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Publications (332)
Background:
Approved therapeutics for peanut allergy are not designed for the many patients with allergic reactions to more than one peanut.
Methods:
We randomly assigned (1:1) participants 4 to 14 years of age reacting to a challenge of between 443 mg and 5043 mg of peanut protein to peanut oral immunotherapy (P-OIT) using home-measured peanut...
Background
Among peanut‐allergic individuals, there is high variability in the amount of peanut that triggers reactions (i.e., reaction threshold) that is not predictable or well‐understood. We conducted this study to characterize relationships between the oral and gut microbiomes and systemic processes associated with reaction threshold in peanut...
GA²LEN and EFA propose minimum specifications for all industrialised countries/regions to work towards to support students with food allergies in educational settings. We reviewed research and legislation and gained feedback from over 100 patient and professional groups. We built shared expectations around: 1. training all school staff about what f...
Background
Peanut allergy is a common, life‐threatening food allergy in children. We evaluated whether dupilumab, which blocks the activity of interleukin (IL)‐4/IL‐13, enhances the efficacy of oral immunotherapy (OIT) AR101 in pediatric patients with peanut allergy.
Methods
A Phase II, multicenter, randomized, double‐blind study was conducted in...
This Anaphylaxis Manifesto calls on communities to prioritise 10 practical actions to improve the lives of people at risk of serious allergic reactions. The Global Allergy and Asthma European Network and the European Federation of Allergy and Airways Diseases Patients' Associations (EFA) compiled patient‐centric priorities. We used qualitative cons...
Background
Limited decision‐support tools are available to help shared decision‐making (SDM) regarding food oral immunotherapy (OIT) initiation. No current tool covers all foods, forms, and pediatric ages for which OIT is offered.
Methods
In compliance with International Patient Decision Aid Standards criteria, this pediatric decision‐aid comparin...
Background
Omalizumab (XOLAIR®)‐assisted multi‐food oral immunotherapy (mOIT) has been shown to safely, effectively, and rapidly desensitize patients with multiple food allergies. In our clinical trial (NCT02626611) on omalizumab‐assisted mOIT, different desensitization outcomes (success or failure of desensitization) were observed following a peri...
Background
Oral food challenges are commonly used when there is uncertainty based on a clinical history as to whether a food allergy exists and to assess whether a food allergy has been outgrown.
Methods
A narrative review was performed, synthesizing available evidence in the literature.
Results
Because food challenges are generally multi-hour pr...
Background
Anaphylaxis is a serious allergic reaction that is effectively treated with epinephrine. Epinephrine autoinjectors are devices that contain fixed doses of medication that can be carried by patients at risk for anaphylaxis so that ready access to first line medication is available outside the medical setting.
Methods
This review will dis...
Purpose of Review
This narrative review explores food allergy prevalence and natural history stratified by life stages, especially in context of evolving knowledge over the last few decades.
Recent Findings
The prevalence of food allergy remains highest in early childhood with common food triggers being cow’s milk, soy, hen’s egg, wheat, peanut, t...
Background:
Food allergies are common and are associated with substantial morbidity; the only approved treatment is oral immunotherapy for peanut allergy.
Methods:
In this trial, we assessed whether omalizumab, a monoclonal anti-IgE antibody, would be effective and safe as monotherapy in patients with multiple food allergies. Persons 1 to 55 yea...
Background:
Atopic dermatitis (AD) is an inflammatory skin condition with multiple systemic treatments and uncertainty regarding their comparative impact on AD outcomes.
Objective:
We systematic synthesized the benefits and harms of AD systemic treatments.
Methods:
For the 2023 AAAAI/ACAAI JTFPP AD guidelines, we searched MEDLINE, EMBASE, CENT...
Background:
Atopic dermatitis (AD) is a common skin condition with multiple topical treatment options, but uncertain comparative effects.
Objectives:
We systematically synthesized the benefits and harms of AD prescription topical treatments.
Methods:
For the 2023 AAAAI/ACAAI JTFPP AD guidelines, we searched MEDLINE, EMBASE, CENTRAL, CINAHL, LI...
Background
Food allergy (FA) and atopic dermatitis (AD) are common conditions that often present in the first year of life. Identification of underlying mechanisms and environmental determinants of FA and AD is essential to develop and implement effective prevention and treatment strategies.
Objectives
We sought to describe the design of the Syste...
This guidance updates 2021 GRADE recomendations regarding immediate allergic reactions following COVID-19 vaccines and addresses re-vaccinating individuals with 1st dose allergic reactions and allergy testing to determine re-vaccination outcomes. Recent meta-analyses assessed the incidence of severe allergic reactions to initial COVID-19 vaccinatio...
Accurate diagnosis of IgE-mediated allergies is necessary to inform risk management for severe allergic reactions, including anaphylaxis, for food, venom and drug allergies. The most widely available laboratory test for allergy is serum specific IgE testing, which is routinely used for food allergy and insect sting allergy. Testing for specific IgE...
Background:
No approved treatment for peanut allergy exists for children younger than 4 years of age, and the efficacy and safety of epicutaneous immunotherapy with a peanut patch in toddlers with peanut allergy are unknown.
Methods:
We conducted this phase 3, multicenter, double-blind, randomized, placebo-controlled trial involving children 1 t...
Numerous scoring systems have been developed to improve and standardize the diagnosis and management of acute allergic reactions and anaphylaxis; however, considerable variability exists amongst these systems. This review article discusses existing severity scoring systems and identifies specific knowledge gaps that remain. Future research is neede...
Background:
Oral immunotherapy (OIT) is limited by adverse events, and most patients require continued treatment to maintain their increased threshold. Adjunctive treatments have been explored to increase the safety and efficacy of OIT.
Objective:
This study aimed to determine the safety and efficacy of E-B-FAHF-2 for inducing remission in subje...
Continuing insight into the molecular mechanisms of atopic disorders has enabled the development of biologics to precisely target these diseases. Food allergy (FA) and eosinophilic gastrointestinal disorders (EGIDs) are driven by similar inflammatory molecular mechanisms and exist along the same atopic disease spectrum. Therefore, many of the same...
Introduction
Food allergy is a significant public health problem with limited treatment options. As Food Allergy Herbal Formula 2 (FAHF-2) showed potential as a food allergy treatment, we further developed a purified version named EBF-2 and identified active compounds. We investigated the mechanisms of EBF-2 on IgE-mediated peanut (PN) allergy and...
Food allergy is a significant health problem affecting approximately 8% of children and 11% of adults in the United States. It exhibits all the characteristics of a "complex" genetic trait, therefore, it is necessary to look at very large numbers of patients, far more than exist at any single organization, to eliminate gaps in the current understan...
Atopic dermatitis affects millions worldwide and is effectively managed by topical treatments, including topical calcineurin inhibitors, pimecrolimus and tacrolimus. In 2005 and 2011, the FDA released reviews associating topical calcineurin inhibitors with a theoretical cancer risk, albeit an uncertain association. We systematically reviewed the ri...
Importance
Patient values and preferences can inform atopic dermatitis (AD) care. Systematic summaries of evidence addressing patient values and preferences have not previously been available.
Objective
To inform American Academy of Allergy, Asthma & Immunology (AAAAI)/American College of Allergy, Asthma and Immunology (ACAAI) Joint Task Force on...
Background
Health-related quality of life (HRQoL) is significantly and substantially reduced in individuals with peanut allergy due to many factors associated with unanticipated or potentially fatal reactions. Further insight on the impact of peanut oral immunotherapy in managing peanut allergy on HRQoL is needed. The aim of this analysis was to as...
Purpose of Review
The goal of this review is to characterize health disparities impacting the recognition and treatment of anaphylaxis.
Recent Findings
Previous research has identified major health disparities related to atopic conditions including asthma, atopic dermatitis, and food allergies (FA); however, disparities related to anaphylaxis have...
These evidence-based guidelines support patients, clinicians, and other stakeholders in decisions about the use of intranasal corticosteroids (INCS), biologics, and aspirin therapy after desensitization (ATAD) for the management of chronic rhinosinusitis with nasal polyposis (CRSwNP). It is important to note that the current evidence on surgery for...
Background
Atopic dermatitis is a prevalent condition in children and can be effectively managed with medications such as topical calcineurin inhibitors (pimecrolimus or tacrolimus). A key unresolved safety concern is whether use of topical calcineurin inhibitors is associated with cancer. We systematically reviewed the risk of cancer in patients w...
Introduction
We assessed health-related quality of life (HRQoL) of pediatric participants across phase 3 and follow-on trials for peanut (Arachis hypogaea) allergen powder-dnfp (PTAH).
Methods
HRQoL data were analyzed from PALISADE (ARC003), ARC004 (PALISADE follow-on; daily dosing cohorts), ARTEMIS (ARC010), RAMSES (ARC007), and ARC011 (RAMSES fo...
Introduction
No approved peanut allergy treatments exist for children <4 years old. This study aimed to assess the efficacy and safety of epicutaneous immunotherapy with a patch containing 250 µg peanut protein among peanut-allergic children ages 1-3 years.
Methods
In a Phase 3, multicenter, randomized, double-blind, placebo-controlled trial (EPIT...
In the last few decades food allergy appears to be increasing in prevalence. Food allergy has a significant impact on the quality of life for patients and their caregivers, largely related to fear of unpredictable, and possibly severe, allergic reactions. As such, many families desire a treatment option that would reduce the risk of allergic reacti...
The concepts of diversity, equity, inclusion are fundamental and more recently heavily discussed within medicine, research, and the larger society. There is increasing awareness that diversity of thoughts, perspectives, and backgrounds yield stronger teams and more effective results. There is also increasing awareness that stark inequities from sys...
Type 2 allergen‐specific T cells are essential for the induction and maintenance of allergies to foods, and Tregs specific for these allergens are assumed to be involved in their resolution. However, it has not been convincingly demonstrated whether allergen‐specific Treg responses are responsible for the generation of oral tolerance in humans. We...
Background
Atopic dermatitis (AD, eczema) is driven by a combination of skin barrier defects, immune dysregulation, and extrinsic stimuli (eg. allergens, irritants, microbes). The role of environmental allergens (aeroallergens) in triggering AD remains unclear.
Objective
Systematically synthesize evidence regarding the benefits and harms of allerg...
Background
Chronic rhinosinusitis with nasal polyposis is associated with a significant disease burden. The optimal use and administration route for intranasal corticosteroids (INCS) when managing CRSwNP are unclear.
Objective
To systematically synthesize the evidence addressing INCS for CRSwNP.
Methods
We searched MEDLINE, EMBASE, and CENTRAL fr...
BACKGROUND
The influence of diet on atopic dermatitis (AD) is complex, and the use of dietary elimination as a treatment has conflicting views.
OBJECTIVE
To systematically review the benefits and harms of dietary elimination for the treatment of AD.
METHODS
We searched MEDLINE, EMBASE, AMED, PsycINFO and CENTRAL from inception to Jan 18, 2022, wi...
Safety concerns are a barrier to oral immunotherapy (OIT). This review aims to describe OIT safety events and explore potential risk factors and mitigating factors. Published clinical and real-world OIT studies were reviewed for data on safety outcomes in OIT. Gastrointestinal symptoms are one of the most common adverse reactions associated with OI...
Type 2 allergen-specific T cells are essential for the induction and maintenance of allergies to foods, and Tregs specific for these allergens are assumed to be involved in their resolution. However, it has not been convincingly demonstrated whether allergen-specific Treg responses are responsible for the generation of oral tolerance in humans. We...
Background
The oral and gut microbiomes have each been associated with food allergy status. Within food allergy, they may also influence reaction thresholds.
Objective
To identify oral and gut microbiota associated with reaction thresholds in peanut allergy.
Methods
59 children ages 4 to 14 years with suspected peanut allergy underwent double-bli...
Objective
Food allergy (FA) affects approximately 8% of children in the US. Management comprises both preventing and treating allergic reactions, which poses unique challenges in the inner-city school setting. In this article, we review the epidemiology of FA in school-aged children and management challenges and opportunities specific to the inner-...
The appropriate at home management of anaphylaxis begins with patient education on recognition and treatment, especially when and how to use epinephrine. Delayed administration of epinephrine as well as having severe symptoms and needing multiple doses of epinephrine to treat symptoms are risk factors for biphasic anaphylaxis. The successful implem...
The diagnosis of immunoglobulin E (IgE) mediated food allergy is based on the clinical evaluation of a patient’s history, physical examination, and specific test results.These tests may include skin prick testing, serum IgE testing, and/or oral food challenge (OFC). Component-resolved diagnosis (CRD) targeting specific allergenic proteins in a food...
Background
Food allergy (FA) data lacks a common base of terminology and hinders data exchange among institutions.
Objective
To examine the current FA concept coverage by clinical terminologies and to develop and evaluate a FA data dictionary (FADD).
Methods
Allergy/Immunology templates and patient intake forms from four academic medical centers...
Background: Bleach bathing is frequently recommended to treat atopic dermatitis (AD), but its efficacy and safety is uncertain.
Objective: Systematically synthesize randomized controlled trials (RCTs) addressing bleach baths for AD.
Methods: We searched MEDLINE, EMBASE, CENTRAL, GREAT from inception to December 29, 2021, for RCTs assigning patients...
Anaphylaxis is a systemic allergic reaction that can be caused by food, drugs, insect bites, or unknown triggers in infants and toddlers. Anaphylaxis rates are increasing. Infants and toddlers may have increased exposure to known and unknown allergens, decreased ability to describe their symptoms, and an expanded differential diagnosis for consider...
Race is a social construct. It is used in medical diagnostic algorithms to adjust the readout for spirometry and other diagnostic tests. The authors review historic evidence about the origins of race adjustment in spirometry, and recent attention to the lack of scientific evidence for their continued use. Existing reference values imply that White...
A growing body of epidemiological data indicates that the prevalence and public health burden of asthma and other common allergic conditions (e.g. atopic dermatitis, food allergy, allergic rhinitis, drug allergy) is greatest among certain historically marginalized populations. However, these historically marginalized populations are often under-rep...
Background
For young children with peanut allergy, dietary avoidance is the current standard of care. We aimed to assess whether peanut oral immunotherapy can induce desensitisation (an increased allergic reaction threshold while on therapy) or remission (a state of non-responsiveness after discontinuation of immunotherapy) in this population.
Met...
Background: Bleach bathing is frequently recommended to treat atopic dermatitis (AD), but its efficacy and safety are uncertain. Objective: To systematically synthesize randomized controlled trials (RCTs) addressing bleach baths for AD. Methods: We searched MEDLINE, EMBASE, CENTRAL, and GREAT from inception to December 29, 2021, for RCTs assigning...
