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The Allergy Explorers

Allergist Who’s Driven to Solve the “Whys” of Food Allergy

allergy explorerShe’s one of the brightest lights in the next generation of allergy researchers. But Dr. Corinne Keet, an assistant professor of pediatrics at Johns Hopkins University, never rests on the laurels for her latest scientific publication or conference presentation. Instead, she is always moving on to her next study, and another key unanswered allergy question.

Keet is a prolific researcher, investigating everything from nutrition in food-allergic children to food allergy treatments, and allergy and asthma in inner-city neighborhoods

In our “Allergy Explorers” series at Allergic Living, we honor researchers who are diligently trying to solve the allergy puzzle. Keet says she’s motivated to do her research by the patients she sees in her clinic – and we’re inspired by her desire to understand allergic disease and find a safe and effective treatment.

Contributing Editor Claire Gagné spoke to allergist Corinne Keet about her current research, her personal connection to the disease, and what it was like to cast doubt on the effectiveness of OIT.

How did you become interested in food allergies?

Corinne Keet: I went into allergy and immunology thinking I would focus on immunodeficiencies, but I was drawn to food allergy because so many people are affected and so little is known compared to a lot of other fields in medicine. For example, we don’t know why some people develop allergies while others don’t, and we still don’t have good treatments for the disease.

I also do have a personal connection – I was allergic to eggs as a child, so allergy was something I thought about from a young age. Fortunately, my allergy was mild, especially compared to what I see in my practice. And I grew out of it by the time I was a teenager.

Where did you study allergy and immunology?

CK: I have been at Johns Hopkins for 11 years; I came to do my pediatric training, stayed for allergy training and then got on as faculty.

What are you currently working on in your research?

CK: Right now I’m working on trying to understand trends in food allergy over time; who is most affected, do blood markers of food allergy (i.e. IgE testing to foods) match trends in self-reported allergy, and why does food allergy seem to be so common now?

It’s a large amount of data – I’m looking at stored samples from large national surveys, and there are approximately 7,000 samples. This research hasn’t been published yet, so I can’t comment on the findings.

You’ve done considerable research on oral immunotherapy (OIT) and sublingual immunotherapy (SLIT). What interesting things are you finding out about these two potential allergy treatment methods?

CK: We did a few studies directly comparing OIT and SLIT for milk and peanut allergy and found that SLIT was much less effective than OIT, but that there were more side effects with OIT. This was interesting because before this scientists had done research on each of these treatments individually, but hadn’t compared the treatments in the same group of people. Our results suggest that, at least as has been seen in the research thus far, SLIT is a less promising treatment.

You have published a study that called the long-term effectiveness of OIT into question. Did you feel like you were dashing everyone’s hopes for a cure?

CK: After our original studies of OIT for milk allergy, we knew this treatment wasn’t yet ready to be used in general allergy practice for safety reasons, but we thought that many patients would come out of OIT ready to put their allergies behind them.

After several more years, some patients were doing really well after completing the therapy, with milk in their diets without problems. But many were still having some problems with milk; reactions every now and then, or feeling terrible if they consumed too much dairy at one time. Only 25 percent were consuming milk without symptoms, whereas 38 percent had frequent or predictable symptoms, and 16 percent were not consuming milk at all. For most patients, they were able to tolerate more milk, but the allergy was still there.

This was disappointing, but I think it’s really important that these therapies are rigorously evaluated before being adopted in the community. These treatments are not low risk, and it’s essential that we understand the benefits and the risks. I know people are anxious for a treatment, but there are dangers in rushing into things.

Next: Dr. Keet looks into the future of food allergy treatments

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