Food allergy researchers propose diagnostic ‘tiers’ to improve food allergy genetics studies
A new approach to harmonizing food allergy phenotypes could improve genetic research in food allergy, according to an international consortium of experts convened by AllerGen researchers.
The authors published their recommendations as a Letter to the Editor in Allergy, the official journal of the European Academy of Allergology and Clinical Immunology. The publication is the main outcome of the International Food Allergy Consortium (InFAC) meeting of more than 30 food allergy genetics researchers and stakeholders, held in Vancouver, BC, in February 2019.
“Food allergies are caused by a complex interplay of genetics and the environment,” said lead author Dr. Yuka Asai, a dermatologist and an associate professor at Queen’s University. “It is critical to pursue joint global approaches to identify the genetic drivers of food allergy; however, the diagnosis of food allergy is based upon both clinical and laboratory parameters that may vary across genetic studies.”
To address this gap, the researchers recommend four “tiers” of food allergy phenotypes to standardize diagnostic definitions, improve sample sizes in genetics studies, and enable large-scale international collaborations. The diagnostic tiers range from a convincing allergic reaction confirmed by oral food challenge (most stringent definition) to laboratory tests that show evidence of sensitization to a food at a level suggestive of an allergy (least stringent definition).
“We need a balance between the oral food challenge – which is considered the gold standard of food allergy diagnosis – and well-accepted global clinical and laboratory surrogate markers,” commented the paper’s senior author Dr. Denise Daley, an associate professor at The University of British Columbia and the Centre for Heart Lung Innovation at St. Paul’s Hospital. “By employing these tiers to phenotype patients, we will be able to pool data across studies, which is a cost-effective method to increase power in large-scale genetic studies.”
“Food allergy phenotypes have been a key hurdle to the progress of international collaborations on food allergy genetic research,” added Dr. Asai. “We believe this paper will open the door to future large-scale studies, improved diagnostics and new treatment options for people living with food allergies.”
In addition to international experts, numerous AllerGen investigators and Network members co-authored the paper including: Dr. Meghan Azad (University of Manitoba); Dr. Edmond Chan (The University of British Columbia); Dr. Ann Clarke (University of Calgary); Dr. Thomas Eiwegger (University of Toronto); Dr. Susan Elliott (University of Waterloo); Dr. Anne Ellis (Queen’s University); Dr. Aida Eslami (Université Laval); Jennifer Gerdts (Food Allergy Canada); Dr. Christine Hampson (The Sandbox Project); Dr. Catherine Laprise (Université du Québec à Chicoutimi); Dr. Bruce Mazer (McGill University); Dr. Diana Royce (AllerGen); Dr. Andrew Sandford (The University of British Columbia); Dr. Elinor Simons (University of Manitoba); and Dr. Lianne Soller (The University of British Columbia).