Allergy Immunology

Our vision is to reduce the personal and societal burden of food allergy, through improving management and developing cures.

Food allergy is one of the most common chronic conditions affecting children in Westernised countries, with rates having increased exponentially in recent decades. Allergist Immunologist and Clinician Researcher, Professor Mimi Tang, who brings clinical and laboratory-based expertise leads our group.

The group members bring broad experience in:

• clinical, basic immunology and patient important outcomes research,
• commercialisation expertise to conduct high-quality multi-centre randomized controlled clinical trials evaluating novel interventions for treatment of food allergies,
• investigating immunological mechanisms underlying allergy vs tolerance to inform development of innovative next generation treatments, and
• development support tools that can be rapidly implemented to keep children with food allergy safe.

The Group also collaborates on randomised trials evaluating prevention strategies (VITALITY, PEBBLES) and longitudinal cohort studies investigating risk factors for food allergy and other allergic disorders (Barwon Infant Study, HealthNuts, SchoolNuts, EarlyNuts) to facilitate the identification of novel prevention strategies.

Our projects

Conducting randomised trials evaluating novel treatments that induce remission of food allergy

The goal of food immunotherapy is to induce remission of food allergy (also called “sustained unresponsiveness). Ongoing trials in our group evaluate remission treatments for:

• Peanut Allergy (PPOIT001, PPOIT002, PPOIT003 LT)
• Egg Allergy (PrEMO, PEAT)
• Milk Allergy (PrEMO)

It also focuses us on evaluating patient-important outcomes, such as Quality of Life and Cost-Effectiveness of novel therapies, which can inform decisions regarding regulatory approval and funding of treatments.

TreEat Study

The TreEat Study tests a new model of care for the prevention of tree nut allergy for infants with peanut allergy. The TreEat study compares a multi-nut oral food challenge versus home introduction of single tree nuts.

• TreEat Study

Investigating the immune mechanisms underpinning the acquisition of long-lasting remission of food allergy

Few therapies in development have been shown to induce long-lasting remission. Our proprietary Probiotic Peanut Oral Immunotherapy (PPOIT) treatment has shown to induce long-lasting remission in a high proportion of treated patients. In contrast, published studies of alternate OIT protocols induce remission that is short-lived, with most patients losing their protection within 12 months of stopping treatment. We are the only group internationally with access to patients with long-lasting remission and are positioned to lead the field in investigating the key immune changes driving long-lasting remission.

Developing tools that improve the management of food allergy (and can be rapidly translated to practice)

AllergyPal

A smartphone app, developed to support families in the management of their child’s food allergy.

Food Allergy / Tolerance / Remission Diagnostic tool (algorithm)

Work is ongoing to develop a tool that reduces the need for a food challenge. This new approach is aimed at:

1. Rapid detection of presence or absence of food allergy and
2. Detection or prediction of treatment response following food immunotherapy.

Identifying effective prevention strategies through collaborations with other research groups

• Randomised trials evaluating novel preventions strategies:
  • PEBBLES Study: Evaluating a topical ceramide cream for prevention of food allergy and eczema (The University of Melbourne).
  • VITALITY Trial: Evaluating vitamin D supplementation for prevention of food allergy.
    
    
• Cohort studies investigating the natural history and risk factors for development of food allergy, to identify novel prevention strategies that can stem the rising tide of food allergy prevalence and improve management approaches for established allergies:
  • HealthNuts, EarlyNuts, SchoolNuts
  • Barwon Infant study (BIS) (Barwon Infant Study, Deakin University)
    
    
• NHMRC CRE-CFAR:
  • Aiming to eradicate food allergy through improved prevention and cure, supported by evidence generated by a collaborative network of research, and to improve management of food allergy through public health policy and clinical pathways (Centre for Food and Allergy Research)

Allergy Flagship

Aiming to maximise the collaborative opportunities across Murdoch Children's Research Institute and the Melbourne Children’s Campus to increase the translation of clinical research into practice.

• Allergy Flagship

Funding

• National Health and Medical Research Council
• National Children’s Research Centre (NCRC - Ireland)
• Allergy and Immunology Foundation of Australasia (AIFA)
• Caponero
• Victorian Medical Research Acceleration Fund & Immunosis Pty Ltd
• Murdoch Children’s research institute (MCRI)
• Prota Therapeutics
• Abbott Nutrition
• Bayer Australia

Collaborations

• Professor Katie Allen, Assoc Prof Jennifer Koplin, Prof Kirsten Perrett – HealthNuts, SchoolNuts, EarlyNuts – establishing the prevalence of food allergy and investigating risk factors for the development of food allergy and other allergic diseases.
• Professor Shyamali Dharmage, Prof Bircan Erbas - Tasmanian Longitudinal Health Study (TAHS), Melbourne Air Pollen Children’s Asthma Health Study (MAPCAH) – investigating risk factors for asthma and food allergy.
• Assoc Prof Peter Vuillermin, Prof Anne Louise Ponsonby – Barwon Infant Study (BIS) – investigating the role of gut microbiota in programming lifetime immune responses.
• Dr Anthony Bosco, Prof Patrick Holt – Gene expression studies related to the investigation of immune mechanisms underlying allergic disease.
• Dr Audrey Dunn-Galvin – University of Cork – Quality of life impacts of food immunotherapy
• Dr Hauke Schmidt, Prof Willem de Vos – University of Wageningen – investigating intestinal microbial signatures associated with the acquisition of remission following oral immunotherapy

Featured publications

• Long-term clinical and immunological effects of probiotic and peanut oral immunotherapy after treatment cessation: 4-year follow-up of a randomised, double-blind, placebo-controlled trial. 2017. 10.1016/S2352-4642(17)30041-X
  
  
• Prebiotic-supplemented partially hydrolysed cow’s milk formula for the prevention of eczema in high-risk infants: a randomised controlled trial. 2016. 10.1111/all.12848
  
  
• Improving timely access to food allergy care: a pragmatic controlled trial. 2020. 10.1111/all.14105
  
  
• Peanut Oral Immunotherapy: State of the Art. 2020. 10.1016/j.iac.2019.09.005
  
  
• Long-term benefit of Probiotic Peanut Oral Immunotherapy (PPOIT) on quality of life in a randomised trial. 2021. 10.1016/j.jaip.2021.07.047