Scott H. Sicherer’s research while affiliated with Icahn School of Medicine at Mount Sinai and other places

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Publications (594)


Peanut Oral Immunotherapy in Children with High-Threshold Peanut Allergy
  • Article

February 2025

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17 Reads

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2 Citations

NEJM Evidence

Scott H. Sicherer

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M. Cecilia Berin

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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 butter versus peanut avoidance. The primary end point was the difference between groups in the proportion tolerating a two-dose-level increase or 9043 mg of peanut protein. For ingestion participants tolerating 9043 mg, sustained unresponsiveness (tolerance off treatment) was tested after 16 weeks of ad lib ingestion followed by 8 weeks of abstinence. Results: Of 73 participants, 38 were randomly assigned to P-OIT and 35 to avoidance. Thirty-two of 38 participants in the ingestion group (84.2%) and 30 of 35 in the avoidance group (85.7%) underwent the primary outcome food challenge. The primary analysis with prespecified multiple imputation for missing values showed 100% success for ingestion versus 21.0% for avoidance (between-group difference, 79.0 percentage points; 95% confidence interval [CI], 64.6 to 93.5; P<0.001). All 32 treated and 3 out of 30 avoiders (10%) tolerated 9043 mg. In the intention-to-treat analysis, sustained unresponsiveness occurred in 68.4% (26/38) on P-OIT versus 8.6% (3/35) tolerating 9043 mg among those avoiding (between-group difference, 59.9 percentage points; 95% CI, 42.4 to 77.3). No dosing reactions were greater than grade 1 severity, and no serious adverse events were reported. Conclusions: In this trial of P-OIT using store-bought, home-measured peanut versus peanut avoidance in high-threshold peanut allergy, those treated achieved significantly higher rates of desensitization with a durable response off treatment. (Funded by the National Center for Advancing Translational Sciences [UL1TR004419] and the National Institute of Allergy and Infectious [U19AI136053]; ClinicalTrials.gov number, NCT03907397.).











Citations (47)


... Open OFCs were performed following PRACTALL recommendations. 12,13 All included food challenges were performed to either confirm or exclude a possible food allergy in patients having presented a previous clinical reaction possibly due to the tested food or put on an elimination diet based on the results of a previous allergy work-up. All those who presented a history of anaphylaxis had a prescription for Adrenaline Auto-Injector (AAI) and patients and/or caregivers are required to present with their emergency kit (including AAI) the day of the OFC. ...

Reference:

Anaphylaxis severity grade, during oral food challenges, assessed by five different classifications
AAAAI–EAACI PRACTALL: Standardizing oral food challenges—2024 Update
  • Citing Article
  • Publisher preview available
  • November 2024

... Puede haber anafilaxia por mecanismos mediados por IgE. [8][9][10][11][12][13][14][15][16][17][18][19] Se han reportado casos de enfermedad del suero por la formación de inmunocomplejos, debido a la producción de anticuerpos contra omalizumab con mecanismos de hipersensibilidad tipo III. Los pacientes pueden padecer fiebre, artralgias, eritema y linfadenopatía. ...

Omalizumab for the Treatment of Multiple Food Allergies

The New-England Medical Review and Journal

... We also performed similar experiments assessing IgE + GC B cells. We cultured single GC B cells (sorted as B220 + GL7 + CD38 − IgD − IgG − ) with feeder cells along with IL-4, IL-2 and IL-10 (enhancing IgE B cell survival 23 ; Fig. 5h). We found that ~25% of GC B clones were IgE + in control mice. ...

CD23+IgG1+ memory B cells are poised to switch to pathogenic IgE production in food allergy
  • Citing Article
  • February 2024

Science Translational Medicine

... Another area of research is the application for omalizumab beyond its current indications. A promising recent trial has demonstrated utility for omalizumab in treating food allergies, specifically in preventing allergic reactions to accidentally exposed food allergens, but future studies will need to validate those findings [58][59][60]. Evidence is growing that IgE could be involved in autoimmune diseases such as in bullous pemphigoid (BP) or systemic lupus erythematosus (SLE), which has sparked the evaluation of omalizumab in those conditions [61][62][63]. ...

Omalizumab for the Treatment of Multiple Food Allergy (OUtMATCH)

Journal of Allergy and Clinical Immunology

... Specifically, saliva and stool ASVs that were identified as threshold-associated microbiota, peripheral blood levels for transcripts in the threshold-associated FcγR-mediated phagocytosis and TLR signaling co-expression modules, abundances for the cell type associated with reaction threshold (i.e., neutrophils), and peanut-specific serum IgE and Ara h 2 antibodies were used in these correlation analyses. As context, we previously found that among all co-expression modules identified by weighted gene coexpression network analysis [29] and Gene ontology (GO) analysis [30] of peripheral blood transcriptome data in this cohort, the FcγR-mediated phagocytosis and TLR signaling modules were specifically associated with reaction threshold [31]. In addition, among all peripheral blood cell types identified by whole blood staining and cytometry in this cohort, only neutrophils were associated with reaction threshold [31]. ...

Joint transcriptomic and cytometric study of peanut allergic children reveals molecular and cellular cross-talk in reaction thresholds
  • Citing Article
  • January 2024

Journal of Allergy and Clinical Immunology

... Food allergy represents an increasingly prevalent immune disease with potential lifethreatening implications, and is the result of a defect in the existing tolerance [183,184]. Oral tolerance (OT) to food proteins is a natural immune process in which the immune system recognizes common antigens as harmless [185]. When this mechanism does not work correctly, the harmless compound is recognized as a menace for the body and is attacked by the immune system, triggering an adverse immunological reaction as displayed in Figure 2. The gastrointestinal tract contains lymphocytes, as well as unique antigen-presenting cells with specialized functions. ...

Epidemiology and the Growing Epidemic of Food Allergy in Children and Adults Across the Globe

Current Allergy and Asthma Reports

... 5 The significance of SA is underscored by its ranking as the third most common immunoglobulin E (IgE)-mediated FA among Israeli children, 6 and the fourth among Australian 7 and Turkish children. 8 Documented fatalities highlight the severity of SA, 9 with strict avoidance remaining the primary management approach, while oral immunotherapy (OIT) shows emerging promise. 10 Exciting data suggests that early introduction of OIT may lead to allergy resolution. ...

Comprehensive Diagnosis, Management, and Treatment of Sesame Allergy
  • Citing Article
  • November 2023

... The most common allergens in acute FPIES include cow's milk, soy, eggs, fish, and cereals [11,12]. However, with recent guidelines endorsing the early introduction of peanuts in early infancy, there has been an increase in peanut-induced FPIES [13]. ...

Food protein-induced enterocolitis syndrome (FPIES) to peanut: Characteristics and long-term outcomes of a large cohort
  • Citing Article
  • October 2023

... More specifically, non-IgE mediated conditions are now classed under Type IVb T2 immune responses and type V tissue-driven, which are cell-mediated reactions that involve Tlymphocytes, eosinophils, a variety of cytokines, and in some conditions include epithelial barrier defects and leaky junctions. 1 The Figure 1). [2][3][4] Typically, non-IgE mediated reactions are delayed, with the onset of symptoms occurring several hours and even up to several days after exposure to a culprit food, with the exception of FPIES. ...

Nomenclature of allergic diseases and hypersensitivity reactions: Adapted to modern needs: An EAACI position paper

... In the case of early sensitization to hazelnut, IgE from a majority of infants, under 1 year of age, with atopic dermatitis bound to the glycinin Cor a 9 [10]. Individuals with allergy to pistachio and cashew have been shown to have reactions to citrus seeds and pectins due to cross-reactivity of citrin, a glycinin, with the 11 S globulins of pistachio and cashew [11]. All three of these 11S globulins showed IgE cross-reactivity with the glycinin from Sichuan pepper seed, Zan b 2 [12]. ...

Citrin: a novel food allergen in citrus seeds and citrus-derived pectin that shows cross-reactivity with cashew and pistachio
  • Citing Article
  • September 2023

Annals of Allergy Asthma & Immunology