FaCES – Filaggrin and the Cutaneous Environment Study
The prevalence of peanut allergy is rising with 1.7% of Canadians affected. Both atopic dermatitis (eczema) and mutations in filaggrin, an important protein involved in maintaining a healthy skin barrier, are significant risk factors for peanut sensitization and allergy. This suggests that the skin barrier may play an important role in allergic sensitization. Our project examines the effects of direct exposure of peanut protein on the skin of peanut-allergic individuals performed via patch testing. Biological outcomes include the evaluation of inflammatory mediators and changes in skin group 2 innate lymphoid cells.
8th Annual Allergy/Asthma Information Association and CAAIF Award for Ontario Research in Food
DR. ANNE ELLIS
Study of molecular pathways regulating severe asthma in women
Dr. Solomon’s research examines the mechanism(s) of action of inhaled glucocorticosteroids (GC), the main treatment for asthma. Severe asthmatics do not respond well to GC and have persistent symptoms despite being prescribed high doses. Previous work by Dr. Solomon’s research group found that severe asthmatic women have more T helper 2 lymphocytes (Th2 cells) in their blood than men with a similar degree of symptoms, suggesting Th2 cells may exhibit sex-specific differences in responsiveness to GC. The objective of the project is to understand how GCs regulate Th2 cells and whether these mechanisms are influenced by estrogen signaling, an important female hormone. This work will determine whether estrogen interferes with the efficacy of GC. If so, our findings will launch further studies to assess whether sex-specific approaches for treating asthma should be developed.
CAAIF/AllerGen NCE Inc. Research Fellowship Award in Clinical Immunology and Allergy
DR. LAUREN SOLOMON
Estimating health state utility values for food allergy in Canada
As new interventions are being developed to manage and treat food allergy, policy-makers will need to decide whether to invest the required resources in this area. Compared to other diseases, food allergies carry a relatively low direct health cost (relatively few hospitalization, ER visits or deaths and low cost of medication with avoidance), its burden stemming mainly from its impact on the quality of life (QoL) of affected families. While the associated increased hypervigilance, anxiety and social restrictions are effectively captured using classical disease-specific quality of life questionnaires, these cannot be translated into monetary terms that can be used to build a proper economical argument for public coverage of new food allergy programs.
We are currently developing a food-allergy specific algorithm for calculating quality-adjusted life-years (QALY) as a mean to quantify the loss of quality of life with food allergy, to be used in cost-utility analyses for food allergy interventions. QALY are a widely accepted instrument for measuring cost-effectiveness of interventions affecting QoL. Lack of QALY measures has been identified by the latest EAACI food allergy guidelines as a major gap in knowledge and a priority for future research endeavours.
The study consists in a four part questionnaire including discrete-choice experiment and time-trade-off exercises asking responders to ponder and rate various health states, to determine their values based on patients’ preferences. The questionnaire will be administered to 1080 food allergic patients across 4 age groups. The algorithm built from this study will then be used to translate results of currently used food allergy questionnaires into QALY, thus establishing an objective value for food allergy treatments for government and policy makers to use. This is critical to allow the transfer of new clinical innovations to real-world practice.
CAAIF Research Grant
DR. PHILIPPE BÉGIN
Genetic variation in CRTh2 influences Th2 cell function and response to medication
Asthma is a multi-factorial disease mediated by Th2 cells and their products. Development and severity of asthma are influenced by our genetics and environmental exposures. Our CAAIF funded study will examine how a genetic variation of CRTh2, an important allergy-related gene, influences Th2 cell function and response to medication. We expect that Th2 cells with this CRTh2 variant will require higher doses of medication to suppress their activity. If so, future work will focus on studying the role of this CRTh2 variant in asthma and in optimizing asthma care.
CAAIF Research Grant
DR. LISA CAMERON
Food allergy and anaphylaxis: a knowledge mobilization event
The free public event “Back to School with Food Allergies” hosted at Winnipeg’s well-known McNally Robinson bookstore occurred several weeks before the start of school. The event presented a diverse panel of speakers: a parent of a child with life-threatening food allergies, a food allergy nurse educator, a pediatric allergist, a psychologist and a URIS (unified referral and intake system) coordinator. URIS is a provincial program that supports health needs of children in the community. Each speaker provided their own unique perspective, but all shared the common goal of keeping children with food allergies safe.
The event was engaging and attended by healthcare professionals, parents, children, teachers and other caregivers. The session started with new findings from a study on parents’ experiences with using an epinephrine auto-injector for their child’s anaphylactic reaction. This recent study suggested that parents are faced with a multitude of emotions after their child is diagnosed with a food allergy and they feel very scared and alone. Parents described feelings of relief and reinforcement after witnessing the effects of using an epinephrine auto injector.
This engaging and interactive event allowed the public to ask questions that furthered their interest and understanding of food allergies. Stimulating conversations included the challenges with eating at restaurants, travel, and school environment, as well as how to deal with fear and anxiety. The conversation about the decision for schools not to stock epinephrine auto-injectors was debated and became the impetus for a mother of a child with food allergy to formally raise this concern with the municipal government to allow epinephrine auto-injectors to be kept in all Manitoba schools.
This valuable evening of networking and discussion highlighted the challenges faced by parents, caregivers and children with food allergies, and hopefully will stimulate further involvement of the broader community.
Allied Health Grant
MS. RISHMA CHOONIEDASS
Needs assessment for food allergy education of school-age students, families, teachers and school staff
Allergic reactions to foods occur in up to 25% of schools. The CSACI Consensus Statement on Anaphylaxis in Schools and Community Settings recommends that the ENTIRE SCHOOL COMMUNITY understand the avoidance strategies, anaphylaxis plans, and emergency protocols and training.
We are evaluating food allergy awareness and education in Winnipeg elementary schools. We have obtained permission from some school divisions to contact the school principals. The principals invite students, caregivers, teachers and school staff to complete a brief, anonymous online survey about food allergy withintheir school so that we can learn about their experiences and education needs. In particular, we have approached students and parents of students WITHOUT food allergies, recognizing the importance of their contribution to keeping children with food allergies safe at school.
We are focusing on questions that evaluate:
Potential positive (e.g. increased sense of responsibility) and negative (e.g. restrictions about bringing food to school and bullying) IMPACTS of food allergy on school-age children and their families
Information about WHO in the school community will benefit from teaching
Information about WHAT needs to be taught
Our immediate goals are to identify gaps in food allergy education in schools and specific areas where food allergy awareness and education may be improved.
Our long term goals are to provide optimal food allergy management guidance to existing school educational programs and to help reduce the burden of food allergies on students, families and schools.