Through support for academic and industry research, FARE promotes the development of new therapies and offers hope for effective treatments. Our primary goals are to accelerate the development of safe, practical therapies that would protect individuals with food allergies against life-threatening anaphylaxis; to develop a deep understanding of the disease; and, ultimately, to find a cure. FARE researchers have contributed to major advances in the field, and although we still have much to learn, the pace of food allergy research is accelerating every day, and new therapies are on the horizon.
This overview explains where we stand today, and how FARE-funded researchers are making a difference.
Revealing the Impact of Food Allergies
Today, it is widely acknowledged that food allergies are a significant and growing public health problem in the U.S. and other developed countries. This understanding of the disease is due, in large part, to the work of epidemiologists – researchers who focus on the causes and distribution of diseases in human populations. Epidemiological studies provide vital clues that help scientists and public health officials to prevent and control disease. (For example, epidemiologists discovered the link between smoking and cancer.)
Over the past 10-15 years, research has provided compelling evidence of the impact of food allergies in the United States. We have learned that up to 32 million Americans, including 1 in 13 children, have a food allergy, and that nearly 40 percent of these children have already experienced a severe or life-threatening reaction. Other studies have revealed the economic burden of food allergies and their damaging effect on families’ quality of life.
The work of FARE-funded investigators continues to provide important data about who gets food allergies and the possible role of such factors as diet, hygiene, geography, ethnicity, and much more. Epidemiologists’ findings provide new avenues for other researchers – such as immunologists and geneticists – to explore. Finally, because these studies provide powerful evidence of the growth and impact of food allergies, they also help advocates make a strong case for laws and policies that create safer environments for people with food allergies, and for federal funding for research.
In 2010, the National Institute of Allergy and Infectious Diseases (NIAID) released Guidelines for the Diagnosis and Management of Food Allergy in the United States. This landmark document – the first of its kind – draws on the expertise of 34 professional associations, federal agencies, and advocacy groups, including FARE. These guidelines are “evidence-based,” meaning that they set forth the best practices for
diagnosing and treating food allergies, based on the highest quality scientific studies available and the consensus of experts in the field. By providing standardized clinical guidelines to generalists and specialists nationwide, this document helps ensure better care for individuals with food allergies.
Further, the guidelines helped establish the direction of research by identifying gaps in our current scientific knowledge of food allergies. Federal agencies, such as the National Institutes of Health (NIH), and FARE use this crucial information as a foundation for planning and funding future research initiatives, including clinical trials of new treatments.
Recognizing food allergy as a critical public health issue, the National Academies of Sciences, Engineering, and Medicine (NASEM) compiled a comprehensive consensus study on the state of food allergy in the U.S. Released in 2016, finding a path to safety in food allergy: assessment of the global burden, causes, prevention, management, and public policy summarizes essential information and makes wide-ranging food allergy science and policy recommendations.
FARE initiated the NASEM consensus study, was its lead sponsor and helped to recruit co-sponsors, including the national institutes of health, the U.S. Department of Agriculture – food and nutrition service, the U.S. food and drug administration, industry groups and patient organizations. FARE co-authored the paper that organized the study topics and worked with others stakeholders to nominate members of the expert panel and the volunteer patient advisory panel. Moving forward, the study’s recommendations for better data collection and evidence-based approaches to patient care and public health policy will inform and improve our future education, advocacy and research efforts.
Unfortunately, strict avoidance of problem foods is still the only way to prevent a reaction. But there is good news: promising research is underway to develop new treatments. In May 2018, FARE published a free, in-depth exploration of this research, titled Hope for a Safer Future: A Special Report on Food Allergy Therapies. The report can be downloaded or read online.
Among other important data, researchers are trying to determine if these therapies will result in desensitization or tolerance. Desensitization means that a person can consume a significant amount of a problem food without experiencing a reaction. However, desensitization is not permanent. In order to stay safe, people would have to continue this therapy for the rest of their lives. Still, a treatment that would desensitize large numbers of people with food allergies – protecting them against potentially fatal reactions – would be life-changing.
The ideal treatment would lead to tolerance – long-lasting immunological changes that would allow people with food allergies to safely eat problem foods, even after the treatment is discontinued.
Immunotherapies to promote protective immunological changes – are being studied at major medical centers nationwide with funding from FARE, the NIH, and other sources. These include studies to investigate oral immunotherapy and sublingual immunotherapy.
- Oral Immunotherapy (OIT)
During OIT, the food allergen (a commercially manufactured powder mixed with a harmless food) is administered slowly, in small but steadily increasing doses, until the patient is desensitized to it. Early clinical trials have demonstrated that OIT is safe and that it is effective in 70-80 percent of patients, provided that it is properly administered in a controlled setting. However, researchers still must determine the most effective dosage and time frame for treatment. Further, they must learn whether or not OIT can desensitize large numbers of patients, and finally, if it can lead to tolerance.
Currently, FARE-funded research is evaluating OIT for walnut. Our ultimate goal is to support advanced clinical trials that will lead to the development of standardized, FDA-approved OIT products for major food allergens, including peanut, tree nuts, milk, egg, fish, shellfish, wheat and soy.
- Sublingual Immunotherapy (SLIT)
The concept behind SLIT is very similar to OIT, except that the food allergen is dissolved in a solution that is placed under the tongue. Research previously funded by FARE compared SLIT and OIT for peanut and found that both approaches were able to desensitize most patients to a degree that is likely to prevent allergic reactions after accidental ingestion. SLIT produced a less robust desensitization effect than OIT, but was also less likely to cause serious allergic reactions. FARE is currently funding a study to determine whether several years of treatment with peanut SLIT will result in clinical tolerance.
- Pre-clinical research
In addition to supporting clinical trials, FARE has invested in fundamental research that can form a foundation for the development of new therapies. One funding path through which FARE sustains innovative laboratory studies is the FARE Investigator in Food Allergy Awards. since July 2015, recipients of the FARE investigator in food allergy awards have been granted $3.6 million dollars to support research proposals that show exceptional potential to advance the field.
Additional initiatives extend FARE’s research efforts to better support the needs of food allergy patients and families nationwide. These include the FARE Clinical Network, the FARE Patient Registry and patient-centered outcomes research.
The FARE Clinical Network (FCN) is a FARE-supported collaboration among top research and clinical institutions serving patients with food allergies. Created to ensure that food allergy patients across the country can access state-of-the-art diagnosis, care and research, the FCN includes more than two dozen member institutions that are developing best practices for patient care, clinical trials to identify new therapies, and data resources to advance research.
Key among those data resources is the FARE Patient Registry a data bank collecting demographic and clinical information about food allergy patients, including clinical histories, lab reports and eventually bio-specimens (serum, DNA and RNA) so that this information can be made available to health care providers, researchers and patients. By harnessing the power of patient data, the registry seeks to accelerate the progress of research and improve food allergy management.
Finally, FARE is working to ensure that food allergy research meets the needs of food allergy patients and families. Through patient-centered outcomes research, FARE is fostering a partnership in which
patients are empowered to work with other key stakeholders to build research programs that are informed by the lived experience of food allergy patients.
FARE’s mission is improve the quality of life and the health of individuals with food allergies, and to provide them hope through the promise of new treatments. From bench-top investigations to clinical trials, from epidemiological studies to comprehensive reports and guidelines, FARE’s unparalleled investment in food allergy research channels the diverse strengths of our scientific, medical and patient communities to drive food allergy research forward.
What to Read Next
FARE conceived and initiated this comprehensive 2016 report on food allergy in the U.S., which was released by the National Academies of Sciences, Engineering and Medicine to inform food allergy research and policy.