Repurposing a drug to prevent anaphylaxis to food allergens by reducing allergen absorption

Funded by Food Allergy Fund

Dr. Stephanie Eisenbarth and Dr. Adam Williams as Principal Investigators

To avoid potentially life-threatening anaphylaxis, individuals with food allergy must avoid the allergen(s) they are sensitized to. Treatment options to prevent anaphylaxis from accidental or therapeutic allergen ingestion remain limited. The goal of our lab is to identify new therapeutic interventions to prevent allergic reactions to food based on fundamental mechanistic studies.

While food-specific IgE is necessary for anaphylaxis, it is not sufficient; some individuals with food-specific IgE do not experience allergic symptoms upon ingesting the allergen(s) they are sensitized to. This unresponsive state has been termed “sensitized tolerant” and suggests that other factors, such as intestinal absorption of allergens, may play a role in symptomatic food allergy. It is important that allergens are absorbed in an intact form in order to be recognized by the immune system and trigger anaphylaxis. While most people absorb detectable levels of intact food allergens after ingestion, the amount varies person to person. We discovered that the degree of food allergen absorption correlates with anaphylaxis in a murine food allergy model and that this absorption could be reduced acutely with particular drugs. We propose that such drugs have the potential to prevent anaphylaxis in patients with food allergy. Although some of these agents are FDA-approved, they have not been used in patients with food allergy.

This Food Allergy Fund award will support a proof-of-concept study to determine whether intact food allergen absorption can be acutely reduced in adults with food allergy. Our study will enroll 21 adults and compare each participant’s absorption of an ingested protein allergen that they are not sensitized to with and without drug pre-treatment. This will enable us to determine whether we can block uptake of intact ingested proteins in humans. The outcome of this study will establish the rationale for a future intervention trial to determine whether we can prevent anaphylaxis in individuals with food allergy.