Vanderbilt University Medical Center has been awarded a seven-year, $5 million award to conduct food allergy research, joining nine other institutions as part of the Consortium for Food Allergy Research (CoFAR).
Researchers Leonard Bacharier, MD, the Janie Robinson and John Moore Lee Professor of Pediatrics and section chief for Pediatric Allergy and Immunology, and Rachel Glick Robison, MD, associate professor of Pediatrics within the Division of Pediatric Allergy, Immunology and Pulmonology, will serve as co-principal investigators for VUMC and Monroe Carell Jr. Children’s Hospital at Vanderbilt and establish a food allergy clinical research center.
CoFAR, established in 2005 by the National Institute of Allergy and Infectious Diseases, is a network of clinical research centers that work together to accomplish food allergy studies that are best carried out across multiple sites. The group looks at preventing and treating food allergies as well as understanding the biological mechanisms underlying food allergies.
“CoFAR is really the epitome of food allergy research in the United States, and to be a part of the 10 sites to carry out this work really puts Vanderbilt in a higher echelon for food allergy research,” Robison said.
Bacharier echoed her comment, adding that “Vanderbilt is now to be considered a leader in food allergy research. This is the place where people should want to come if they or their families have food allergies because you are accessing people who are on the cutting edge of the work being done to advance the field.”
The CoFAR funding further establishes Vanderbilt as a top food allergy center. In 2018, Monroe Carell and VUMC were named as part of the FARE Clinical Network — a research coalition of leading food allergy centers dedicated to the development of effective approaches to treatment while improving the quality of patient care.
Food allergies affect about 1 in 10 adults and 1 in 13 children in the United States. A food allergy is a medical condition in which exposure to certain foods triggers a harmful immune response, which can range from mild (itchiness, hives) to severe or life-threatening (difficulty breathing, throat tightening). While more than 160 foods are known to cause allergic reactions, the top nine most common food allergies are: peanuts, tree nuts, milk, egg, wheat, soybeans, shellfish, fish, and sesame.
Currently, there is no cure for food allergies. Avoidance is often the most effective management tool to prevent a reaction, though increasing availability of therapies for some allergens, like peanuts, is proving effective as an additional layer of protection in some individuals. Several of these therapies are offered at Vanderbilt, including an oral immunotherapy clinic for peanut allergies.
The consortium, which includes 10 clinical research centers and one leadership center, will collaborate to determine which specific large-scale clinical trials will be conducted networkwide in this cohort of CoFAR. Each site submitted proposals for what those studies could be, and they will be determined over the next year.
An example of a recent major study for CoFAR was the OUtMATCH clinical trial. Researchers found that treatment with omalizumab (Xolair) substantially increased the amount of peanut, tree nuts, egg, milk, and wheat that multifood-allergic children as young as 1 year could consume without experiencing an allergic reaction. The Food and Drug Administration approved Xolair for people with food allergy based on the study findings.
Bacharier said each site will also carry out a study at the local level as part of CoFAR. Vanderbilt researchers have proposed a clinical trial looking at alpha gal syndrome (AGS), initially studying it in adults. Alpha gal, known as the “red meat” allergy, is commonly contracted through a tick bite, most typically the lone star tick.
For the study, Vanderbilt has proposed feeding alpha-gal-free meat to adult participants. The goals would be to understand why some patients in tick-endemic areas develop clinically evident AGS after a bite, while others do not, and why the clinical expression of AGS is variable amongst patients and changes over time.
Other Vanderbilt researchers who will be involved in the CoFAR research are: Scott Smith, MD, MPH, Elizabeth Phillips, MD, Cosby Stone Jr., MD, MPH, and Edward Iglesia, MD, MPH.
Prior to being named to the latest CoFAR funding cycle, Vanderbilt became a study site for one of the consortium’s current studies, Systems Biology of Early Atopy, or SUNBEAM, which examines pregnant women and their offspring to understand before birth and beyond how food allergies develop. The national study of about 2,500 pregnant women aims to identify prenatal and early childhood markers of high risk for food allergy and atopic dermatitis, or eczema, as well as biological pathways that lead to these conditions. Bacharier, who is the lead site investigator for Vanderbilt’s role in SUNBEAM, says VUMC hopes to enroll about 200 pregnant women.