Tuesday, June 06, 2000

Progress against food allergies


Children's Hospital discovery could lead to treatment

By Tim Bonfield
The Cincinnati Enquirer

        Researchers at Children's Hospital Medical Center have made a discovery that could sharply improve treatment for people suffering intestinal problems caused by food allergies.

        A study, published today in the Proceedings of the National Academy of Sciences, reports that a protein called eotaxin plays a crucial role in triggering severe intestinal inflammation when exposed to an allergy-causing food.

        The study was based on tests conducted with genetically engineered mice, but studies involving people could begin within a year or two, said study authors Drs. Marc Rothenberg and Simon Hogan.

        If a drug can be developed to block this protein's function in humans, it would work much like an antihistamine does for preventing allergic inflammation in the airways — a major advance, the researchers said.

        “This pathway appears to be a common response for gut allergies,” Dr. Hogan said. “That means if a person could take an anti-eotaxin medication, it wouldn't matter what antigen (the substance that triggers an allergic reaction) a person was allergic to.”

        A new treatment would be important because food allergies have become more commonly diagnosed in the past two decades. “We've seen a doubling of cases and we don't understand why,” Dr. Rothenberg said.

        Surveys over the years have reported that 25 percent to 30 percent of parents think their children have a food allergy, based on bad reactions to a type of food. However, experts estimate the number of food allergies actually ranges between 2 percent and 8 percent of the population, Dr. Rothenberg said.

        Allergic reactions to food can be sudden and severe, such as a person sensitive to peanuts breaking out in hives or having difficulty breathing.

        Food allergies that strike in the gut can take longer to appear, making it harder to pinpoint the troublesome food. Another problem is that early symptoms of food allergies in the gut — cramps, diarrhea, difficulty swallowing and vomiting — often mimic other illnesses.

        Undiagnosed, however, food allergies can build into long-term problems, including slowed growth in children, chronic pain and organ damage.

        The researchers decided to focus on eotaxin because other studies in asthma patients had found the protein plays a role in triggering airway inflammation.

        To get more answers about whether the protein also was involved in gut food allergies, the Children's Hospital researchers bred a line of laboratory mice that do not produce eotaxin. When fed a type of egg protein that normally triggers an allergic response, there was no significant inflammation.

        Until now, researchers did not have an animal model to study food allergies in the gut. By confirming the protein's connection to gut allergies in mice, the discovery gives pharmaceutical companies a target for developing treatments for humans, Dr. Rothenberg said.

        If successful, anti-eotaxin medications could go beyond food allergies.

        Creston Martin, a 15-year-old boy from New Albany, Ind., has been coming to Children's Hospital for nearly two years.

        When he was 13, Creston spent three weeks in the hospital, including a week in intensive care when his body started to surge with excessive amounts of eosinophils, a type of white blood cell that appears to be regulated by eotaxin.

        At first, Creston struggled for days with extreme exhaustion. He started to lose weight. When his skin started to look jaundiced, it was time to go the hospital, said his mother, Mary Martin.

        He needed intensive care because the oversupply of eosinophils started causing a dangerous inflammation of his heart.

        Doctors in New Albany and Louisville initially thought Creston had lymphoma or leukemia, but tests were negative. They referred him to Children's Hospital in Cincinnati, where he was diagnosed with ideopathic hypereosinophilia syndrome. Anti-inflammatory medications helped control the worst of the problem, which then appeared to subside on its own.

        “He's in remission now. But they still don't know why it happened,” Mrs. Martin said.

        While Creston has returned to his favorite hobbies of playing basketball and golf, his mother and the researchers at Children's Hospital hope their work will result in a medication that can help if his condition ever strikes again.

Hospital targets food disorders



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