being avoided. How do the current studies do with regard to inducing desensitization?Assuming it works, how long does it last? Who does it work for?
Burks' studies: OIT for peanut lead to passing a 5000mg challenge while SLIT was only 1000mg. Participants in OIT trials-only 25% passed an oral challenge 4 weeks post treatment discontinuation c/w 75% while still on treatment. Anne Ellis, M.D ‏@DrAnneEllis
41% pts appear to be tolerant after 1-3 years of peanut immunotherapy Matthew Bowdish, M.D ‏@MatthewBowdish
Burks: Peanut OIT - those who developed tolerance had lower baseline PN IgE than those who did not. Dr Melinda Rathkopf ‏@mrathkopf
So there does seem to be a difference in the kids who will respond to the therapy and those who won't. Longer therapy is better. More direct therapy (OIT) works better than smaller doses (SLIT). And, it appears to last for 4 out of 10 kids if it's kept up over time. However, Burks' assessment of all this is:
Critical gaps in OIT/SLIT for food mean its not ready for routine clinical use. David Fischer, MD ‏@IgECPD
A future question to be answered: would starting with younger kids who presumably have more malleable immune systems improve the response? In order to find out:
Impact peanut study. 2000mg maintenance dose for 4 years. Multicenter study. Sakina Bajowala, M.D ‏@allergistmommy
W Burks announces IMPACT study targeting 140 children under 4 with  to peanut.  @WayneShreffler
Burks' next study "Impact" - peanut allergic kids aged 1- 4 to see if OIT will be more likely to induce tolerance if started earlier. Anne Ellis, M.D ‏@DrAnneEllis
So...something to be on the lookout for if you have a child under the age of four and are just starting out on this fun journey.

What a wonderful glimpse into the #AAAAI world!  I am very grateful to these tweeters for sharing these conferences as they occur.

Follow me on Facebook or Twitter  

Popular posts from this blog

Turn Trash to Treasure: An Easy Way to Help SAGE and the Corvallis Environmental Center!

Clear clutter and unwanted items from your home and you can help raise funds for the Corvallis Environmental Center--all year long!  Just take your unwanted items to an ARC Thrift Store where they sell them and donate the proceeds to the CEC.  It easy!  Here's how:

1. Collect Items in Good Condition

Not all donate-able items are eligible, so check out the list of items that will raise money for the CEC:
2. Put a sticker on each eligible item Stickers are located in a big envelope on the window outside of the CEC office at 214 SW Monroe Ave., Corvallis

3. Drop-off Items at The ARC! Items can be dropped off anytime during store hours at either location.

The ARC Thrift Stores:
928 NW Beca Street, Corvallis (541) 754-9011
936 Main Street, Philomath (541) 929-3946

Monday-Saturday: 10am-5:30pm
Sunday: 12pm-5:30pm
Thanks so much for helping support SAGE and the other programs of the Corvallis Environmental Center!!!

Beans, Beans and More (or Less) Allergenic Beans!

We have a little good news this week: my son passed a home bean challenge for both pinto and cannellini (white) beans last night. Hooray!

At our last allergist visit, they ran the numbers on a number of varieties of beans and many were Class 0, with values like 0.68. My son's doctor thought it was reasonable to try these at home.

Going to stop for a moment and interject: DON'T DO THIS WITHOUT YOUR DOCTOR'S DIRECTION. A lot of things go into whether home challenges are a good idea for your child: how serious the allergen typically is, how far the hospital, how experienced the parents are with recognizing reactions. Many doctors are not comfortable with this at all. But, in our case, it makes sense to do some challenges at home because my son tests slightly allergic to dozens of foods.

He has avoided all beans since around age five, when he started developing new allergies. First it was tuna. Then cashews. Then (to our great surprise), he suddenly became allergic to garbonzo be…

Best Food Allergy Tweets/Posts From 2013 ACAAI Meeting

Sorry, guys...I've been very busy the last couple of weeks, but just over a week ago one of the largest allergy and asthma conferences, the annual American College of Allergy, Asthma and Immunology, was tweeting its brains out.

Here were the tweets and (virtual) presentations I thought were most interesting:

ACE inhibitors are often used to treat high blood pressure. I believe Lisinopril was the one specifically mentioned. This goes hand in hand with the idea that older patients, especially men, can see changes in the severity of their allergic reactions as they age.

Here's an answer on the question many of us asked about component testing. Just as with RAST, the number itself doesn't matter; just the positive result.

Gross! But yes, give your kids the bobber after the dog/ brother/ mailman licked it.

Conversely, tree-nut-allergic individuals have a 30% incidence of concurrent peanut allergy. 
So stop blaming yourselves, FA mommies! I've said this consistently - Mother Natur…