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ChAllenging to Foods with Escalating ThrEsholds for ReducIng Food Allergy

挑战食品，提高减少食物过敏的阈值

基本信息

批准号：
10415891
负责人：
SCOTT H SICHERER
金额：
$ 40.71万
依托单位：
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-06-06 至 2023-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10415891
关键词：
Address Adult Affect Allergens Allergic Allergic Reaction Allergy to eggs Allergy to peanuts Biological Markers Biological Products Child Clinical Combined Modality Therapy Diagnostic Dose Eating Enrollment Evaluation Food Food Hypersensitivity Foundations Goals Grant Home Hypersensitivity Immune Immunologics Immunotherapeutic agent Immunotherapy Individual Ingestion Instruction Intervention Measurable Medical Milk Milk Hypersensitivity Nutritional Oral Participant Patients Periodicity Persons Phenotype Production Proteins Protocols documentation Quality of life Randomized Reaction Recovery Reporting Safety Sampling Schedule Severities Specimen Speed Supervision Sustainable Development Symptoms Target Populations Testing Visit allergic response base clinical care clinical practice cost desensitization dietary approach egg experience feeding food allergen food challenge intervention cost neglect nutrition omalizumab oral diagnostics oral immunotherapy personalized approach programs prototype reaction rate response side effect standard of care success

项目摘要

Project Summary/Abstract CAFETERIA Trial (Project 1) (ChAllenging to Foods with Escalating ThrEsholds for ReducIng Food Allergy). Food allergy affects up to 8% of children and approximately 5% of the adults, with serious consequences for quality of life and nutrition. Many current potential food allergy treatments under study address individuals who develop allergic reactions to very small amounts of the food, even trace amounts. However, not everyone with food allergy is exquisitely allergic. Based on studies of individuals undergoing diagnostic feeding tests, the majority experiencing allergic reactions develop symptoms after having ingested amounts that are often above an eighth of a teaspoon and usually much more. Currently, when a person with food allergy has an allergic reaction during a diagnostic feeding test, they are instructed to strictly avoid the food; this is standard clinical practice and is also a general instruction for anyone reporting allergic reactions to a food. Clinical care has not suggested, thus far, that allergic patients ingest “sub-threshold” amounts of food allergen (amounts below those causing symptoms). However, the notion that strict avoidance could speed recovery of a food allergy has been entirely reversed by the results of studies of oral immunotherapy (giving initially trace amounts of an allergen and gradually increasing) and a new practice of having persons with egg or milk allergy ingest these foods in bakery goods if they are able (a finding identified by our group in a prior AADCRC grant that resulted in a worldwide change in practice). Both of these approaches have shown that ingestion of the allergen, if tolerated, appears to increase the threshold of reactivity and may speed recovery. Here we use peanut allergy as a prototype. Our hypothesis is that ingesting escalating sub-threshold amounts of peanut will be safe, increase threshold, and may speed recovery of peanut allergy. The study will enroll children shown to have moderate peanut allergy during a feeding test and randomize them to continue avoidance or to ingest a small but easily measurable amount of the food, an amount below that which causes symptoms. These children will undergo periodic supervised feeding tests to see if the amount can be increased, and will be compared to those following the current standard of care, avoidance. In addition, study participants will have bio-specimens obtained for evaluation in two additional Projects in this Program to understand mechanisms and biomarkers that can inform a personalized approach to peanut allergy. If this approach is successful, it will fundamentally change the worldwide approach to peanut allergy management, for perhaps the majority of affected individuals, and can be implemented easily by allergists.

项目摘要/摘要自助餐厅试验（项目一）(对食品的挑战与升级