by Kate Kruschwitz
Shock. It describes Denise Bunning's state as she watched her 6-month-old son, Bryan, take his first sip
of infant formula. It also describes Bryan's violent allergic response—
anaphylactic shock. His eyes rolled back, his lips and tongue swelled and he nearly stopped breathing. Still in her nightgown, Denise rushed him from their Chicago high-rise to her nearby pediatrician, where emergency treatment saved his life.
Bryan's milk, egg and nut allergies—and, later, his baby brother Daniel's—drastically altered the family's life and motivated Denise, a former teacher,
and her husband, David, a former hedge fund manager, to seek answers. In 2002, they created the Food Allergy Foundation, whose recent $3.5 million gift to Children's Hospital Boston promises to change the prognosis for the 11 million children and adults suffering from food allergies. Thanks to the Bunnings' vision, Children's Division of Allergy and Immunology is poised to unravel the mysteries
of this deadly, disabling and poorly
With food-induced anaphylaxis in children and adults responsible for 150 to 200 deaths a year, David and Denise learned to be vigilant. Knowing that a single bite of the wrong food can be fatal affects grocery shopping, family meals, birthday parties, school lunches and restaurant trips. It means living with unremitting stress and fear. To help cope, Denise formed the first food allergy support group in Illinois in 1997—and watched Chicago-area membership
burgeon to 250 families.
Researcher Dale Umetsu, MD, PhD, and his colleagues in the
Division of Allergy and Immunology, headed by Raif Geha, MD, are studying the combination of genetic and environmental factors that trigger inappropriate—and deadly—immune responses to harmless proteins in food. At least a dozen genes are suspected of having a role in food allergies and related diseases. How individual genes are engaged and how they collectively activate an allergic response is a complex puzzle Children's investigators are putting together, one piece at a time. Their strategy is to attack and neutralize immune system disorders at cellular and molecular levels—and they've already discovered important clues about the origin of allergies.
But it wasn't just a local phenomenon. A national school nurse study, which the Bunnings funded, showed food allergies affect an average of 10 children in every
elementary school in the United States. "It's an epidemic no one really understands," asserts David. "And it developed so fast, there's been no time for organization. To find effective treatments and cures, the federal government must get involved. Currently the National Institutes of Health (NIH) allocates $40 million annually to asthma, but only $8 million to food allergy. We'd like to change that."
The Bunnings' Food Allergy Project raises awareness among lawmakers and the public through advocacy and education. It also awards grants for promising research. "By priming the pump with private funding, we hope to attract NIH support for allergy research," says David. "That's our ultimate goal." The Bunnings are counting on Children's researcher Dale Umetsu, MD, PhD, one of the world's foremost experts in allergic diseases, to speed that breakthrough.
"Previously, our food allergy research had been part of a broader look at the immunobiology of allergies in general," says Umetsu. "The Bunnings' start-up money allows us to sharpen the focus on food allergy—and boost it to the next level." This gift helps develop the division's infrastructure by enabling Children's to acquire the latest analytical equipment and provide support for young, talented investigators. It will accelerate current research and allow for pilot studies. "To develop good therapies, we need to understand the basic science—what causes allergies and what prevents them in non-allergic people," Umetsu says. "We can draw on Children's large patient population for more extensive study, comparing individual immune systems at the cellular and genetic level. This is key to understanding why food allergies have become so widespread."
One of the most promising research areas aims to "reverse" allergies by developing treatments or vaccines that either
stimulate a "normal" response or block an inappropriate immune response. For example:
Umetsu and colleagues were the first to identify a four-member family of genes—T-cell immunoglobulin mucin (TIM) —that plays a critical role in the development of allergy and asthma. One family member, ethe TIM-1 gne, shows a special interaction with the hepatitis A virus that seems to protect against allergy.
In animal studies of anaphylaxis, Umetsu's group discovered a new role for a common bacteria called Listeria. When combined with other agents, Listeria can act as a catalyst to induce specific protection against food-triggered anaphylaxis, as well as allergy and asthma.
Umetsu's team recently discovered a new type of immune system T-cell—called natural killer T (NKT)—that is prominent in asthma. They're investigating whether NKT cells are important in food allergy and whether new therapies to block NKT function could block food allergy development
"Good things happen when you have a world-class group like Children's Division of Allergy/Immunology," says David Bunning. "With Dr. Raif Geha, Dr. Umetsu and the entire research enterprise, and Dr. Lynda Schneider's food allergy and asthma clinic, everything is so advanced, productive and organized. We can imagine a not-too-distant future where we'll have immune therapies, like those for asthma, moderating food allergy's deadliest reactions. For so many families like ours, who live on heightened alert, it would be a huge relief."
For more information about how you can support food allergy research at Children's Hospital Boston, please contact Christine Meng in the Children's Hospital Trust at (617) 355-4675; email@example.com