Population Allergy

Prevention, early intervention, improved health and wellbeing for children and families living with food allergy

Australia is considered the allergy capital of the world, with over five million people living with allergic diseases. In children, our HealthNuts study has shown up to 10 per cent of 12-month-olds in Australia have a clinically confirmed food allergy. Hospital data also show a rapid increase in food allergy and anaphylaxis, with admissions in Australia increasing by 350 per cent over the past two decades. 

To help address this public health crisis, our research is working to address the rising allergy epidemic in Australia and provide relief and hope to children who are living with food allergy and their families. This work informs clinical guidelines and public health policy for the clinical care and management of childhood food allergy.

Our vision is to help prevent the current 10 per cent of infants developing food allergy by generating, translating and evaluating new knowledge about novel strategies to prevent – and early targeted interventions to treat – young children with food allergy. Specifically, our research looks at three levels of prevention:

• Primary: prevention of the development of food allergy
• Secondary: prevention of adverse events in food allergic children
• Tertiary: aiding the development of tolerance

The Population Allergy Group is one of the leading food allergy research centres in Australia. Our group secured a highly prestigious Centre for Research Excellence grant from the National Health and Medical Research Council in 2012, 2017 and 2022. This grant funds the Centre for Food & Allergy Research.

In August 2022, the National Allergy Centre of Excellence (NACE), hosted at the Murdoch Children's, launched following a four-year Federal Government investment of $10.2 million. As the country’s peak allergy research body, the NACE will develop infrastructure to enable cutting-edge research into allergy prevention, intervention and management. NACE Director and Murdoch Children's Population Allergy Group Leader, A/Prof Kirsten Perrett, and the Executive Committee will lead four broad pillars to underpin a national plan of action addressing drug, food, insect and respiratory allergic disease: 

1. An Allergy Research Hub will oversee a Clinical Trials Network and an Allergy Studies Directory to improve access to treatments.
2. A Repository and Discovery Hub will harness the power of big data analysis to drive individualised healthcare.
3. An Evidence and Translation Hub will establish living systematic reviews to seamlessly connect evidence and practice.​​
4. A Training and Innovation Hub will support and mentor the next generation of allergy experts. 
   
   

VITALITY trial - Vitamin D and allergy trial

Eden's story

Hear from Professors Kirsten Perrett and David Burgner about our efforts to find a StrepA vaccine, to help prevent infections like Eden's.

Dr Melanie Neeland - Food allergy research

Get the latest information

For the latest information and news, see our Food allergy page and find more resources below.

• Speech disorder and allergy research centres receive funding boost
• World-first allergy centres launched to prevent and treat allergies
• Babies sought for whooping cough vaccine clinical trial to help prevent allergies
• Sterilising dummies linked to increased risk of food allergies
• Decrease in peanut allergy among infants after guideline changes
• Infants sought for vitamin D trial aiming to reduce food allergy
• Federal commitment to help prevent, cure and manage food allergies
• 40 percent of adolescents with food allergies are experiencing frequent anaphylactic episodes
• Children growing out of some food allergies but Australian allergy levels still sky-high

More resources

• Our Allergy Flagship
• How does COVID-19 impact kids?
• Meet A/Prof Kirsten Perrett
• Centre for Food & Allergy Research
• National Allergy Centre of Excellence (NACE)

Our projects

National Allergy Centre of Excellence (NACE)

The National Allergy Centre of Excellence (NACE), hosted at the MCRI, launched in August 2022 following a four-year Federal Government investment of $10.2 million. As the country’s peak allergy research body, the NACE will develop infrastructure to enable cutting-edge research into allergy prevention, intervention, and management. NACE Director and MCRI Population Allergy Group Leader, A/Prof Kirsten Perrett, and the Executive Committee, will lead four broad pillars to underpin a national plan of action addressing drug, food, insect, and respiratory allergic disease: 

1. An Allergy Research Hub will oversee a Clinical Trials Network and an Allergy Studies Directory to improve access to treatments
2. A Repository and Discovery Hub will harness the power of big data analysis to drive individualised healthcare
3. An Evidence and Translation Hub will establish living systematic reviews to seamlessly connect evidence and practice
4. A Training and Innovation Hub will support and mentor the next generation of allergy experts.

Centre for Food & Allergy Research (CFAR)

The Centre for Food & Allergy Research (CFAR) is an Australia-wide research collaboration working towards the prevention, treatment, and management of food allergy. The Population Allergy Group at MCRI coordinates CFAR, and our network includes over 150 researchers and clinicians based at Australia’s leading medical and research institutions, including seven universities, four medical research institutes, and three paediatric hospitals. CFAR is funded by the National Health and Medical Research Council of Australia as a Centre of Research Excellence and is recognised as a World Allergy Organisation Center of Excellence. The CFAR website serves as a central hub for information about paediatric food allergy research taking place in Australia, including links to trials currently recruiting participants.CFAR will collaborate and work alongside the Food Allergy Stream of the National Allergy Centre of Excellence.

• Centre for Food and Allergy Research (CFAR)
• Food and allergy research
• World Allergy Organisation Center of Excellence

ADORED (Allergic Disease Onset Prevention Study)

Improving the understanding between gut immunity and allergic diseases could pave the way for better approaches to reduce eczema, food allergy, asthma and other allergic diseases. This infant allergy development prevention research study is running across multiple research sites in Australia, including the Murdoch Children’s, and across the United States. The study is recruiting pregnant mothers or mothers who have just given birth within the last seven days. The biological mother, biological father or biological sibling of the baby must have a history of asthma, eczema, a food allergy, or allergic rhinitis.

• Adored study

Aravax AVX-201

Aravax AVX-201 is a Phase 2 study in adolescents and children with peanut allergy. The trial aims to evaluate the efficacy and safety of PVX108 – a novel immunotherapy designed to precisely retrain the immune system to tolerate peanut allergens and reduce the risk of severe allergic reactions. PVX108 has been studied in AVX-001 – a First in Human Phase 1 randomised double-blind clinical trial in adults. AVX-001-EXT was a follow-up study that demonstrated PVX108 was safe and well tolerated in participants with peanut allergy, including those with asthma. In 2023, Murdoch Children’s Research Institute – along with sites in South Australia, New South Wales and Western Australia – began recruiting four- to 17-year-olds for the AVX-201 study.

• Aravax clinical trial

EarlyNuts

Australia has among the highest reported rates of childhood food allergy, a potentially life-threatening condition. New evidence shows that earlier introduction of allergenic foods such as peanut can reduce the risk of food allergy. This is reflected in new infant feeding guidelines. This study will measure current infant feeding practices and whether earlier allergen consumption has reduced the rate of food allergy among the population. Results will inform strategies to improve the uptake and efficacy of timely allergen introduction for food allergy prevention.

• EarlyNuts study

EPITOPE and EPOPEX trials

The EPITOPE study is designed to evaluate the safety and efficacy of a novel desensitisation method, called EPicutaneous ImmunoTherapy (EPIT) with the Viaskin® Peanut patch in young children aged between one to three years, diagnosed with peanut allergy. In this double-blind placebo-controlled trial, participants were randomised to receive treatment or a placebo, to determine if one year of daily patch wear could facilitate desensitisation of peanut allergy. All children who complete one year of EPITOPE participation enrol in the open-label follow-on study, EPOPEX, where they continue to wear the Viaskin® Peanut patch daily for up to three years.

HealthNuts Study

This is the world’s first comprehensive population-based study of food allergy with objective measurement of true food allergy. It will enable us to better understand the natural history of allergic disorders, including food allergy, asthma, eczema, and hay fever, and the risk factors for developing these conditions in childhood. HealthNuts recruited 5300 children at 12 months of age, who were followed up at ages four, six, and 10. The 15-year-old follow-up began in 2022 and aims to understand why some children outgrow their food allergies while, for others, it persists into adolescence. We are also investigating the impact of food allergy on children’s future health.

• HealthNuts

LMNOP Pilot Study (Low-dose Multi-nut Oral Immunotherapy trial in Pre-schoolers)

The LMNOP pilot study is testing a new treatment approach for food allergy. The study is looking at whether over 18 months, children undergoing low-dose, multi-nut oral immunotherapy (OIT) treatment can safely achieve sustained unresponsiveness (the participant can pass an oral food challenge after having paused treatment for several weeks) at a higher rate than children under standard care (avoidance of allergic nuts) develop natural tolerance. OIT involves parents giving their children small amounts of two nuts they are allergic to daily at home over 18 months.

• LMNOP Pilot Trial

MIST

Each year over 40,000 people have their tonsils out – it is the most common elective childhood operation in Australia—but this number could be reduced thanks to a simple nasal spray. This study is working to determine if a nasal spray called mometasone can moderate snoring, improve sleep and decrease the need for surgery. This medicine is already commonly used in children with hay fever and is available over the counter. Children aged three to 12 were invited to take part as snoring affects up to 10 percent of children.

MIST+

MIST+ builds on the recently completed MIST trial and is looking at whether a nasal spray can effectively treat snoring and sleep disturbance in children aged 3-12 years. Snoring and breathing problems during sleep are very common and affect a large number of children. Currently, the most common treatment is surgery. However, surgery is invasive, costly, and has an increasingly long wait time. MIST+ aims to use medical therapy to reduce the need for surgery and improve the quality of life of many children. The children taking part in MIST+ will use a saline nasal spray for six weeks and those who continue to experience snoring and sleep problems will then be treated with either a saline spray or with a common steroid spray called mometasone for a further 6 weeks.

• MIST+ trial

Novartis Peanut

The Novartis Study (CQGE031) is a multi-centre study investigating the effectiveness of the medication Ligelizumab in children and adolescents with severe peanut allergy. Children aged between six- and 17 years can take part in the 52-week study, which will determine whether Ligelizumab can decrease sensitivity to peanuts. The medication will be given as an injection to participants each month with regular appointments held at MCRI to measure its effectiveness.

OPTIMUM Study

This is a multi-centre study investigating whether one dose of ‘whole cell’ pertussis (whooping cough) vaccine given at two months of age instead of the current ‘acellular’ pertussis vaccine can help protect young children against allergic outcomes. Vaccines work by training the immune system to recognise what certain germs look like. Researchers believe some vaccines might also help to prevent allergy by making the immune system less likely to react to things that are not harmful, like food. Babies aged between six- and 12 weeks are invited to take part. The research involves three study visits over 18 months.

• OPTIMUM Study

The PrEggNut Study

Current evidence suggests the ideal time to prevent food allergy may be during pregnancy and breastfeeding, but little is known about the effect of what mothers eat during pregnancy and breastfeeding on the risk of food allergies in their babies. This research is testing whether the amount of eggs and peanuts a mother eats during pregnancy and breastfeeding has an influence on her baby’s food allergy development. Study results will develop national recommendations about how much egg and peanut to eat during pregnancy and breastfeeding to reduce egg and peanut allergies in babies.

• PrEggNut Study

SchoolNuts

The SchoolNuts study aimed to identify the lifestyle factors which are common to children suffering from food allergy; assess the impact of food allergy on the risk of asthma and severity, and identify factors that are likely to modify food allergy and asthma. The study was completed in 2016 and found adolescents with food allergy are frequently exposed to food allergens. Those with asthma and more than two food allergies were at the greatest risk for adverse food reactions. Those with nut allergies were most at risk of severe reactions. SchoolNuts recruited around 10,000 students and their parents from Melbourne schools to answer a questionnaire on lifestyle factors like diet and allergy history.

• SchoolNuts

TreEat

Allergies to tree nuts, such as almond, cashew, hazelnut, and walnut can be severe, often lifelong, and seem to increase. Children with peanut allergy are at higher risk for developing tree nut allergies. We know that eating nut and egg in the first year of life can be protective for the development of peanut and egg allergies, however, it is not known if this applies to other allergens, including tree nuts. This study aims to determine the safest and most effective way to introduce tree nuts into the diet of infants with peanut allergy to prevent the development of further nut allergies.

• TreEat Study

VITALITY Trial

The cause of Australia’s rise in food allergy in recent years is unknown. The number of people experiencing allergic reactions has also significantly increased. The aim of this study is to see the relationship between food allergy, vitamin D, and immune function in infants. Infants aged between six-to12-weeks who are predominantly breastfed and not taking Vitamin D are taking part. Each infant is given a vitamin drop each day and attends a free allergy test at 12 months of age. Over 2,700 infants have been enrolled in the study. We have now also begun our 6-year follow-up. We are inviting VITALITY participants back into the clinic when they turn six (6) years old for another free allergy test, as well as lung function, dental, hearing, and cardiometabolic assessments. 

• VITALITY Trial

Funding

• The Murdoch Children’s Research Institute
• Allergy and Immunology Foundation Australia
• Immune Tolerance Network
• DBV Technologies
• Novartis
• EpworthCentre for Paediatric Allergies
• ThePasse& Williams Foundation
• Melbourne Children’s
• National Health and Medical Research Council
• SioltaTherapeutics
• TheThrasherResearch Fund
• Royal Children’s Hospital Foundation

Collaborations

• The Murdoch Children’s Research Institute
• The Royal Children’s Hospital Melbourne
• The University of Melbourne
• National Allergy Strategy
• Australasian Society of Clinical Immunology and Allergy
• Allergy & Anaphylaxis Australia
• Centre for Food & Allergy Research
• James Cook University
• The University of Sydney
• The University of Western Australia
• The University of Adelaide
• Monash Medical Centre 
• The Children’s Hospital at Westmead 
• Women’s and Children’s Hospital, Adelaide 
• Robinson Institute, Adelaide University 
• Women's & Children's Health Research Institute 
• Cork University Hospital
• Food Allergy Center, Massachusetts General Hospital, Boston 
• Griffith University 
• The University of Queensland 
• The University of Manchester 
• Telethon Kids Institute
• Perth Children’s Hospital
• The Sydney Children’s Hospitals Network
• UNSW Sydney
• Deakin University
• The Florey Institute of Neuroscience & Mental Health
• Walter & Eliza Hall Institute of Medical Research

Featured publications

• *Brettig, T., Dang, T., McWilliam, V., Peters, R.L, Koplin, JJ., Perrett, KP. The Accuracy of Diagnostic Testing in Determining Tree Nut Allergy: A Systematic Review. Journal of Allergy and Clinical Immunology- In PracticeJournal of Allergy and Clinical Immunology- In Practice. May 2021; 9(5), 2028-2049.*  
  
  
• *Peters, R. L., Barret, D. Y., Soriano, V. X., McWilliam, V., Lowe, A. J., Ponsonby, A. -L., Koplin JK, Perrett, K. P. (2020). No cashew allergy in infants introduced to cashew by age 1 year. Journal of Allergy and Clinical Immunology, 147(1), 383-384. This is the first report internationally to identify a modifiable factor (early allergen introduction) that may prevent tree nut allergy.
  
  
• Soriano VX, Peters R, Ponsonby A-L, Dharmage S, Perrett K, Field M, Knox A, Tey D, Odoi S, Gell G, Perez B, Allen K, Gurrin L, Koplin J. Earlier ingestion of peanut following changes to infant feeding guidelines: The EarlyNuts Study. J Allergy Clin Immunol 2019; 144(5):1327-1335. This demonstrates a dramatic shift towards earlier peanut introduction in infants following changes to Australian infant feeding guidelines (led by our Centre for Food and Allergy Research). It was highlighted as a “high profile article of special clinical interest” by the American Academy of Allergy, Asthma and Immunology (AAAAI).
  
  
• Perrett KP, Jachno K, Nolan TM, Harrison LC. Association of Rotavirus Vaccination with the Incidence of Type 1 Diabetes in Children. JAMA Pediatrics. 2019; 173(3), pp280-282. (FWCI 40.2. Altimetric score 626, top 5%. WoS 51 Citations). This is the first direct evidence of decline in incidence of type 1 diabetes following rotavirus vaccine. This received extensive global media and informed Australian linkage study (AIHW).
  
  
• Peters, R. L., Koplin, J. J., Gurrin, L. C., Dharmage, S. C., Wake, M., Ponsonby, A. -L., . . . Study, H. (2017). The prevalence of food allergy and other allergic diseases in early childhood in a population-based study: HealthNuts age 4-year follow-up. Journal of Allergy and Clinical Immunology, 140(1), 145-153.e8. We report that although two thirds of children will outgrow their food allergies by age four, allergic diseases are a significant burden on Australian children with up to 50 per cent experiencing allergies (food allergy, eczema, asthma or rhinitis) in the first four years of life.