Pediatric Grand Rounds (CME): Update on Food Allergy and Therapeutic Outcomes

Education goals for this session:

• Discuss food allergy vs non food allergy diagnoses
• Review mechanisms of etiology and pathology of food allergy
• Learn new methods for diagnosing food allergy and review prevention and future
  steps for food allergy
• Explain new clinical trial results for food allergy therapy 

Session Description:

The prevalence of food allergies is rising and the standard of care is not optimal, consisting of food-allergen avoidance and treatment of allergen-induced systemic reactions with adrenaline. Accurate diagnosis, prevention and treatment are pressing needs. The analysis of disease mechanisms lies at the forefront of food allergy research.

In individuals with food allergy, sensitization to food allergens results in inappropriate inflammatory immune responses to common foods. Many clinical trials in food allergy aim to establish functional immune tolerance in place of this sensitization. Immunotherapy often results in desensitization — a temporary increase in the threshold for allergen reactivity — instead of durable sustained unresponsiveness. 

The mechanisms of desensitization are not well understood and may differ from those of the healthy state of immune tolerance. Technological advances, such as high-throughput instruments for CyTOF (cytometry by time of flight mass spectrometry) and single-cell quantitative PCR, that are capable of quantifying multiple parameters simultaneously have converged with rapid advances in big data analytics to enable unprecedented discoveries in the signaling pathways underlying immune tolerance, sensitization and desensitization to food allergens. Increased understanding of the cells involved (e.g., epithelial cells, ILC2s, T helper cells, mast cells, eosinophilic cells), cytokines (e.g., IL-4, IL-5, IL-9, IL-13, IL-25, IL-33), antibodies (e.g., IgE, IgG) and other pro-inflammatory molecules (e.g., histamine, tryptase) in allergic mechanisms has led to the development of many drugs that are currently being tested in clinical trials. Sensitive and specific biomarkers for determination of FA endotypes, risk of developing allergies, reaction severity, and prognosis with treatment are essential components in the path towards promising research advances, therapeutic innovations and the challenges that remain.

CME Credit

Accreditation

The Stanford University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation

The Stanford University School of Medicine designates this live activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)TM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Cultural and Linguistic Competency

California Assembly Bill 1195 requires continuing medical education activities with patient care components to include curriculum in the subjects of cultural and linguistic competency.  The planners and speakers of this CME activity have been encouraged to address cultural issues relevant to their topic area. The Stanford University School of Medicine Multicultural Health Portal also contains many useful cultural and linguistic competency tools including culture guides, language access information and pertinent state and federal laws. You are encouraged to visit the portal: http://lane.stanford.edu/portals/cultural.html