Administrative Core

在过去的20年里，由IgE介导的食物过敏的流行率有所增加，现在食物过敏 影响3.5%到4%的美国人口，仅花生过敏一项就是导致 在美国，严重和致命的食物引起的过敏反应，影响了150万美国人，并且翻了一番 在过去的十年中，幼儿的患病率很高。这一增长的原因尚不清楚，但很明显 目前预防花生过敏和严重过敏反应的策略 意外摄入花生后不起作用。同样，嗜酸性食管炎(EE)，主要是 一种儿童食物过敏障碍的患病率有所上升，其潜在机制是 认识不足，在预防和治疗方面的努力也不令人满意。 五年前，一个由来自五所大学的调查人员组成的联盟成立了一个调查小组 Ig E介导的牛奶、鸡蛋和花生过敏的自然历史和潜在的免疫学机制， 并测试新型重组花生蛋白疫苗EMP-123的效力。为了完成 为了实现这些目标，建立了一个明确的行政结构。尽管生产问题 推迟EMP-123的供应，行政核心能够有效地指导观测 研究并启动了3项免疫治疗试验。在这里提出的扩大财团中， 行政核心将继续协调和促进研究地点、NIAID和 SACC，并优化努力，研究与自然 我们已建立的队列中食物过敏的病史，完成正在进行的花生狭缝试验，并评估 另外两种治疗策略的疗效。随着新站点的增加，管理核心 将致力于调查食物过敏在EE中的作用，比较和对比自然历史 EE的免疫学和遗传学标记与IgE介导的食物过敏的免疫和遗传标记。 凭借其已证明的成功记录，这个新财团的综合资源提供了 这是解决这些日益严重的疾病的根本原因的独特机会。

The prevalence of IgE-mediated food allergy has increased over the past 2 decades and food allergy now affects 3.5% to 4% of the U.S. population, and peanut allergy alone, which is the single leading cause of severe and fatal food-induced allergic reactions in the US, affects 1.5 million Americans and has doubled in prevalence in young children in the past decade. The reasons for this increase are unknown, but it is clear that current strategies for preventing the development of peanut allergy and the severe allergic reactions following accidental ingestion of peanuts are not effective. Similarly, eosinophilic esophagitis (EE), primarily a food hypersensitivity disorder in children, has increased in prevalence, its underlying mechanisms are poorly understood and efforts at prevention and treatment are unsatisfactory. Five years ago a Consortium consisting of investigators from five universities was formed to investigate the natural history and underlying immunologic mechanisms of IgE-mediated milk, egg and peanut allergy, and to test the efficacy of a novel recombinant peanut protein vaccine, EMP-123. In order to accomplish these objectives, a well-defined administrative structure was established. Although production issues delayed the availability of EMP-123, the Administrative Core was able to effectively directe the observational study and initiated 3 immunotherapeutic trials. In the expanded Consortium proposed here, the Administrative Core will continue to coordinate and facilitate interactions between study sites, the NIAID and SACC, and to optimize efforts to investigate basic immunologic mechanisms associated with the natural history of food allergy in our well established cohort, complete a Peanut SLIT trial underway, and evaluate the efficacy of two additional therapeutic strategies. With the addition of a new site, the Administrative Core will direct efforts to investigate the role of food allergy in EE, comparing and contrasting the natural history and immunologic and genetic markers of EE with those of IgE-mediated food allergy. With its demonstrated record of success, the combined resources of this new Consortium provide a unique opportunity to address the underlying basis of these growing disorders.