Researchers to decode links between food allergy and eczema

A significant percentage of people with atopic dermatitis – commonly known as eczema – also suffer from food allergy.

Some studies, for example, have found that infants with atopic dermatitis (AD) are six times more likely to be allergic to eggs, and as much as 11 times as likely to have peanut allergy.

But while the connection is well-known to physicians, the reasons remain elusive.

Now, researchers at the University of Michigan are launching a new program to identify specific genetic variants that predispose people to AD and food allergies, with a focus on genetic determinants that link the diseases and the progression from one to another.

Nicknamed M-FAD – the Michigan Food and Atopic Dermatitis Program – this interdisciplinary project is a collaboration between the Mary H. Weiser Food Allergy Center (MHWFAC), the University of Michigan’s food allergy scientific research hub, and the Michigan Medicine Department of Dermatology’s inflammatory skin disease research program.

The five-year study will be the largest ever done on the genetic predisposition for these two diseases, integrating data gleaned from more than 60,000 patients and 500,000 healthy control subjects, along with the mutational screening of more than 1,000 pediatric and adult patients, using data from large population-based biobanks and patient data collected through the Michigan Genomics Initiative (MGI).

Scientists will use the information to identify the mechanisms by which one disease promotes the development of the other, via powerful statistical analysis. Eventually, the study will be extended to include asthma and allergic rhinitis, two other conditions often seen in patients with AD and food allergy.

“Atopic dermatitis is a well-known risk factor for the development of food allergy, and both of these diseases are part of the "atopic march," which is the progression of allergic disease during childhood and adolescence,” said James R. Baker Jr., MD, director of the MHWFAC.

“Bringing experts in the genetic predisposition and development of atopic dermatitis to collaborate with experts in food allergy should provide synergies to understanding both diseases, and the common occurrence of these two important medical problems,” he said.

Researchers aim to create a “molecular map” of the pathology of AD and food allergy, using state-of-the-art sequencing techniques that decipher the genetic instructions contained in a single cell. The goal is to identify how those biological mechanisms contribute to skin inflammation and allergic food reactions, thereby advancing the development of new treatments for patients.

Key questions to be addressed include:

Does the skin barrier’s local immune function play a role in food allergies?
What is the genetic and molecular link between AD, food allergy, asthma, and related conditions?
How do the mechanisms of food allergy in children and food allergy in adults differ?
What new biomarkers might inform the detection and personalized treatment of food allergies?

The M-FAD team will be led by MHWFAC faculty including Baker, MHWFAC Scientific Director Nick Lukacs, PhD, and physician-researcher Chase Schuler, MD, as well as by investigators from the dermatology department, Johann E. Gudjonsson, MD, PhD and Alex Tsoi, PhD.

“Using our access to large biobanks with comprehensive genetic and clinical information along with state-of-the-art sequencing technologies to measure gene expression and chromatin state down to a single-cell- level will allow us to unravel the pathogenesis and relationship between these conditions at a level that has not been previously achievable,” said Dr. Gudjonsson.

The study, which is made possible through the generosity of an anonymous philanthropist, is expected to begin recruiting subjects in 2023.