When Joshua was one-year-old, he had his first anaphylactic reaction to cashews in a cupcake. It was one of the scariest moments of our lives, rushing him to the hospital. Food allergies affect our lives every day and we have to be constantly vigilant.  It strikes me how little is known about how food allergies occur. It’s incredibly important to me personally that we learn why food allergies are so prevalent and why they are increasing. We need to understand the mechanisms in our bodies that lead to the genesis of food allergies so we can stop them.

I was speaking at an immunology conference in China in 2019 about gut-neuro-immune signaling and how the gut’s nervous system interacts with the immune system in the small intestine to fight off Salmonella enterica infections. After that talk, (FASI Chief Scientific Officer) Dr. Ruslan Medzhitov, Ph.D., came up to me and asked if I wanted to be part of the food allergy consortium that he was organizing and working on. I was very honored, as I greatly admire Dr. Medzhitov’s work and he is one of the most respected scientists in our field.

Ruslan realized that the neuroimmune connection was critical to understanding food allergies and he saw that my work examining the interaction between the gut, nervous system, and immune system was relevant. We have found that specialized sensory neurons called nociceptors regulate the entry points of Salmonella in the gut. The same neurons could also regulate food allergen entry and immune responses in the gut. Therefore, understanding how sensory neurons communicate with the gut could be important in food allergies. We are also doing research on how itch could connect to food allergies. Sensory neurons in the skin mediate itch. In terms of allergies, we know that a lot of patients who have eczema on their skin are at risk of developing food allergies.  We hypothesize that there is a potential connection with itch, which is characteristic of eczema. One consequence of itch is that when you scratch and damage the skin barrier, it could promote entry of allergens through that barrier that could ultimately lead to the development of food allergies. On the other hand, neuronal circuits could also link the skin to the gut. We are currently researching the connection between the skin and the gut, and development of systemic food allergies, which we believe could relate to a nervous system connection.

We are asking these questions: Do gut-innervating sensory neurons regulate the immune response to food allergens? Could blocking these neuroimmune interactions help prevent allergen sensitization? We are also looking at how neurons contribute to anaphylaxis itself.  We are also asking is there a connection of itch and food allergies. Could targeting itch also lead to decreased food allergies? Finally, we would like to understand how the nervous system is changed long-term by food allergies.  By learning the underlying basis for food allergies, maybe we can reset those changes. I’m hoping we can make treatments more effective or find a different approach to treating food allergies that we haven’t thought about. That would be exciting!

By networking with all the other scientists, I learn about the latest exciting developments in this field. The seminars and talks are amazing. FASI is bringing people into the field who are not primarily allergists. By bringing top neuroscientists and immunologists together, we all learn from each other. These unique interactions would never happen without FASI. FASI is a new paradigm, where I can develop collaborations and mentorship opportunities across different disciplines with other principal investigators from top research hospitals, including at Yale, Boston Children’s Hospital, Harvard, Mass General, and the Brigham and Women’s Hospital.

Definitely. Some of the same mechanisms, like neural-immune signaling, could have a major impact on chronic pain or itch, which we see in other diseases. The principles we are thinking about, like mapping neural circuits and how they affect the gut and the skin, could lead to new treatments for anything that’s affecting these two systems, such as chronic pain, itch, eczema, obesity, and even neurological diseases such as Parkinson’s, and autism spectrum disorder for example.