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 leads our group, bringing significant clinical and laboratory-based expertise to the role.
The group members bring broad experience in:
- Clinical, basic immunology and patient-important outcomes research
- Commercialisation expertise to conduct high-quality multi-centre randomised controlled clinical trials evaluating novel interventions for the treatment of food allergies
- Investigating immunological mechanisms underlying allergy versus tolerance to inform the development of innovative next-generation treatments
- Developing support tools that can be rapidly implemented to keep children with food allergy safe
The Allergy Immunology 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.
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Improving the lives of children and families living with food allergy
Watch as Stella speaks to Allergist Immunologist, Professor Mimi Tang about her role at MCRI.
Group Leaders
Group Members
HILO – Peanut Oral Immunotherapy Study
This study aims to compare the effectiveness of high dose probiotic peanut oral immunotherapy (PPOIT) and high dose peanut oral immunotherapy (no probiotic) versus low dose peanut oral immunotherapy for the remission of peanut allergy.
Read more...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 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.
Long-term health and economic outcomes of peanut oral immunotherapy compared with standard care
Oral Immunotherapy (OIT) is an emerging treatment. The only approved treatment (available in the US, UK, EU) is a desensitisation peanut OIT drug, Palforzia, that offers protection against accidental exposure to small amounts of peanut-contaminating packaged foods. However, there is ongoing controversy about whether desensitisation offers greater benefit than standard care (allergen avoidance) because treatment must be continued indefinitely, causes more reactions than avoidance, and there is no improvement in quality of life (compared with placebo).
Evidence on long-term outcomes, including reactions and quality of life impact with OIT is essential to guide practice and policy.
We will examine long-term outcomes from our NHMRC-funded randomised trial (PPOIT003) that evaluated Peanut OIT in 201 children with peanut allergy aged one to 10 years, to establish whether OIT offers greater benefit than standard care (allergen avoidance) in the real world.
Outcomes for OIT will be compared to an external control group of untreated peanut-allergic individuals drawn from an existing cohort study (HealthNuts) with more than 10 years of longitudinal outcomes already collected. Findings will inform policy and practice decisions, ensuring optimal outcomes for food-allergic individuals.
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:
- Rapid detection of presence or absence of food allergy and
- 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.
Funding
- National Health and Medical Research Council
- Allergy and Immunology Foundation of Australasia (AIFA)
- Caponero
- Victorian Medical Research Acceleration Fund & Immunosis Pty Ltd
- Prota Therapeutics
- Abbott Nutrition
- Bayer Australia
- National Children’s Research Centre (NCRC – Ireland)
- Murdoch Children’s Research Institute (MCRI)
Collaborations
- Associate Professor Rachel Peters and Associate Professor Jennifer Koplin: HealthNuts, SchoolNuts, EarlyNuts – establishing the prevalence of food allergy and investigating risk factors for the development/resolution of food allergy and other allergic diseases.
- Professor Shyamali Dharmage, Professor Bircan Erbas and Dr Don Vicendese – Epidemiological studies investigating risk factors for asthma and food allergy, long-term outcomes following Food Oral Immunotherapy.
- Associate Professor Peter Vuillermin and Professor Anne Louise Ponsonby: Barwon Infant Study (BIS) – investigating the role of gut microbiota in programming lifetime immune responses.
- Dr Anthony Bosco and Professor Patrick Holt – Gene expression studies related to investigation of immune mechanisms underlying allergic disease.
- Dr Audrey Dunn-Galvin (University of Cork) – quality of life impacts of food immunotherapy.
- Dr Hauke Schmidt and Professor Willem de Vos (University of Wageningen) – investigating intestinal microbial signatures associated with acquisition of remission following oral immunotherapy.
Featured publications
Additional publications
Ashley SE, Bosco A, Tang MLK. Transcriptomic changes associated with oral immunotherapy for food allergy. Pediatr Allergy Immunol. 2024; 35:e14106. doi:10.1111/pai.14106
Rosser SA, Lloyd M, Hu A, Loke P, Tang MLK. Associations between gender and health-related quality of life in people with IgE-mediated food allergy and their caregivers: A systematic review. Clin Exp Allergy. 2024 Feb;54(2):93-108. doi: 10.1111/cea.14450. Epub 2024 Feb 7. PMID: 38321912.
Leung ASY, Pawankar R, Pacharn P, Wong LSY, Pham D, Chan G, Rengganis I, Zhao J, Wang JY, Woo KCK, MD,j Ito K, Jeong K, Recto M, Lucas M, Nagao M, Lobo RCM, Munkhbayarlakh S, Sumadiono S, Huq SR, Ranasinghe T, and Mimi Tang MLK, on behalf of the Asia Pacific Association of Allergy Asthma and Clinical Immunology food allergy and anaphylaxis and junior member committees. Perspectives and gaps in the management of food allergy and anaphylaxis in the Asia-Pacific Region. The Journal of Allergy and Clinical Immunology:In Practice. 2023
Huang L, Dalziel K, Lloyd M, Loke P, Lozinsky AC, Tang MLK. Cost-effectiveness analysis of probiotic peanut oral immunotherapy (PPOIT) versus placebo in Australian children with peanut allergy alongside a randomized trial. BMJ Open 2023;13:e075521
Hu A, Lloyd M, Loke P, Lozinsky AC, O’Sullivan M, Quinn P, Gold M, Tang MLK. Association of reaction symptoms and eliciting dose with health-related quality of life in children with peanut allergy. The Journal of Allergy and Clinical Immunology: In Practice, 2023 Oct;11(10):3195-3202.e4
de Holanda Coelho GL, Lloyd M, Tang MLK, DunnGalvin A. The Short Food Allergy Quality of Life Questionnaire (FAQLQ-12) for adults. Journal of Allergy and Clinical Immunology: In Practice 11(5):1522-1527.e5
Lloyd M, Loke P, Mack DP, Sicherer SH, Perkin MR, Boyle R, Leung, ASY, Lee BW. Levin M, Blumchen K, Fiocchi A, Ebisawa M, de Oliveira LCL, Tang MLK. Varying approaches to management of IgE-mediated food allergy in children around the world. Journal of Allergy and Clinical Immunology: In Practice 11(4):1010-1027.e6
Lloyd M, Nandinee P, Munblit D, Tang MLK. Endpoints and outcomes following immunotherapy for food allergy: What is meaningful for patients? Journal of Allergy and Clinical Immunology: In Practice. 11(4): pp 998-1007
de Holanda Coelho GL, Loyd M, Tang MLK*, DunnGalvin A. Food Allergy Satisfaction with Life Scale: A Complementary Measure to Health-Related Quality of Life. Clinical and Translational Allergy. March 2023. 13(3): e12233
Loke P, Hsiao KC, Lozinsky AC, Ashley SE, Lloyd M, Pitkin S, Axelrad CJ, Jayawardana KS, Tey D, Su EL, Robinson M, Leung ASY, Dunn Galvin A, Tang MLK. Probiotic peanut oral immunotherapy is associated with long-term persistence of 8-week sustained unresponsiveness and long-lasting quality-of-life improvement. Clin Exp Allergy. 2022 Jun;52(6):806-811.
Hsiao KC, Ponsonby AL, Ashley S, Lee CYY, Jindal L; PPOIT Study Team, Tang MLK. Longitudinal antibody responses to peanut following probiotic and peanut oral immunotherapy (PPOIT) in children with peanut allergy. Clin Exp Allergy. 2022 Apr 11.