Found in Translation: Extensive Experience Studying Related Diseases Leads to Novel Ideas of Where to Look Next in Food Allergy

Nicholas W. Lukacs, Ph.D., is an immunologist and scientific director of the Mary H. Weiser Food Allergy Center. His position gives him a bird’s-eye view of all the research at the center while allowing him to pursue his own investigations, which are primarily focused on exploring prenatal and neonatal connections to how and why food allergy develops. Here he answers eight questions about his work.

Nicholas W. Lukacs, Ph.D., draws on a whiteboard
Nicholas W. Lukacs, Ph.D., is the scientific director of the Mary H. Weiser Food Allergy Center and the Godfrey D. Stobbe Professor of Pathology.

What is your area of food allergy research?

Food allergy research is really in its infancy. It’s just really starting to take off.

A number of folks in the center, including myself, are trying to understand how food allergy first gets established. Especially since these children who become food allergic or are food allergic, their first episode happens very early in life, even before they are exposed to a lot of the foods. For example, with the first introduction of peanuts, some of them can be anaphylactic. Trying to understand how food allergy develops is important because we may be able to intervene prior to them even being born.

What are your current research projects?

It is estimated that 90 percent of an infant’s early life is spent in the home with their parents, so the idea that the environment is influencing immune response is very strong.

One of the projects that we have is a multicenter project with Henry Ford in Detroit to look at a birth cohort of children and their mothers. What are the mothers’ nutrition? How are they influencing the development of allergic response?

We think there may be some predisposition to food allergy that’s occurring, even before birth. Really understanding the mechanisms is going to be the underlying basis for development of prevention in therapy.

Why is this area of research important to the field of food allergy?

There is no treatment for this disease. We don’t know how to prevent it yet. There are some ideas behind why it develops: People are living in a cleaner environment and are not exposed to bacteria early in life that they should be. More parents are allergic and therefore they pass that on to their children. Coming in where we’re at, it really gives us the opportunity to establish areas that researchers really haven’t investigated.

We take a lot of cues from other diseases. I’ve worked in allergic asthma for 25-plus years, for example, and when I started, it was a similar situation where the disease had been rising quickly but the cause and the mediators that drive it weren’t known at all. We can take some cues from that disease, but food allergy is a very different disease than other allergic diseases.

This is a real opportunity for us as a group to not only work in our individual labs in research, but to work together to really get a synergy behind the mechanisms that are driving this.

What results have you found so far?

We know from studies that we’ve done through the original birth cohort at Henry Ford in this multicenter collaboration is that the bacteria at 1 month in these newborns can predict whether they are going to get severe allergies or not. That includes multiple food allergies.

For example, the most severe asthmatics at age 10 can be predicted based upon their gut microbiome at 1 month of age. This is what we’re finding in some of the prenatal and neonatal preclinical studies we’re doing in our lab: It’s very early on in life that the immune system is established based upon how it interacts with the environment.

“After 20 to 25 years of research in asthma, we have treatments that are very specific to treating the disease itself. We have nothing in food allergy, so it becomes an area of need where we need to understand what’s happening before we can really treat the disease specifically.”

Nicholas W. Lukacs, Ph.D.

What is the significance of these results?

There are multiple factors in children that includes the way that they’re born, whether they are breastfed, but there are underlying factors that are embedded in what is the health of the mom, what is the microbiome and metabolic state of the mother. Until now, no one’s really looked at the impact of these on food allergy. I think our studies may be paradigm-shifting in how to envision not only related to infectious disease, but if the child was premature, were they on oxygen for an extended period of time, etc. We really need to flush those questions out from a clinical standpoint, but also understanding the mechanisms in the laboratory will help us maybe have biomarkers, or help us understand the treatment better.

Within the center, with the different expertise of our researchers we’ll be able to use all of these strengths to figure out what data means as we bring data in from the laboratory. This will help us know what to look at in those clinical cohorts.

Why are you passionate about this area of research?

Because it’s compelling. After 20 to 25 years of research in asthma, we have treatments that are very specific to treating the disease itself. We have nothing in food allergy, so it becomes an area of need where we need to understand what’s happening before we can really treat the disease specifically. Food is one of the first allergens that you detect in kids. That doesn’t mean they are going to have anaphylactic disease, it just means that the exposure is probably early on and if they are predisposed, they’re going to react to it.

I wanted to come into this field because as researchers we want to understand the unknowns and solve the unknowns. For me, a lot of those unknowns are linked to disease. I think the biggest issues we have to understand first is what are the mechanisms that drive this disease: Why does it develop? Why is it sustained?

We have our pretty strong suspicions on why they are sustained or maintained over the number of years. But why it develops and what do we need to look for to know how to identify children that are susceptible and find the link to how we can treat them or treat their moms to try to avoid it.

What do you wish people understood about your research?

This is not a short haul. There’s going to have to be a lot of research to be conducted before this is done. In the first three years of the center, we’ve built the base of the research with a really strong base of researchers that are smart, very accomplished and understand the goal.

Now we’re expanding into trying to identify what we can do in the disease to intervene. This takes time, and it takes funding because we need to build not only the resources to do the research, the tools, but we also need to build the a community of researchers that are interested in this disease problem.

What do you ultimately hope to accomplish with your research?

One in 13 kids, 2 kids in every classroom, have a food allergy. This is not only a need to understand the disease and treat the children, but it’s a need to expand the understanding of the general public.

All of the information that we learned in the last 25 years in other diseases, including allergic asthma and IBD, and some of the other diseases that don’t seem like they are directly linked will come into play here and speed things along faster, but we have to have an understanding of the disease first before we can appropriately integrate those other types of information.

I am hopeful and optimistic that five years from now, we’re going to be talking about how we’re helping 50% or 75% of food-allergic patients. Areas including diagnostics and predictive factors are really important because as you know, it’s scary if you have food allergies.

As we have more researchers engage in the research and more funding come into the field, it’s going to happen at a faster pace.