Preventing growth in respiratory and allergic disease
Our research has turned allergy and asthma triggers (allergens) against themselves, preventing the conditions before they start and changing international health policy.
A world-first trial of allergen exposure in Southampton established a viable approach to prevent allergy
A key study with Guys & St Thomas BRC found fewer allergies developing in early years
Modelling the introduction of peanut in infancy has informed food allergy prevention guidance in Europe
Deliberate allergen exposure
Asthma and allergy affect one-in-three children and bring a risk of sudden, life-threatening crises. Our work with local families showed that allergen exposure in infancy drives tolerance, not allergy. Drawing on this, we conducted a world-first trial of deliberate allergen exposure. That saw infants receiving small doses of allergens by mouth to prevent allergy.
Using allergens from the house dust mite, it showed that the approach worked in those at high risk of developing allergy. We went on to prove that oral dosing can prevent asthma at six years of age (published here). Further studies linked epigenetic changes seen in the infants (switching on or off of genes) to allergy and asthma. These findings have advanced approaches to early prediction and prevention of allergy.
Focus on food allergies
We have applied this approach to the growing issue of food allergies. Our key study involved infants at high risk of peanut allergy, working with Guys & St Thomas BRC. The trial tested the carefully controlled use of an infant friendly form of peanut in their diet. This was shown to be safe and resulted in much fewer allergies developing (published here).
We went on to demonstrate that use of egg in infants’ diet had the same effect on egg allergy. We are now looking at whether this approach still works mid-childhood, as seen in the case of dust mite allergen.
Informing European allergy prevention
To speed up real-world use, we have modelled how to introduce peanut in infancy across the whole population. This model provides a blueprint for its use as a public health prevention effort. It also informed the recently published European food allergy prevention guideline (published here). With scientific leadership by Professor Graham Roberts, that guideline combines all evidence agreed on internationally. It gives governments a basis for developing the use of allergenic foods in infancy to prevent suffering.
Our future work will build on this experience. We will develop the evidence-base for our house dust mite intervention and an approach to encourage parents to introduce allergenic foods earlier.