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Division Focus: UNC Food Allergy Initiative

For a growing number of people, the simple pleasures of enjoying a summer snack can pose problems ranging from a mild case of the hives to anaphylactic reaction requiring emergency medical attention. The UNC Food Allergy Initiative was founded in 2012 to provide research, patient care, and education for those dealing with this condition—more than 12 million people in the United States alone.

“I became interested in pediatric allergy and immunology during medical school and later residency,” says Wesley Burks, MD, executive director and principal investigator. “I had a mentor in this field whose passion for caring for patients exemplified everything that I wanted to emulate. Later, during my fellowship training, I helped take care of patients that had life-long allergic or immunologic diseases, which at the time had no treatment available. I was attracted to research in this field in order to try and change the way these patients are cared for.”

“Our research team was based at Duke for many years,” Dr. Burks continues. “Then in 2011, we had an opportunity to move to UNC Chapel Hill to be a part of this outstanding research community.” Brian Vickery, MD, also made the move to UNC and now is director of the program.

Food allergy is caused by an abnormal reaction of the immune system to one or more of the proteins in a food. While reactions to food—including such problems as heartburn—are common, true food allergies can develop into serious and life-threatening allergic reactions.

UNCFAI comes at this problem from two directions: basic science research and clinical research. Basic research involves analyzing biological specimens to better understand the allergic response and how it might be halted and even reversed.

Clinical research is the study of new medicines and treatments in order to see how well they work and whether they are safe. Many such studies are very small at the beginning; if the results seem promising, a larger study is conducted. But before any study can start, a panel of physicians, healthcare workers, and community members meet to assess the study’s safety. The Food and Drug Administration require these panels, called an Institutional Review Board. Deanna Hamilton, RN, Lauren Herlihy, NP, Jill French, RN, and Pam Steele, CPNP, coordinate these studies. Edwin Kim, MD, is the physician lead of the group.

The UNCFAI research lab features a tissue culture room and Good Manufacturing Practices (GMP) facility. Lab director, Mike Kulis, PhD, who has worked with Dr. Burks since 2006, oversees the daily operations of the lab, mentors trainees and helps determine the direction of the research projects.

The lab performs cellular and serologic studies on human samples from subjects enrolled in the OIT (oral immunotherapy) and SLIT (sublingual immunotherapy) clinical trials. This work aims to determine immunologic responses to allergens and then how these responses are altered with OIT and SLIT. Rishu Guo, MD, PhD, Xiaohong Yue, MS, and Huamei Zhang are the primary researchers working on these studies.

The GMP facility provides expertise in manufacturing the investigational drug products for the clinical trials. Ayeshia Beavers and Nicole Szczepanski weigh precise amounts of food proteins on analytical balances for OIT doses. They also prepare a liquid formulation of peanut proteins, which is administered in vials fitted with pumps in SLIT trials.

The lab also has trainees that perform novel research studies in their areas of interest. They include fellow, Ben Wright, MD, who is interested in the mechanisms of OIT and in developing new treatment approaches, such as encapsulating peanut proteins in nanoparticles for improved immunotherapy. Kelly Orgel is an MD/PhD student studying regulatory mechanisms that may be involved in suppressing allergic responses.

The UNCFAI has close to 200 active research participants currently enrolled in clinical trials. Though each study has unique research questions incorporated into the nuances of its design, most of our participants undergo a daily exposure to an allergen (peanut or egg) in the form of a “dose,” similar to the way we all talk about taking a dose of Tylenol or a dose of antibiotics. Participants take doses either through ingestion (mixing with a food and eating it), sublingually (placing drops under the tongue) or epicutaneously (placing a patch on the skin).

Additional Resources:

Food allergy symptoms and diagnosis

Food allergies Q&A 

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