Category Archives: Immunology

Immunology

Fighting infection with curiosity – Pursuit

As a child I wanted to be an artist, not a scientist. But my mum, who was an artist, wanted me to do a sensible degree she was concerned that its tough to have a stable job as an artist.

So when I went to university in the UK, where I did a degree in biology.

The irony, of course, is that you never have an entirely stable job in science either. During the first couple of years of my degree I didnt take it very seriously, and science as a career wasnt on the cards for me at all.

Then in the third year of my degree, everything changed when I contracted glandular fever. Studying immunology coincided with having an infection that made me feel terrible.

Im a fixer, so I started to research what was wrong with me and what could be done about it.

Until that point, science had largely just been learning from textbooks and recalling information. By doing self-directed research, I started to realise how completely fascinating viruses and the immune system are.

I absolutely fell in love with immunology and went on to do my PhD on the immune response to Epstein-Barr virus the virus that causes glandular fever.

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It was while studying for my PhD that I became obsessed with research. My mentor was world expert Professor Alan Rickinson at the University of Birmingham. He had actually worked with Tony Epstein and Yvonne Barr, who had first discovered the virus.

I began researching the role of T cells, a type of white blood cell that combats viral infection which Ive now been researching ever since.

Alan gave me free rein and I found research was totally creative and exciting. I dont draw artistically much these days, but sketch out my scientific ideas all the time.

When I dream about a problem or an ongoing issue in the lab, I wake up and think, was it that molecule we should look at? and Id draw out the molecular pathways of how something might theoretically work.

By researching T cells I realised how amazing they are they can fight HIV, malaria and cancer. I began looking around for post-doctoral opportunities in T cell research. I went to a Keystone conference in the US where Professor Frank Carbone from the University of Melbourne presented his then unpublished work on tissue-resident memory T-cells (Trms).

Up until this point, T cell research had largely focused on T cells that circulate in the blood, but Trms are specialised to operate in tissues of the body such as the skin, where they can more effectively control localised virus infections.

Listening to him I was just blown away and decided right then and there to ask him for a post-doc position in Melbourne. I was nervous just going up to him cold because I can be pretty shy, but sometimes you just need to do it. And he said sure.

It was the best and worst time of my life. It was the best time because the work was so exciting. But it was a high pressure situation working in a highly competitive field, plus the pressure to publish and win grants.

And it is soul-destroying when no matter how hard you push or how many hours you work sometimes your experiments just dont work or go anywhere and you cant see the wood for the trees.

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That is why it can be tough for young researchers working on single projects. In that respect, being head of a lab is somewhat easier because you can put projects that arent working aside for a while, and work on something else before coming back to them.

I have had projects that have been dead for years that Ive been able to reinvigorate in the wake of new discoveries or new technology.

My turning point came when for the first time I was able to demonstrate that embedded Trms could stop a skin infection. We were vaccinating mice by embedding Trm in the skin and then subsequently infecting that skin site with herpes simplex virus.

This is a virus that causes an ulcer-like lesion on the skin, so you can really see when youve stopped the infection. Thats when I realised that this stuff really works!

The endgame now is to work out how to engineer and boost the numbers of Trms where you want them so they can better fight infections. Just a few years ago this was a bit of a pipe-dream, but so many people are working in this area of research now that Trm-based therapies are very possible.

There are already phase I clinical trials under way for embedding Trms in the liver to treat malaria, as well as for embedding them in the mucosa to fight simian immunodeficiency virus (SIV), which is the primate version of HIV.

Our team are now also working with pharmaceutical companies to design drugs that target molecules to boost Trms.

What I worry most about in the Australia research sector is funding for discovery research. There is a real push now towards funding translational research that is focused on applying discoveries.

But if that comes at the expense of funding basic research, it will discourage researchers from doing blue-sky research and making discoveries the danger is that then the discovery pipeline will run out and there will be fewer ideas left to translate.

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Like many fields, medical research can be a bit of a boys club. It can be intimidating to be the only woman in the room. Its getting better all the time, but Ive had some horrifically condescending things said to me. You have to develop a thick skin.

Just from observation, I dont think women put themselves forward as much as men, and this means women can be overlooked more often. You have to be prepared to stand up for yourself and sometimes have the difficult conversations.

It isnt easy and it certainly goes against my nature, but every time Ive had a tough conversation Im always happy that I did.

I never planned to be a Laboratory Head. I really enjoyed my time as a post-doctoral researcher focused on the fun stuff that is making breakthroughs and solving puzzles. But then you get grants and fellowships, and suddenly you can employ people and start to build a team.

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I find that a huge responsibility, mentoring young scientists and keeping different projects on track. But as a team, and together with collaborators, the work we can do now is incredibly broad.

I know it sounds cheesy but the research is so fun and so collaborative. Its what has always surprised me.

As told to Andrew Trounson

Banner: A computer illustration of a T cell interacting with another part of the immune system, a dendritic cell. Picture: Getty Images

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Fighting infection with curiosity - Pursuit

Immunology

Coronavirus is not killing 3.4% of patients. How the rate got inflated and why it will get lower – Houma Courier

In February, Chinese researchers said 2.3% of people infected in that country had died from the coronavirus. This week, world health officials put the worldwide figure at 3.4%, a figure that President Donald Trump labeled Wednesday night as false.

That may not be the best choice of words, but Trump has a point: Any calculation of a death rate is premature at this point, and the real figure is almost certainly lower. With the help of a special kind of blood test, better numbers are on the way.

The issue is not that health agencies cant count, but that in the heat of an epidemic, patients with mild or no symptoms do not seek treatment, arent immediately identified, and therefore arent counted as survivors in calculating fatalities. Plus, testing those who do seek treatment has been seriously delayed in some countries, including the United States.

So on Tuesday, when the World Health Organization divided the 3,112 deaths known at that point by the 90,870 confirmed patients, for a death rate of 3.4%, they really should have been dividing by a bigger denominator if only they knew what it was.

You get an unfairly high estimate of the severity and the case fatality risk, Marc Lipsitch, professor of epidemiology at the Harvard Chan School of Public Health, said at a press briefing.

The blood screening that will provide better estimates is called a serologic test, which allows researchers to identify people who were infected with a virus weeks after they recover, said Catharine Paules, an infectious diseases physician at Penn State Health Hershey Medical Center.

That is different from the kind of rapid testing that takes place during an epidemic, when samples from suspected patients (in this case, nasal swabs) are tested for the virus itself. Soon after a person recovers, the virus can no longer be detected.

Serologic testing, on the other hand, detects the presence of antibodies that patients immune systems have produced in response to the virus, Paules said. These antibodies are produced at detectable levels within a few weeks of the initial exposure.

Rather than looking for the actual virus, a serologic test is looking for an individuals immune response to the virus, she said.

With some viruses, such as measles, antibodies can be detected years after a person was infected. With respiratory viruses, antibody levels tend to decline more quickly, but should still be detectable for several months after an infection, she said.

Armed with a serologic test, epidemiologists can test the blood from a representative sample of community members, arriving at a robust estimate of how many people were infected in a broader population. Such screening already is underway in Singapore, using a test developed by researchers at Duke-NUS, a medical school in that country with ties to Duke University. Other countries are still in the process of developing such tests.

In all likelihood, epidemiologists say, the true death rate is well below 3.4%, and even lower than the 2.3% in the Chinese study.

Yet that is not entirely good news, if it means the virus has been circulating undetected in much higher numbers. If the virus were to kill, say, 1% of 300,000 infected patients, thats the same result as 3% of 100,000: 3,000 deaths.

Generally, testing a persons blood for antibodies is done in two phases, said Stanley Perlman, a University of Iowa professor of microbiology, immunology and pediatrics.

The first round commonly involves a technique called ELISA, which makes use of customized enzymes (the E in the acronym) to detect the antibodies in question, said Perlman, a member of the American Association of Immunologists.

The second round, called a neutralizing assay, involves directly putting a patients blood sample to the test, by seeing if it will neutralize the actual virus.

In the short term, physicians are focused on treating the sick. But before long, they will have a better idea of the true scope of the problem.

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Coronavirus is not killing 3.4% of patients. How the rate got inflated and why it will get lower - Houma Courier

Immunology

Children are more likely to have other allergies if they have FPIES – Health Europa

The researchers from the Childrens Hospital of Philadelphia (CHOP) have found that children with a rare food allergy known as food protein-induced enterocolitis syndrome (FPIES), have a significantly higher chance of being diagnosed with other allergic conditions. These conditions include eczema, traditional food allergy and asthma. However, the researchers also found that FPIES did not directly cause those other allergies.

The condition causes repetitive vomiting, diarrhoea, and lethargy several hours after eating a trigger food, frequently cows milk, soy, and grains. The condition typically develops during infancy, although it can sometimes occur in older children and adults.

Melanie Ruffner, M.D., Ph.D., attending physician in the Division of Allergy and Immunology and the Center for Pediatric Eosinophilic Disorders at CHOP said: This work refines our view of the natural history of FPIES and expands our understanding of the relationship between this condition and other allergic diseases,

Its important for clinicians to keep in mind that patients with FPIES have a higher frequency of allergic manifestations and therefore provide appropriate screening and care as needed.

Previous research has collectively shown patients with FPIES have increased rates of eczema, other food allergies and asthma so-called atopic allergies researchers have not investigated the association between FPIES and other allergies to look for a potential causal link.

To begin the investigation Ruffner and her collaborators looked at a cohort of more than 150,000 paediatric patients, of which 214 had FPIES. The researchers followed the patients over a period of time to see if there were differences in the timing of when FPIES patients developed atopic allergies compared to other patients. The investigators then compared the rate of atopic allergies in FPIES patients to those without FPIES.

The results published in the Journal of Allergy and Clinical Immunology: In Practice, reveals that those with FPIES had substantially higher allergy rates than patients without the condition.

FPIES patients were diagnosed with traditional food allergy at about six times the rate of those without FPIES and with atopic dermatitis at about twice the rate. The research team found that there was a slightly smaller increase in the rate of asthma diagnoses, but those with FPIES were still diagnosed at a higher rate than those without the disease.

However, when the research team looked at the timing of the development of allergies, and whether a diagnosis of FPIES would lead to atopic allergies later in life, they did not find a causal link between the two.

Therefore, FPIES does not cause other allergic disorders but instead is associated with them unlike the progression of atopic disorders like eczema in infants to hay fever, food allergies and asthma in older children.

David Hill, M.D., Ph.D., corresponding author, attending physician in CHOPs Division of Allergy and Immunology explained that: Although there is an increased rate of atopic allergies in patients with FPIES, our analyses demonstrate that a prior diagnosis of FPIES does not increase the rate of atopic allergies later in life,

This pattern of association supports a yet-unknown cause, such as a shared predisposition to both types of allergy.

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Children are more likely to have other allergies if they have FPIES - Health Europa

Immunology

UGA and EpiVax announce collaboration to develop COVID-19 vaccine – Red and Black

The University of Georgias Center for Vaccines and Immunology is collaborating with the Rhode Island-based pharmaceutical company EpiVax to develop a COVID-19 vaccine.

EpiVax has previously worked on vaccine reengineering with the Avian influenza, and a press release said EpiVax will implement their rapid analysis and vaccine design to the COVID-19 vaccine.

The press release said CVI Director Ted Rosss lab has already obtained the COVID-19 virus, and they will work in a high-security containment facility to begin testing.

As of press time, Georgia has two patients with COVID-19, one of whom recently returned from Italy. This morning, a press release from the Office of Governor Brian Kemp stated that the Georgia Department of Public Health is waiting for a confirmation from the Centers for Disease Control and Prevention of a positive test for COVID-19 in Floyd County, Georgia.

The initial test was completed by the Georgia Public Health Laboratory on March 5, and CDC protocols require CDC verification before confirming the presumptive positive COVID-19 cases.

President Donald Trump is touring the Centers for Disease Control and Prevention in Atlanta on March 6. The trip was briefly canceled after it appeared a CDC employee developed symptoms of the virus; however, test results later cleared the employee.

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UGA and EpiVax announce collaboration to develop COVID-19 vaccine - Red and Black

Immunology

EpiVax partners with UGA researcher on Covid-19 vaccine – Pharmaceutical Technology

]]> EpiVax works towards a new vaccine against the novel coronavirus. Credit: CDC on Unsplash.

Visit our Covid-19 microsite for the latest coronavirus news, analysis and updates

Follow the latest updates of the outbreakon ourtimeline.

EpiVax has partnered with University of Georgia (UGA) researcher Ted Ross for the development of a vaccine against Covid-19 caused by the coronavirus.

Ted Ross is a vaccine expert and director of UGAs Center for Vaccines and Immunology (CVI).

EpiVax developed in silico / computational tools to detect the viral sequence regions that need to be included in vaccines while avoiding sequences linked to less effectiveness or safety.

Previously, the company used its vaccine reengineering approach to Avian influenza (H7N9) under a programme with UGA and UMASS Medical School. The programme receives its funds from the US National Institutes of Health (NIH).

According to EpiVax, rapid analysis and vaccine design were effective for H7N9, expected to aid the Covid-19 vaccine candidate.

EpiVax and the Ross lab have sought more funds from the NIH to support the rapid development of their Covid-19 candidate.

Ross lab had already obtained the novel coronavirus for testing. The new vaccine candidate will be produced and tested at the lab.

In a separate development, Generex Biotechnology entered into a contract with EpiVax to leverage computational tools for identifying epitopes that can produce peptide vaccines against Covid-19.

Generex will also use its NuGenerexImmuno-Oncology Ii-Key technology.

EpiVax has detected multiple hotspots in the amino acid sequences of coronavirus proteins.

Generex will now use epitopes predicted by EpiVax to generate a series of synthetic amino acid peptides that can imitate the virus epitopes. These peptides will be sent to China for testing with blood samples of coronavirus patients who have recovered.

The blood samples are expected to contain immune cells and antibodies that will recognise the peptides, proteins and nucleic acids of the virus.

With blood sample testing, the company aims to validate if the predicted sequences will be suitable vaccine peptides.

Last month, Generex signed a contract with four companies in China for the development of an Ii-Key Peptide-based Covid-19 vaccine.

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EpiVax partners with UGA researcher on Covid-19 vaccine - Pharmaceutical Technology

Immunology

Scientists say they’ve identified 2 strains of COVID-19 – Abccolumbia.com

One strain was common in Wuhan, China, then dropped off significantly.

By Erin SchumakerABC News Scientists from China said theyve identified two strains of COVID-19 linked to the recent outbreak.

Coronaviruses are a large family of RNA viruses, and when RNA viruses replicate quickly, they often mutate.

Researchers analyzed 103 sequenced genomes using strains from China, and found that 70% of strains were one type, which they called L. The L strain was more aggressive than the remaining 30% of strains, which were dubbed S.

The first strain was more common at the beginning of the outbreak, in Wuhan, China, but its frequency decreased after early January. That drop-off could be a result of the strict measures China put in place to try and stem the spread of the virus.

The new paper, published Tuesday in the National Science Review from the Chinese Academy of Sciences, is preliminary, the papers authors cautioned.

The scientists only analyzed strains from China, so more information is needed about strains from other countries to determine whether the same viruses have spread worldwide.

Dr. Stanley Perlman, a professor of microbiology and immunology at the University of Iowa who has researched SARS and MERS, said that the new paper didnt prove that one strain was more aggressive or faster spreading than the other.

For now, it looks like there are two strains, but we do not know exactly what this means, said Perlman, who is not connected to the new paper.

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Scientists say they've identified 2 strains of COVID-19 - Abccolumbia.com

Immunology

Groundbreaking Study Finds Peanut Allergy Likely Starts In The Gut – Allergic Living

Photo: Getty

Scientists have long knownthat when it comes to allergic reactions, the IgE antibody is the main culprit.But a groundbreaking new study has found the gut plays a powerful role in theprocess. Researchers at Stanford University say their findings could not onlyhelp determine the root cause of allergies, but also lead to life-changingtreatments.

The California research teamused an endoscope to take tissue samples from the esophagus, stomach and smallintestine of 19 peanut-allergic people taking part in an oral immunotherapytrial. Then they closely examined those cells and compared them with ones foundin the blood.

According to study lead author Ramona Hoh, PhD, they found that peoples rapid response to allergens is due in part to a memory response thats contained in specific kinds of B cells in the gut. When those B cells encounter an antigen like peanut in a person with peanut allergy, they can switch into plasma cells and start pumping out reaction-inducing IgE antibodies.

So this may be how these IgE antibodies get produced so quickly, because theyre actually residing in the stomach and duodenum tissue, Hoh, a senior scientist in the department of pathology at Stanford University, told Allergic Living. She notes that the number of these IgE-producing cells was hundreds of times higher in the gut than whats typically found in the bloodstream.

Using genetic analysis, the researchers were also able to confirm that the cells were being made in the stomach and the duodenum of the small intestine. This showed they were not being generated elsewhere in the body, and then traveling to the gut.

Whats more, many of thepatients shared similar peanut-reactive IgE DNA sequences, which means theirimmune systems see peanut proteins in a similar way.

We think thats extremely interesting because with antibodies youre dealing with this hugely complex, diverse universe, study co-author Dr. Scott Boyd told Allergic Living. But if you look at enough people, you start to recognize the common patterns that are associated with the disease.

We think that may allow usto say whos a better candidate for a certain kind of treatment, for example,or may allow us to better distinguish who is just sensitized to the allergen,but may not react strongly if they eat it, said Boyd, the principalinvestigator at Stanford Medicines Scott Boyd Labratory for Human Immunology.

Titled Origins andclonal convergence of gastrointestinal IgE+ B cells in human peanut allergythe studywas published in the journal ScienceImmunology. While it focused on peanut allergy specifically, Hoh and Boydbelieve the process could be similar for other allergens.

We set out to study peanutallergy because of its high incidence in the population, says Boyd. But inprincipal, we could have done the same study for tree nut allergy or shellfishallergy or others, and we suspect that we would have had similar findings, thatthere would be a lot of these IgE-expressing B cells in the gut.

Hoh adds that the gut of a non-allergicperson looks decidedly different. That difference was most clear in thestomach and the stomach isnt really a tissue thats known to have a lot ofplasma cells or B cells of any type, she says. So it was a pretty dramaticfinding.

IgE is the main catalyst behind allergic reactions. When people have allergies to peanuts or other substances, they develop IgE antibodies that recognize the proteins and other components of those specific allergens. The IgE then binds to the surface of mast cells. With exposure to the allergen, those cells then release inflammatory substances such as histamine. These set off reactions that can range from swollen eyes to hives or digestive symptoms and, in more serious cases, anaphylaxis.

In people without allergies, B cells are most often involved with helping to protect against infectious disease. For example, if you get a vaccination for measles or mumps, the B cells get stimulated by the vaccine and pump disease-fighting antibodies into your blood cells.

By analyzing the B cells that produce the allergen-specific IgE, the Stanford team hoped to help find the root cause of allergies. Until now, researchers have been almost entirely restricted to looking at the cells they can detect in the blood of patients, because getting samples of tissues in the gut is extremely challenging. Their efforts paid off.

We know the human body iscomplicated, and a much bigger space than the blood alone. And there arecertain tissues, like those in the digestive system where, if someone has foodallergy, the reaction starts, says Boyd. And we had reason to suspect theremay be a whole separate aspect of the immune system thats localized to thetissues of the gut and the digestive system, and that those would be worthstudying.

Besides furthering the understanding of how allergic reactions work, Boyd and Hoh say the research could lead to better diagnosis, treatment and prevention. They raise the possibilty for treatments that could prevent the IgE antibodies from triggering reactions.

Boyd points to a recentstudy involving patients with cat allergies, in which participants weregiven a biologic drug that blocked the IgE response and significantly reduced theseverity of their allergic reactions. Theres no reason one couldnt try to dothe same thing for peanut allergy, says Boyd. It might be a bit morecomplicated because there are more allergen molecules involved, but it wouldseem like a viable thing to try.

In recent years, scientistshave developed a far greater understanding of the role the humanmicrobiome plays in the allergic process, and Boyd says theyre starting toreally hone in on potentially life-changing answers, which could lead totargeted treatments.

My guess is there are goingbe more new treatments approved for allergy, and things that might be moresuitable for one patient compared to another in the years ahead, says Boyd.So I think theres room for guarded optimism in patients who suffer from thesedisorders.

See the full study here.

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Groundbreaking Study Finds Peanut Allergy Likely Starts In The Gut - Allergic Living

Immunology

Mount Sinai and Harbour BioMed Collaborate to Advance Novel Biotherapies for the Treatment of Cancer and Coronavirus COVID-19 – BioSpace

NEW YORK & CAMBRIDGE, Mass. & ROTTERDAM, Netherlands & SUZHOU, China--(BUSINESS WIRE)-- Mount Sinai Health System and Harbour BioMed (HBM) have entered into a multi-year, multifaceted collaboration to develop novel, fully human antibodies for the treatment and prevention of various diseases including oncology and immunology.

This press release features multimedia. View the full release here: https://www.businesswire.com/news/home/20200306005051/en/

The collaboration will also utilize the H2L2 Harbour Mice platform to generate monoclonal antibodies against the coronavirus SARS CoV 2 COVID-19 (commonly known as COVID-19). These fully human monoclonal antibodies could be used therapeutically for people who have been exposed to the virus, or prophylactically for individuals with a high risk of exposure, such as healthcare workers. The antibodies have the potential to prevent spread of the virus by blocking infection of cells.

We are pleased to be able to collaborate with HBM at this time and leverage our experience in therapeutic antibody generation as well as the viral expertise of the Microbiology Department with the unique human antibody producing mice from Harbour, said Professor Thomas Moran, PhD, Director, Center for Therapeutic Antibody Development (CTAD) at Icahn School of Medicine at Mount Sinai.

This is a unique collaboration that will give HBM access to Mount Sinais innovative research driven from its clinical practices. The agreement demonstrates HBMs commitment to develop novel medicines and foster fast-track innovative research. We will push the boundaries of science and the development of new medicines that will ultimately translate into better treatments for patients, said Jingsong Wang, MD, PhD, Founder, Chairman & Chief Executive Officer of HBM.

The relationship with HBM is yet another opportunity for Mount Sinai to develop new treatments for significant diseases and conditions, said Erik Lium, PhD, President, Mount Sinai Innovation Partners. This work will bring Mount Sinais innovation ecosystem one step closer to the drug development process.

About Mount Sinai Health System

The Mount Sinai Health System is New York City's largest academic medical system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai is a national and international source of unrivaled education, translational research and discovery, and collaborative clinical leadership ensuring that we deliver the highest quality carefrom prevention to treatment of the most serious and complex human diseases. The Health System includes more than 7,200 physicians and features a robust and continually expanding network of multispecialty services, including more than 400 ambulatory practice locations throughout the five boroughs of New York City, Westchester, and Long Island. The Mount Sinai Hospital is ranked No. 14 on U.S. News & World Report's "Honor Roll" of the Top 20 Best Hospitals in the country and the Icahn School of Medicine as one of the Top 20 Best Medical Schools in country. Mount Sinai Health System hospitals are consistently ranked regionally by specialty by U.S. News & World Report.

About Mount Sinai Innovation Partners

Mount Sinai Innovation Partners (MSIP) is responsible for driving the real-world application and commercialization of Mount Sinai discoveries and inventions, and the development of research partnerships with industry. Our aim is to translate discoveries and inventions into health care products and services that benefit patients and society. MSIP is accountable for the full spectrum of commercialization activities required to bring Mount Sinai inventions to life. These activities include evaluating, patenting, marketing and licensing new technologies building research, collaborations and partnerships with commercial and nonprofit entities, material transfer and confidentiality, coaching innovators to advance commercially relevant translational discoveries, and actively fostering an ecosystem of entrepreneurship within the Mount Sinai research and health system communities. For more information, please visit http://www.ip.mountsinai.org.

About Harbour BioMed

Harbour BioMed is a global, clinical stage biopharmaceutical company developing innovative therapeutics in the fields of immuno-oncology and inflammatory diseases. The company is building its proprietary pipeline through internal R&D programs, collaborations with co-discovery and co-development partners and select acquisitions.

The company's internal discovery programs are centered around its two patented transgenic mouse platforms (Harbour Mice) for generating both fully human monoclonal antibodies and heavy chain only antibodies (HCAb) based immune cell engager (HBICETM) bispecific antibodies. Harbour BioMed also licenses the platforms to companies and academic institutions. The company has operations in Cambridge, Massachusetts; Rotterdam, The Netherlands; and Suzhou & Shanghai, China.

View source version on businesswire.com: https://www.businesswire.com/news/home/20200306005051/en/

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Mount Sinai and Harbour BioMed Collaborate to Advance Novel Biotherapies for the Treatment of Cancer and Coronavirus COVID-19 - BioSpace

Immunology

Physicians’ Education Resource to Present Live Symposium on Asthma at the 2020 American Academy of Allergy, Asthma & Immunology Annual Meeting -…

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Immunology

Children with a rare food allergy have higher chance of being diagnosed with other allergies – The Medical News

Researchers at Children's Hospital of Philadelphia (CHOP) have found that children with a rare food allergy known as food protein-induced enterocolitis syndrome, or FPIES, have a significantly higher chance of being diagnosed with other allergic conditions, including eczema, traditional food allergy and asthma. But the researchers also found that FPIES did not directly cause those other allergies.

The study was published in the March issue of The Journal of Allergy and Clinical Immunology: In Practice.

"This work refines our view of the natural history of FPIES and expands our understanding of the relationship between this condition and other allergic diseases," said first author Melanie Ruffner, M.D., Ph.D., attending physician in the Division of Allergy and Immunology and the Center for Pediatric Eosinophilic Disorders at CHOP. "It's important for clinicians to keep in mind that patients with FPIES have a higher frequency of allergic manifestations and therefore provide appropriate screening and care as needed."

FPIES causes repetitive vomiting, diarrhea, and lethargy several hours after eating a trigger food, frequently cow's milk, soy, and grains. The condition typically develops during infancy, though it can occasionally occur in older children and adults.

Although previous research has collectively shown patients with FPIES have increased rates of eczema, other food allergies and asthma - so-called atopic allergies - researchers have not investigated the association between FPIES and other allergies to look for a potential causal link.

To do so, Ruffner and her collaborators looked at a cohort of more than 150,000 pediatric patients, of which 214 had FPIES. The investigators compared the rate of atopic allergies in FPIES patients to those without FPIES. They also followed the patients over time to see if there were differences in the timing of when FPIES patients developed atopic allergies compared to other patients.

The authors found that those with FPIES had substantially higher allergy rates than patients without the condition. FPIES patients were diagnosed with traditional food allergy at about six times the rate of those without FPIES and with atopic dermatitis at about twice the rate. There was a slightly smaller increase in the rate of asthma diagnoses, but those with FPIES were still diagnosed at a higher rate than those without the disease.

However, when the research team looked at the timing of the development of allergies, and whether a diagnosis of FPIES would lead to atopic allergies later in life, they did not find a causal link between the two. Thus, unlike the so-called atopic march - the progression of atopic disorders from eczema in infants to hay fever, food allergy and asthma in older children - FPIES does not cause other allergic disorders but instead is associated with them.

Although there is an increased rate of atopic allergies in patients with FPIES, our analyses demonstrate that a prior diagnosis of FPIES does not increase the rate of atopic allergies later in life. This pattern of association supports a yet-unknown cause, such as a shared predisposition to both types of allergy."

David Hill, M.D., Ph.D., corresponding author, attending physician in CHOP's Division of Allergy and Immunology

Source:

Journal reference:

Ruffner, M.A., et al. (2020) Elevated Atopic Comorbidity in Patients with Food ProteinInduced Enterocolitis. Journal of Allergy and Clinical Immunology: In Practice. doi.org/10.1016/j.jaip.2019.10.047.

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Children with a rare food allergy have higher chance of being diagnosed with other allergies - The Medical News