Christina's Story: From Trial Participant to Laboratory Intern
Over the years, Dr. Kari Nadeau has mentored a number of high school and college students through summer internships. In 2017, Christina Stankey, a rising junior at Yale University, spent nine weeks working in the Nadeau lab at the Sean N. Parker Center for Allergy and Asthma Research at Stanford University. Having grown up with food allergies, Christina has always been interested in biological research and curious about the mechanisms that caused her to have severe reactions to common foods. During high school, she interned as a clinical researcher analyzing culture data from blood and lung fluids of patients with empyema, a form of complicated pneumonia at the Children’s Respiratory and Critical Care Specialists in Minnesota. After she completed her analysis, she presented the results of her study at the 2016 American Thoracic Society meeting. At the hospital in Minnesota, “I particularly liked attending weekly case conferences where physicians, nurses, pharmacists, social workers, and other health care specialists discussed challenging cases,” she shared. “It made me aware of the complexities and challenges of patient care.” Now at Yale, she is working in the lab of Dr. Ruslan Medzhitov, a world renowned immunologist, who is trying to answer a fundamental question – why do allergies exist? Allergies are likely not simply a biological blunder but rather an essential defense against noxious chemicals. To test this hypothesis, Christina is studying how the body senses and responds to bitter compounds with structural similarities to allergens in an effort to understand whether common elements between noxious compounds and allergens trigger the allergic response.
During her internship at the Sean N. Parker Center for Allergy and Asthma Research, she sought to find answers to a fundamental question — what are the biological changes that are occurring in those who become desensitized via oral immunotherapy? In particular, she examined changes in IgE and IgG4, antibodies associated with allergic diseases. IgE is commonly produced in high amounts in those with allergies. There has also been some evidence that the levels of another antibody, IgG4, are increased and are protective against allergic disease. When allergens bind to IgE (that are bound to immune cells), the cells release a number of inflammatory molecules, such as histamine, and mediate an allergic reaction. It is thought that IgG4 protects against these allergic reactions, possibly by blocking the action of IgE. Christina evaluated the changes in antibody dynamics in patients undergoing immunotherapy. At the end of her internship, Christina presented the results of her study to the Nadeau Lab members and has submitted an abstract for the 2018 American Academy of Allergy, Asthma & Immunology meeting. Similar to other studies, her results indicate that IgE levels decrease and IgG4 levels increase in those who are desensitized with oral immunotherapy. Further, she found that there were changes in the binding patterns of both IgE and IgG4.
As an infant, Christina had eczema and was eventually diagnosed with food allergies to milk, eggs, shellfish, soy, peanuts, and tree nuts. She also had allergies to pollen, dogs, and cats. She has faced several severe reactions and has had to inject epinephrine on multiple occasions. Nevertheless, she enjoyed school and sports with a few precautions, such as a milk-free lunch table. Christina has taken her food allergies in stride. “Having food allergies has taught me to understand the value of delayed gratification and situational awareness, and to recognize risk and potential signs and symptoms of allergic reactions,” she said, emphasizing the positive life lessons she has learned from having food allergies. Although she eventually outgrew allergies to egg, milk, soy, shellfish, peanut and almond during childhood, she continued to have allergies to other tree nuts. When her parents heard about the immunotherapy trials conducted by Dr. Nadeau, they immediately placed Christina on the waiting list. During her senior year in high school she started oral immunotherapy and is now on a maintenance dose consisting of various amounts of cashews, macadamia nuts, pinenuts, hazelnuts, walnuts, pecans, and brazil nuts.
Christina is very thankful to Dr. Nadeau as a patient and as an intern. Desensitization to tree nuts has made a huge difference to her life, empowering her to go about her daily activities without the threat of a severe reaction from accidental exposure to food contaminated with tree nuts. She most appreciated this newfound safety when she studied abroad in Italy. This summer, she was thrilled to be back at Stanford, this time as an intern instead of a patient. “I really enjoyed my time at Stanford and the Nadeau Lab,” said Christina. “Dr. Nadeau continues to inspire me and I am very thankful for her mentorship and continued support.” Christina is now back at Yale and will soon be taking her MCAT and applying to medical schools. Team members at the Center enjoyed working with Christina and were sad to see her go at the end of summer. We wish her the very best in her future endeavors!
Interview by Vanitha Sampath
Vanitha Sampath received her PhD in Nutrition from the University of California at Davis. At the Sean N. Parker Center for Allergy and Asthma Research, as a medical writer and content manager, she enjoys being in the midst of groundbreaking research in asthma and allergy and is committed to communicating the scientific advances of the Center and spreading awareness of its mission and vision.