Immune basis of clinical phenotypes of food allergy
We take advantage of the heterogeneity of food allergy to study immune mechanisms of disease. For example, some individuals react to trace amounts of peanut while others react only after eating several peanuts. Some individuals with egg allergy can tolerate baked forms of egg, while others react. Some children outgrow their food allergies while others do not. We study how the immune system differs between each of these scenarios, using well-characterized cohorts of patients. We focus on identifying and phenotyping allergen-specific T cells, as well as the acute effector response including basophils. We use multi-parameter flow cytometry, mass cytometry, and bulk and single cell transcriptional profiling to describe the allergen-specific immune response.
Immune basis of response to allergen immunotherapy
Allergen immunotherapy is being extensively studied for the treatment of food allergy. The impact of route of administration, age at treatment initiation, and dose of immunotherapy are all under investigation. In collaboration with these clinical studies, we are performing longitudinal immune profiling to identify mechanisms of treatment response, and to identify immune predictors of treatment success.
Early life exposures and infant immunity
Food allergy commonly develops within the first year of life, and the rapid rise in frequency of food allergy points to a role for environmental factors. In collaboration with Dr. Rosalind Wright, we are studying the impact of prenatal stress on the development of the infant immune system. In collaboration with Dr. Hugh Sampson and Dr. Jose Clemente, we are studying the impact of mode of delivery (vaginal versus caesarian birth) on infant immunity.
Skin-gastrointestinal communication in food allergy
Eczema (allergic skin inflammation) in early life is a risk factor for the development of food allergy, and sensitization to foods can occur by exposure on the skin. Immune tolerance can also be induced through the skin, and epicutaneous immunotherapy (i.e. the peanut patch) generates gut-homing Tregs that suppress food allergy. We use mouse models to dissect the mechanisms by which food allergy and immune tolerance can both be initiated by topical exposure to foods on the skin.