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Publications (1,010)
Background
Gut microbiota influence food allergy. We showed that the natural compound berberine reduces IgE and others reported that BBR alters gut microbiota implying a potential role for microbiota changes in BBR function.
Objective
We sought to evaluate an oral Berberine-containing natural medicine with a boiled peanut oral immunotherapy (BNP)...
Background
Despite a better understanding of the epidemiology, pathogenesis, and management of patients with anaphylaxis, there remain knowledge gaps. Enumerating and prioritizing these gaps would allow limited scientific resources to be directed more effectively.
Objective
To systematically describe and appraise anaphylaxis knowledge gaps and fut...
Regional and national legislation mandates the disclosure of “priority” allergens when present as an ingredient in foods, but this does not extend to the unintended presence of allergens due to shared production facilities. This has resulted in a proliferation of precautionary allergen (“may contain”) labels (PAL) which are frequently ignored by fo...
Despite the substantial health and economic burden caused by RSV-associated illness, no vaccine is available. The sole licensed treatment (palivizumab), composed of a monoclonal neutralizing antibody, blocks the fusion of the virus to the host cell but does not prevent infection. The development of a safe and efficacious RSV vaccine is therefore a...
Background
Accurate diagnosis of peanut allergy is a significant clinical challenge. Here, a novel diagnostic blood test using the peanut bead‐based epitope assay (“peanut BBEA”) was developed utilizing the LEAP cohort and then validated using two independent cohorts.
Methods
The development of the peanut BBEA diagnostic test followed the National...
Due to its richness in antigen presenting cells, e.g., dendritic cells (DC), the skin has been identified as a promising route for immunotherapy and vaccination. Several years ago, a skin delivery system was developed based on epicutaneous patches allowing the administration of antigen through intact skin. Using mouse models, we have shown that epi...
Background: Inflammatory bowel disease (IBD) involves an increase in T effector cells in the intestines that disrupts the normal balance with T regulatory cells (Tregs). A therapy that restores this balance has the potential to treat IBD. We have shown that epicutaneous exposure to OVA induces Tregs that are able to induce tolerance. The Tregs also...
Background
Eliciting doses (e.g. ED01 or ED05 values, the amount of allergen expected to cause objective symptoms in 1% and 5% of the allergic population) are increasingly used to inform allergen labelling and clinical management. These values are generated from food challenge, but the frequency of anaphylaxis to these low levels of allergen exposu...
Background
In the Learning Early About Peanut Allergy (LEAP) trial, early consumption of peanut in high-risk infants was found to decrease the rate of peanut allergy at 5 years of age. Sequential epitope-specific (ses-)IgE is a promising biomarker of clinical peanut reactivity.
Objective
To compare the evolution of ses-IgE and ses-IgG4 in children...
Allergic reactions occur when IgE molecules become crosslinked by antigens such as food proteins. Here we create the ‘AllerScan’ programmable phage display system to characterize the binding specificities of anti-allergen IgG and IgE antibodies in serum against thousands of allergenic proteins from hundreds of organisms at peptide resolution. Using...
Analysis of epitope-specific antibody repertoires has provided novel insights into the pathogenesis of inflammatory disorders, especially allergies. A novel multiplex immunoassay, termed Bead-Based Epitope Assay (BBEA), was developed to quantify levels of epitope-specific immunoglobulins, including IgE, IgG, IgA and IgD isotypes. bbeaR is an open-s...
Background
There is no widely adopted severity grading system for acute allergic reactions, including anaphylactic and non-anaphylactic reactions, thus limiting the ability to optimize and standardize management practices and advance research.
Objective
The aim of this study was to develop a severity grading system for acute allergic reactions for...
Background
CoFAR investigators previously reported 52-week outcomes from a randomized, controlled trial of peanut EPIT, observing modest and statistically significant induction of desensitization, highest in children ages 4-11 years.
Objective
To evaluate changes in efficacy, safety, and mechanistic parameters following extended open-label peanut...
Allergic reactions occur when IgE molecules become crosslinked by antigens such food proteins. The physiologic consequences range from mild to life-threatening. Here we create the ‘AllerScan’ bacteriophage display library for efficiently profiling allergic antibodies to characterize binding specificities associated with known allergens. AllerScan e...
Background
The prevalence of tree nut allergy has increased worldwide, and cashew has become one of the most common food allergens. More critically, cashew allergy is frequently associated with severe anaphylaxis. Despite the high medical need, no approved treatment is available and strict avoidance and preparedness for prompt treatment of allergic...
Background
Peanut allergy is characterized by the development of IgE against peanut antigen.
Bjective
Evaluate the evolution of epitope-specific (es)IgE and esIgG4 in a prospective cohort of high-risk infants to determine if antibody profiles can predict peanut allergy after 4 years of age.
Methods
The endpoint was allergy status at 4⁺ years; sam...
Background
Food allergy quality of life (FAQL) is impaired in children with peanut allergy. Food CAllergy Quality of Life Questionnaires (FAQLQs) provide disease-specific insight into the burden of peanut allergy and potential FAQL changes following peanut immunotherapy.
Objective
To examine FAQL changes in children following treatment with epicut...
Background
The use of inconsistent definitions for anaphylaxis outcomes limits our understanding of the natural history and epidemiology of anaphylaxis, hindering clinical practice and research efforts.
Objective
To develop consensus definitions for clinically relevant anaphylaxis outcomes utilizing a multidisciplinary group of clinical and resear...
Background
We previously reported the safety and efficacy of epicutaneous immunotherapy (EPIT™) for peanut allergy (250 μg, daily epicutaneous peanut protein; DBV712 250μg) in a 12-month randomized controlled study (PEPITES) of peanut-allergic children aged 4-11 years.
Objective
To assess interim safety and efficacy of an additional 2 years of EPI...
In the wake of the COVID-19 pandemic and massive disruptions to daily life in the spring of 2020, in May 2020 the CDC released guidance recommendations for schools regarding how to have students attend while adhering to principles of how to reduce the risk of contracting SARS-CoV-2. As part of physical distancing measures, the CDC is recommending t...
Background: Misdiagnosis of peanut allergy is a significant clinical challenge. Here, a novel diagnostic blood-based test using a Bead-Based Epitope Assay (peanut BBEA) has been developed on the LEAP cohort and then independently validated on the CoFAR2 and POISED cohorts.
Methods: Development of the peanut BBEA followed the National Academy of Med...
Background:
Epicutaneous immunotherapy (EPIT) for peanut allergy is a potential novel immunotherapy that utilizes the unique cutaneous immunologic properties to induce desensitization. A randomized, double-blind, placebo-controlled Phase 3 trial (PEPITES) in peanut-allergic children 4-11 years demonstrated an epicutaneous patch (DBV712) with 250 m...
Background:
Epicutaneous immunotherapy is a potential novel immunotherapy that utilizes unique cutaneous immunologicproperties. In a phase III, randomized, double-blind, placebo controlled clinical trial, an epicutaneous patch (DBV712) with 250 micrograms of peanut protein applied once daily for 12-months was statistically superior to placebo in d...
Background
While desensitization and sustained unresponsiveness (SU) have been shown with egg oral immunotherapy (OIT), the benefits of baked egg (BE) therapy for egg allergy have not been well studied.
Objective
To evaluate the safety and efficacy of BE ingestion compared to egg OIT in participants allergic to unbaked egg but tolerant to BE.
Met...
Background
Egg‐white ovomucoid, that is, Gal d 1, is associated with IgE‐mediated allergic reactions in most egg‐allergic children. Epitope‐specific IgE levels have been correlated with the severity of egg allergy, while emerging evidence suggests that other antibody isotypes (IgG1, IgG4, IgA, and IgD) may have a protective function; yet, their epi...
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Peanut epitope-specific IgE antibodies (esIgE) have been associated with the severity of peanut allergy; whereas concomitant increases in epitope-specific IgG1, IgG4, IgA and IgD might ameliorate allergic symptoms by “blocking” IgE-mediated reactions. In this study, we analyzed antibody repertoires in a CoFAR2 cohort of high-risk children to elucid...
Precision allergy molecular diagnostic applications ([email protected]) is increasingly entering routine care. Currently, more than 130 allergenic molecules from more than 50 allergy sources are commercially available for in vitro specific immunoglobulin E (sIgE) testing. Since the last publication of this consensus document, a great deal of new in...
Background:
Unexpected allergic reactions to peanut are the most common cause of fatal food-related anaphylaxis. Mechanisms underlying the variable severity of peanut allergic reactions remain unclear.
Objectives:
To expand mechanistic understanding of reaction severity in peanut allergy.
Methods:
We performed an integrated transcriptomic and...
Identification of allergenic IgE epitopes is instrumental for the development of novel diagnostic and prognostic methods in food allergy. In this work, we present the quantification and validation of a Bead-Based Epitope Assay (BBEA) that through multiplexing of epitopes and multiple sample processing enables completion of large experiments in a sh...
Capsule summary:
The majority of children with sustained unresponsiveness after extended egg OIT are able to successfully introduce dietary egg. OIT outcome may be predictive of frequency, type (concentrated, baked), and quantity of egg ingested in the long term.
Background:
Sesame is an allergen of increasing importance.
Objective:
We sought to characterize the outcomes of oral food challenges (OFCs) to sesame and evaluate the diagnostic accuracy of skin prick testing (SPT), sesame and Ses i 1-specific IgE (sIgE).
Methods:
We reviewed sesame OFCs performed at the Mount Sinai pediatric allergy clinic b...
Background
The consumption of lentil is common in the Mediterranean area and is one of the causes of IgE‐mediated food allergy in many countries. Len c 1 is a well‐defined allergen of lentil and approximately 80% of the patients with lentil allergy recognize the purified Len c 1 protein. We sought to identify IgE and IgG4 sequential epitopes of Len...
Background:
Food allergies are a significant public health issue, and the only effective management option currently available is strict avoidance of all foods containing the allergen. In view of the practical impossibility of limiting risks to zero, quantitative allergen risk assessment and management strategies are needed.
Objective:
We sought...
Nearly 40% of children with moderate‐to‐severe atopic dermatitis (AD) have IgE‐mediated food allergy (FA). This clinical observation has been extensively documented by experimental data linking skin inflammation in AD to FA, as well as by food challenges reproducing symptoms and avoidance diets improving AD. Although food avoidance may improve AD,...
Background: Current in vitro methods for peanut allergy diagnosis have limitations in utility. Here we present a novel diagnostic blood-based test using a Bead-Based Epitope Assay (BBEA) that has been developed and then independently validated.
Methods: Development of the test followed the National Academy of Medicine’s established guidelines. Dis...
Introduction: Egg-white ovomucoid (OVM) is associated with IgE-mediated allergic reactions in most egg allergic patients. Epitope-specific IgE and IgG4 binding have been correlated with the severity of egg allergy, while higher circulating IgA and IgD might be associated with protective responses. The ability to measure epitope-specific antibody bi...
Background: Identification of allergenic IgE epitopes is instrumental for the advancement of diagnostic and prognostic tests for food allergy. We’ve developed a novel Bead-Based Epitope Assay (BBEA) to screen multiple epitopes in a large number of samples. In this work, we’ve proposed a quantification and validation pipeline, characterizing the ass...
Background
Prognostication of peanut allergy (PNA) is relevant for early interventions. We aimed to determine baseline parameters associated with the development of PNA in 3‐ to 15‐month‐olds with likely egg and/or milk allergy, and/or moderate to severe atopic dermatitis (AD) and a positive egg/milk skin prick test (SPT), but no known PNA.
Method...
Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus triggered by immune hypersensitivity to food. Herein, we tested whether genetic risk factors for known, non-allergic, immune-mediated diseases, particularly those involving autoimmunity, were associated with EoE risk. We used the high-density Immunochip platform, enco...
Introduction
Les dosages d’IgE spécifiques actuels ont une capacité limitée à prédire quels enfants allergiques aux protéines de lait de vache (PLV) peuvent tolérer le lait cuit. Le test de provocation oral (TPO), test de référence pour confirmer la tolérance, fait encourir le risque de réaction allergique sévère et est consommateur en ressources....
Introduction
L’allergie au sésame est une allergie en augmentation et potentiellement sévère. Cependant les seuils des outils diagnostics actuels n’ont pas été clairement définis. Notre objectif était de définir la validité des tests diagnostiques de l’allergie au sésame actuels selon les résultats de tests de provocation orale (TPO) à cet aliment...
The skin is an immune organ comprised of a large network of antigen-presenting cells such as dendritic cells, making it an attractive target for the development of new vaccines and immunotherapies. Recently, we developed a new innovative and non-invasive vaccination method without adjuvant based on epicutaneous vaccine patches on which antigen form...
Background
As there is limited data on the sustainability of desensitization of multifood-oral immunotherapy (multifood-OIT), we conducted a multisite multifood-OIT study to compare the efficacy of successful desensitization with sustained dosing vs discontinued dosing after multifood-OIT.
Methods
We enrolled 70 participants, aged 5–22 years with...
The skin immune system must discriminate between innocuous antigens and pathogens. Antigen applied topically using a Viaskin® patch elicits immune tolerance that can suppress colitis and food allergy. Here we show how topical antigen is acquired and presented by dendritic cells in the skin. Topical antigen is acquired by Langerhans cells (LC) and C...
In a recent trial of milk oral immunotherapy (MOIT) with or without omalizumab in 55 patients with milk allergy treated for 28 months, 44 of 55 subjects passed a 10-g desensitization milk protein challenge; 23 of 55 subjects passed the 10-g sustained unresponsiveness (SU) challenge 8 weeks after discontinuing MOIT.
We sought to determine whether I...