FARE is the largest private source of funding for food allergy research. Below you can read about some of FARE’s research grants that are currently underway, as well as findings from selected FARE research grants that have been completed.
- Determine the genetic underpinnings of food allergy;
- Understand the immune mechanisms that lead to allergic reactions to food;
- Develop general, highly effective treatments for patients with food allergies, based on scientific findings; and
- In the longer term, develop methods to prevent food allergy in at least a portion of susceptible children.
Current Research Grants
FARE Investigator in Food Allergy Awards
The FARE Investigator in Food Allergy Awards provide salary and research support over a two- to five-year period, allowing outstanding new and mid-career investigators to direct, or redirect, their career toward the study of food allergy, including the development of theories, tools, methods or approaches to advance food allergy research. Since the program’s launch in 2015, three new investigator awards and five mid-career investigator awards have been announced.
2017 Mid-Career Investigator Award Recipients
Robert Anthony, PhD
Massachusetts General Hospital and Harvard Medical School (Boston)
Dr. Anthony is examining the role of antibody glycosylation – the addition of sugar molecules to antibody proteins – in promoting or limiting allergic reactions.
Stephanie Eisenbarth, MD, PhD
Yale School of Medicine
By studying a rare, inherited sensitivity to food allergens, Dr. Eisenbarth is searching for insight into mechanisms that underlie food allergies in the general population.
2015 New Investigator Award Recipients
Jessica O’Konek, PhD
University of Michigan (Ann Arbor)
Dr. O’Konek is researching the modulation of food allergy responses with nanoemulsion-based allergy vaccines, exploring the possibility of providing protection against anaphylaxis with intranasal administration of nanoemulsion combined with egg or peanut antigens.
Duane Wesemann, MD, PhD
Brigham and Women’s Hospital (Boston)
Dr. Wesemann seeks to identify the extent to which primary Ig repertoires can be influenced by microbial and dietary exposures early in life and examine how modification of these exposures can reduce the allergic response to food.
2015 Mid-Career Investigator Award Recipients
Simon Hogan, PhD
Cincinnati Children’s Hospital Medical Center
Dr. Hogan’s work focuses on identifying the key proteins and cells that cause the blood vessel fluid leak leading to severe anaphylaxis triggered by foods. This knowledge will have important implications for developing new treatment strategies and therapeutics for preventing the development of severe, life-threatening food reactions.
Michiko Oyoshi, PhD
Boston Children’s Hospital and Harvard Medical School
Dr. Oyoshi is examining the role of maternal antibodies transferred to babies through breast milk in inducing oral tolerance in children. This study may support potential beneficial effects of maternal allergen exposure during pregnancy and lactation on protecting babies from food allergy.
Erik Wambre, PhD
Benaroya Research Institute (Seattle)
Dr. Wambre investigates the specific T cell responses to peanut allergic components to determine the cellular and molecular mechanism associated with peanut sensitization, as well as those that lead to restoration and maintenance of protective responses.
Select Active Grants
Edwin Kim, MD and Wesley Burks, MD
University of North Carolina School of Medicine, Chapel Hill, NC
Drew Bird, MD
UT Southwestern Medical Center, Dallas, TX
Grant title: Peanut sublingual immunotherapy trial
Dr. Burks’ previous studies on sublingual immunotherapy (SLIT) and oral immunotherapy (OIT) for peanut have shown that both approaches can desensitize most patients to a degree that is likely to prevent allergic reactions after accidental ingestion. However, while SLIT appears to be far safer than OIT, it produces a less robust desensitization effect. The long-term objective of this study is to develop a safe and effective treatment for peanut allergy that will enable patients to develop tolerance. To that end, this study of 48 patients aims to determine whether 36 months of treatment with peanut SLIT will result in clinical tolerance. It also seeks to define the changes in the body’s immune system that lead to tolerance. The research team hopes that this study will provide a strong scientific basis for the development of SLIT and other treatments that aim to produce long-term clinical tolerance to peanuts and other foods.
Stacie Jones, MD
Arkansas Children’s Hospital, Little Rock, AR
Grant title: Walnut oral immunotherapy in tree nut-allergic children and adults
Patients with tree nut allergy are typically allergic to multiple tree nuts (walnuts, almonds, cashews, etc.) and most retain their allergy for a lifetime. The participants in this study are allergic to walnut and at least one other tree nut. Dr. Jones and her team hypothesize that walnut oral immunotherapy (OIT) will reduce the severity of these patients’ response to multiple tree nuts (desensitization). This study seeks to whether walnut protein OIT can desensitize patients to walnut, whether walnut protein OIT can desensitize patients to other tree nuts and whether this therapy promotes tolerance – that is, can it produce changes in the immune system that might allow patients to safely eat problem foods, even after treatment is discontinued?
Hugh A. Sampson, MD
Icahn School of Medicine at Mount Sinai, New York, NY
Grant title: Oral immunotherapy for wheat allergy
Wheat is a common cause of food allergy in infancy and childhood. Since wheat is widely used in westernized diets, strict avoidance is very common and accidental ingestions are frequent. Studies of oral immunotherapy (OIT) for milk, egg, and peanut allergy have shown promising results, although adverse reactions are not infrequent. This study is evaluating the safety and effectiveness of OIT for wheat allergy. Four centers are participating in this study: Mount Sinai, Johns Hopkins School of Medicine (Baltimore, MD), Lurie Children’s Hospital (Chicago, IL), and Stanford University School of Medicine (Stanford, CA). Enrollment is complete; FARE will provide results when available.
Fred Finkelman, MD
University of Cincinnati College of Medicine/Cincinnati Children’s Hospital Medical Center
Grant title: Rapid suppression of food allergy with anti-FceRI antibody
Dr. Finkelman and his team are developing a potential new therapy that could rapidly and safely suppress food allergies. They have developed a monoclonal antibody, a special type of antibody that is grown in the laboratory. The monoclonal antibody targets specific cells that are responsible for the symptoms of a food allergy reaction. It deactivates these cells, making them harmless. In a previous study, the researchers were able to suppress food allergies in mice over a period of weeks. Their FARE-funded study will enable them to continue their work in mouse models with the goal of adapting the treatment to humans and making it work faster – possibly within 24 hours. If successful, this treatment could be applied to all food allergies, and possibly to other allergic diseases, such as skin allergies. This treatment would be especially beneficial to individuals with difficult-to-treat multiple food allergies, since it would allow physicians to desensitize these patients to all of their allergens at the same time. If this study, which is also funded by NIH, is successful, the next step will be testing in a primate model, which could lead to a Phase 1 clinical trial in humans.
Described below are a selection of FARE-funded studies that are notable for their impact on the field or that provide particularly valuable information for individuals and families who are living with food allergies. While we associate these grants with their principal investigators, it’s important to recognize that the work described below is accomplished by research teams
LEAP and LEAP-On Studies: Effects of Early Peanut Consumption on Peanut Allergy Prevalence
Gideon Lack, MD
King’s College London, UK
Randomized Trial of Peanut Consumption in Infants at Risk for Peanut Allergy (LEAP Study)
New England Journal of Medicine, February 2015
The LEAP (Learning Early About Peanut Allergy) study was primarily co-funded by the National Institutes of Health (NIH) and FARE. The results of this study, published in February 2015 in the New England Journal of Medicine, showed that sustained consumption of a peanut-containing snack by babies at high risk for developing peanut allergy prevented them from researchers tested the hypothesis that foods containing peanut – if started during the first year of life – could elicit a protective immune response rather than an allergic reaction. More than 600 children between 4 months and 11 months of age were enrolled in the LEAP study to compare the likelihood of developing peanut allergy in children who either ate or avoided peanut until the age 5. All of the infants in the study were considered at high risk for developing peanut allergy because they had severe eczema and/or egg allergy. Peanut consumption achieved an 86 percent reduction in peanut allergy at age 5 among children who had negative skin prick tests to peanut at study entry, and a 70 percent reduction in peanut allergy among those who were sensitized to peanut (positive skin prick test) at the beginning of the study.
Effect of Avoidance on Peanut Allergy after Early Peanut Consumption (LEAP-On)
New England Journal of Medicine, April 2016
The LEAP-On study followed children from the LEAP study’s peanut-consuming and peanut-avoiding groups for an additional year, during which all of the children avoided peanut. Results showed that allergy prevalence did not increase significantly when children ate peanut until their fifth birthday and then stopped eating peanut until age 6. After a year of peanut avoidance, 4.8 percent of LEAP-On participants that previously ate peanut had developed peanut allergy. In comparison, peanut allergy prevalence among LEAP-On participants who had avoided peanut since infancy was 18.6 percent.
The strength of the LEAP and LEAP-On findings led to a revision in clinical guidelines for how and when parents should introduce peanut-containing foods to their infants. The new peanut introduction guidelines were released by the National Institute of Allergy and Infectious Diseases in early 2017.
Other Completed Grants
Wesley Burks, MD
University of North Carolina School of Medicine, Chapel Hill, NC
Grant title: Oral immunotherapy for peanut-allergic patients
According to a national prevalence study funded by FARE, peanut allergy is the most common food allergy in U.S. children under 18. Oral immunotherapy (OIT) may prevent life-threatening reactions in these children. During OIT, patients ingest small but steadily increasing doses of a food allergen until they are desensitized to that food. The ultimate goal is to teach the person’s immune system to tolerate the allergen.
Dr. Burks’ study had two aims. First, he and his team used peanut OIT to try to lower the risk of anaphylactic reactions by raising the threshold dose needed to cause an allergic reaction. Second, they wanted to determine whether or not this new treatment can permanently change the peanut-specific immune response in peanut-allergic patients. The results suggested that most children can be desensitized to peanuts if they respond well to the initial treatment and do not have significant allergic gastrointestinal effects. The data also showed significant immunological changes. However, the development of long-term tolerance is still under active investigation. It is important to note that, while this treatment is promising, additional studies must be conducted before it is ready for clinical use.
Ruchi S. Gupta, MD, MPH
Northwestern University Feinberg School of Medicine/Lurie Children’s Hospital, Chicago, IL
The Prevalence, Severity, and Distribution of Childhood Food Allergy in the United States
Pediatrics, July 2011
Prevalence studies pinpoint how many people in a population have a specific disease at a given time. This national survey of 38,480 families was the largest study ever conducted on the prevalence of food allergies in U.S. children. Dr. Ruchi Gupta and colleagues collected extensive information on each food allergy reported, including date of onset, method of diagnosis, and reaction history. Data on race and ethnicity, gender, socioeconomic status, and geographic region were also collected.
Key findings include:
- An estimated 5.9 million U.S. children – eight percent, or roughly two in every classroom – have a food allergy
- 38.7 percent of the children in the survey had a severe or life-threatening allergy
- 30.4 percent had multiple food allergies
- Children with food allergies were most commonly allergic to peanuts (25.2 percent), milk (21.1 percent) and shellfish (17.2 percent), followed by tree nuts (13.1 percent), and egg (9.8 percent)
- Severe reactions were most common among children with a tree nut, peanut, shellfish, soy, or fin fish allergy
- Children aged 14-17 years were most likely to have a severe food allergy
- Food allergies affected children in all geographic regions
- Asian and African American children were more likely to have a convincing history of food allergy, but were less likely to receive a formal diagnosis when compared to white children
Geographic Variability of Childhood Food Allergy in the United States
Clinical Pediatrics, September 2012
Children living in urban centers have a much higher prevalence of food allergies than those living in rural areas, according to this FARE-funded study conducted by Dr. Ruchi Gupta and colleagues. In particular, children in large cities are more than twice as likely to have peanut and shellfish allergies compared to those in rural communities. This data suggests that environmental factors play a role in the development of food allergy.
This study, the first to map children’s food allergies by geographical location in the United States, included 38,465 children, 18 years and under, who comprised a representative sample of U.S. households. Their food allergies were mapped by ZIP code. Key findings include:
- In urban centers, 9.8 percent of children had food allergies, compared to 6.2 percent in rural communities, almost a 3.5 percent difference.
- Peanut allergies were twice as prevalent in urban centers as in rural communities, with 2.8 percent of children having the allergy in urban centers compared to 1.3 percent in rural communities.
- Shellfish allergies were more than twice as prevalent in urban versus rural areas: 2.4 percent of children have shellfish allergies in urban centers compared to 0.8 percent in rural communities.
- The states with the highest overall prevalence of food allergies were Nevada, Florida, Georgia, Alaska, New Jersey, Delaware, Maryland and the District of Columbia.
The study controlled for household income, race, ethnicity, gender and age. It tracked food allergy prevalence in urban centers, metropolitan cities, urban outskirts, suburban areas, small towns and rural areas.
The Economic Impact of Childhood Food Allergy in the United States
JAMA Pediatrics, November 2013
Childhood food allergy results in significant direct medical costs for the U.S. health care system and even larger costs for families with a food-allergic child. To determine the economic impact of childhood food allergy on families, 1643 U.S. caregivers of a child with a current food allergy were surveyed between November 28, 2011 and January 26, 2012. The caregivers were asked to quantify the direct medical, out-of-pocket, lost labor productivity, and related opportunity costs. As an alternative means of valuing the cost of food allergies, the caregivers were asked their willingness to pay for an effective food allergy treatment. Key findings include:
- The overall economic cost of food allergy was estimated at $24.8 billion per year. This equates to $4184 per year per child.
- Direct medical costs were $4.3 billion annually, including clinician visits, emergency department visits, and hospitalizations.
- Costs borne by the family totaled $20.5 billion per year.
- Annual lost labor productivity costs of $0.77 billion were reported, representing time off from work for medical visits.
- Out-of-pocket costs were $5.5 billion annually, of which roughly one-third represents the cost of special foods.
- Opportunity costs relating to a caregiver needing to leave or change jobs totaled $14.2 billion per year.
- Caregivers reported a willingness to pay of $20.8 billion annually – $3504 per year per child – for food allergy treatment.
Kari Nadeau, MD, PhD
Stanford University, Stanford, CA
Safety and feasibility of oral immunotherapy to multiple allergens for food allergy
Allergy, Asthma & Clinical Immunology, January 2014
Thirty percent of food-allergic children suffer from more than one food allergy, and those with multiple food allergies are three times more likely to have severe food allergy. Multiple food allergies also pose greater economic, nutritional and social burdens on patients and their families. Studies specifically evaluating OIT to multiple food allergens have not yet been performed to address this important need.
The concept of simultaneous introduction of multiple offending allergens is not new. Subcutaneous multiple allergen immunotherapy (“allergy shots”) has been safely and effectively used for environmental allergens, such as hay fever, for more than a century.
In this study, researchers showed that participants allergic to multiple foods can be safely desensitized to up to five foods simultaneously using a modified OIT protocol. Safety measurements were the primary endpoint of this study, which found that multiple allergen OIT may be feasible and relatively safe when performed in a hospital setting with trained personnel. The authors note that larger, randomized studies are required to continue to test safety and efficacy of multiple allergen OIT.
Scott H. Sicherer, MD, PhD
Mount Sinai School of Medicine, New York, NY
U.S. Prevalence of Self-Reported Peanut, Tree Nut, and Sesame Allergy: 11-Year Follow-Up
Journal of Allergy and Clinical Immunology, June 2010
In the U.S., peanut and tree nut are among the most common causes of fatal and near-fatal reactions to food. This was the third of three studies, conducted at five-year intervals by Dr. Scott Sicherer and colleagues, which examined peanut and tree nut allergy prevalence in the U.S., that is, how many people in the U.S. have peanut or tree nut allergy at a given time. The results of all three studies were published in the Journal of Allergy and Clinical Immunology (JACI).
In 1997, following a first national phone survey, the researchers concluded that peanut and tree nut allergies represented “a significant health concern.” The follow-up study, conducted in 2002, showed that the rate of peanut and tree nut allergies had not increased significantly in adults. However, peanut allergy had doubled among children during the previous five years. Subsequent studies in the United Kingdom and Canada also showed a high prevalence of peanut allergy in schoolchildren
With the passage of another five years, Dr. Sicherer and his colleagues used the same methodology as in the previous studies to take another look at the prevalence of peanut and tree nut allergies in the U.S. They surveyed 5,300 households — more than 13,500 individuals — and compared the results to the earlier surveys. Among other important data, this follow-up study showed that, while the prevalence of peanut and tree nut allergies remain steady among adults, peanut allergy in children more than tripled from 1997 to 2008. The rate of childhood tree nut allergy also increased, from 0.2% in 1997 to 1.1% in 2008.
Both this study and the 2002 project were funded by FARE; the most recent study was co-funded by the National Institutes of Health (NIH).
Xiaobin Wang, MD, ScD, MPH
Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
Genome-Wide Association Study Identifies Peanut Allergy-Specific Loci and Evidence of Epigenetic Mediation in U.S. Children
Nature Communications, February 2015
Johns Hopkins University Bloomberg School of Public Health (Baltimore, MD) and Lurie Children’s Hospital/Northwestern University Feinberg School of Medicine (Chicago, IL) formed a consortium to conduct research and publishes manuscripts on food allergy and related conditions, using data from the Children’s Memorial Food Allergy Study, representing about 1300 families (biologic parents and food-allergic child). The investigators also analyzed data from the Boston Birth Cohort (8,500 mother-infant pairs) and the Chinese Twin Cohort (2,000 twin pairs). The overarching goal of the project was to discover causes of food allergy relating to genetics, epigenetics (that is, gene modifications) and gene-environment interactions.
The investigative team published the first large-scale genome-wide association study of food allergy. This work revealed that genetic variants in the HLA-DR and HLA-DQ regions confer significant risk of peanut allergy. This genetic effect may be mediated by altered DNA methylation of the HLA-DQB1 and HLA-DRB1 genes.
Robert A. Wood, MD
Johns Hopkins University, Baltimore, MD
A Randomized, Double-Blind, Placebo-Controlled Pilot Study of Sublingual Versus Oral Immunotherapy for the Treatment of Peanut Allergy (sublingual vs. oral immunotherapy)
Journal of Allergy and Clinical Immunology, May 2015
Previous studies have shown that both sublingual immunotherapy (SLIT) and oral immunotherapy (OIT) are promising treatments for peanut allergy. However, additional studies are needed to further evaluate the safety and effectiveness of these therapies, and to understand the mechanisms of desensitization and tolerance.
During SLIT, the food allergen is administered under the tongue. During OIT, patients ingest the allergen, which is administered as a powder that is mixed with a harmless food. In this study, partially funded by FARE, Dr. Wood and his team set out to compare the safety, efficacy and mechanistic correlates of peanut OIT and SLIT. Study participants were randomized to receive active SLIT/placebo OIT or active OIT/placebo SLIT. After unblinding, therapy was modified per protocol to offer an additional six months of therapy. Researchers concluded that OIT appeared far more effective than SLIT for the treatment of peanut allergy but was also associated with significantly more adverse reactions and early study withdrawal. Sustained unresponsiveness after four weeks of avoidance was seen in only a small minority of subjects.