May 12, 2008
Statement of Daniel Rotrosen, M.D.,
Director, Division of Allergy, Immunology and Transplantation,
National Institute of Allergy and Infectious Diseases and
Anthony S. Fauci, M.D.,
Director, National Institute of Allergy and Infectious Diseases
National Institutes of Health
May 11-17 marks the 11th Annual Food Allergy Awareness Week, a time set aside to increase the public's awareness of food allergies and the potential challenges they pose. In an average week in the United States, two or three otherwise healthy Americans will lose their lives due to allergic reactions to foods. Approximately 6 to 8 percent of children under age 4 and nearly 4 percent of persons age 5 and older have a food allergy.
Aside from their immediate and sometimes life-threatening consequences, food allergies affect an individual’s health, nutrition, development and quality of life. These burdens disproportionately affect children. For children and their families, severe food allergies are accompanied by the fear of future serious reactions and the stigma of avoiding common foods, particularly in school lunchrooms and other social settings, where others too often do not understand the seriousness of the allergy.
Allergic reactions to foods occur when the immune system over-reacts to food proteins, setting off a cascade of events that can range from itchy hives to difficulty breathing, cardiovascular collapse and a systemic, life-threatening allergic reaction known as anaphylaxis. Approximately 30,000 cases of food-induced anaphylaxis occur in the United States each year, leading to as many as 200 deaths.
Even with assiduous avoidance of known food allergens, each year, approximately one of every four food allergic individuals will have an accidental exposure that leads to a food-induced reaction. Currently, the only treatments for food allergy are allergen avoidance and management of reactions caused by allergen exposure.
The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), is the nation’s principal supporter of food allergy research. NIAID’s broad support of basic research in allergy and immunology provides an increasingly better understanding of the immune system and how, in certain people, foods trigger an allergic reaction. NIAID also supports clinical trials that are attempting to alter the body’s immune system so that it no longer triggers allergic reactions. Working with young children who are at high risk of developing food allergies, NIAID-supported scientists and doctors are exploring new immune-based approaches to prevent the development of food allergies.
Little is known about why only some people develop food allergies. Research may provide insight into the genesis of food allergy and suggest approaches that may prevent children from developing allergies to certain foods. For example, the NIAID-supported Consortium of Food Allergy Research is conducting an observational study that has enrolled more than 400 infants who have allergies to milk or eggs. Most will lose their allergies to milk and eggs within a few years, but some will develop allergy to peanuts. The study will follow the children for at least five years and study immunologic changes that accompany either the loss of allergy to foods or the development of allergy to peanuts. Another study, the Urban Environmental Factors and Childhood Asthma Study, a project of the NIAID Inner City Asthma Consortium, is an observational study monitoring a cohort of children from birth for a number of factors, including the appearance of specific antibodies to foods. This study will provide data to address the relationship between asthma and food allergy. In addition, the NIAID Immune Tolerance Network is conducting a trial to determine whether feeding a peanut-containing snack to young children at risk of developing peanut allergy will prevent its development.
Although much is being done to address the problem of food allergy, many challenges remain. One of our greatest challenges in food allergy research is engaging new and established scientists to work in this area. NIAID is particularly pleased to announce that this week nearly a dozen awards will be made to investigators in a new program that will recruit new food allergy researchers and attract established researchers in other disciplines to bring fresh perspectives to the field. All of the NIAID awardees in this program will be new food allergy researchers, and one-third are first-time NIH grant recipients.
NIAID also is working with the U.S. Food and Drug Administration to address challenges involved in food allergy clinical research to ensure safe, effective and ethical designs for these clinical trials, many of which need to be conducted in young children and infants. NIAID is working with more than 20 institutes and centers at NIH, other federal agencies, professional societies and patient advocacy groups to develop comprehensive clinical guidelines for the diagnosis and treatment of food allergies. These guidelines will provide direction to clinicians, families, and patients for diagnosing and managing food allergies. In July NIAID will convene a coordinating committee to oversee this multistep effort.
Much progress has been made in the scientific understanding of food allergies and in the public’s awareness of how to manage them. But for millions of individuals, especially children, food allergies continue to limit their activities and threaten their health and lives. As we observe Food Allergy Awareness Week, we need to redouble our efforts to understand food allergies and reduce the limitations and suffering they impose on people who have them.
Anthony S. Fauci, M.D., is director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health in Bethesda, Maryland. Daniel Rotrosen, M.D., is director of the Division of Allergy, Immunology and Transplantation at NIAID.
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Last Updated May 12, 2008