Reducing Risk: Blood Test May One Day Predict Severity of Allergic Reaction

Simon Hogan, Ph.D., is the Askwith Research Professor of Food Allergy at the Mary H. Weiser Food Allergy Center and an experimental pathologist. He conducts research with other investigators in the center and also heads up his own studies on the most serious — and possibly deadly — reaction to food allergy: anaphylaxis. Here he answers seven questions about his work.

Simon Hogan, Ph.D., with a pipette
Simon Hogan, Ph.D., is the Askwith Research Professor of Food Allergy at the Mary H. Weiser Food Allergy Center.

What area of food allergy are you currently investigating?

Our focus is to better understand the immunological processes that contribute to severity of food-induced anaphylaxis. Currently, there are blood tests available to predict whether you may have a reaction to a specific food; however, there is no test available to predict with accuracy the severity of your reaction to that food. If we better understood the underlying processes that contribute to severity of food-induced anaphylaxis, we could design and develop a blood test to predict the severity of the reaction, and also design and develop ways to prevent a severe reaction from occurring in the first place.

Why are you passionate about this area of research?

Initially, it was the scientific intrigue of understanding the immune pathways that underlie food allergic reactions. However, over the years I have had the opportunity to meet with many families and children who are impacted by this disease, and heard of their daily struggles related to what foods they can and cannot eat, and the psychological and social challenges wrapped around accidental exposure and lifestyle. These challenges in a world where there’s no FDA-approved therapy for food allergy I felt were unacceptable and highlighted the real urgency for better understanding of food allergies. It is my belief that with this knowledge we will be able to develop targeted therapies for food allergy and change the outcome for food allergy sufferers.

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

One big concern for food allergic sufferers is accidental exposure. Food allergy sufferers are constantly concerned about what will be the context of the environment and accessibility to treatment in the event of an accidental exposure. If we are able to develop therapeutics that may not necessarily prevent a food allergic reaction, per se, but could prevent a severe life-threatening reaction from occurring after accidental exposure, we believe this would provide significant comfort for families of food allergy sufferers and enable them to life a fulfilling life.

Secondly, a good number of emerging therapies (oral immunotherapy-OIT) are based around exposure to the allergic foods. One of the concerns associated with this type of therapeutic approach, whereby an individual is exposed to the eliciting food, is the induction of a food-allergic reaction. Many food allergy individuals suffer from anxiety and apprehension in utilizing these effective therapies because of the possibility of having a reaction. It is our belief that the development of therapeutics that could prevent a severe reaction may be used as adjunctive therapy with the eliciting food during OIT that could alleviate concerns and the anxiety about having a severe reaction during treatment.

What results have you found so far?

We recently have been able to identify several immune mediators that seem to modify the severity of food-induced anaphylaxis. We have been able to show in these experimental systems that blocking the function of these immune mediators reduces the severity of a food-induced anaphylactic reaction.

“It is my belief that with this knowledge we will be able to develop targeted therapies for food allergy and change the outcome for food allergy sufferers.”

Simon Hogan, Ph.D.

What is the significance of these results?

While we have more research to do to fully understand how these immunological processes regulate food-induced anaphylaxis, we believe these exciting observations provide great hope that one day we will be able to use a therapy that could prevent a severe reaction from occurring, following exposure to the food.

What direction do you see your research taking in the future?

Our recent studies have identified an important contribution for blood vessels in the severity of food-induced anaphylaxis. Our next step is to focus on how these immune mediators that are released during a food-allergic reaction communicate to the blood vessels and alter the severity of the food reaction.

What do you wish people understood about your research?

The time it takes to do discovery research. We are intensely focused day in and day out on trying to better understand food-induced anaphylaxis. Developing the hypothesis, designing and developing experimental systems to test the hypothesis, performing the experiments that test the hypothesis and to interpret the datasets — all of this takes a significant period of time and money.

I also think it’s also very important to acknowledge the selflessness of the great scientists and physician scientists of the past. Mast cells were discovered by Dr. Paul Ehrlich in 1879 and IgE in 1966-1967 by two independent groups from Denver, Colorado and Uppsala, Sweden.

Because of these important initial discoveries, we now know a lot about the individual cells and immune molecules involved in atopy and food allergy; IgE, mast cells, histamine, histamine receptors, interleukin-4, for example, because of their efforts.

The gap in knowledge and our challenge is to understand how do all these individual components come together in a sequence of events to cause a severe food-induced reaction.

It is my belief that in a somewhat reduced timeframe, we can contribute to this understanding, which I am confident will lead to the development of sustained and effective therapies for food allergy sufferers.