De­vel­op­ing a cure for al­ler­gies

Dis­cov­ery of ‘bad’ im­mune sys­tem cells brings forth hope of im­proved treat­ment, or even cure, for al­lergy dis­or­ders.

The Star Malaysia - Star2 - - Health - By SANDI DOUGHTON

AL­LERGY suf­fer­ers know the drill: eyes that itch and wa­ter; sneezes that won’t stop; the fear that a hid­den morsel of peanut will trig­ger a life-or-death cri­sis.

Over-the-counter drugs and al­lergy shots de­liver re­lief to some peo­ple, but not oth­ers.

Now, a dis­cov­ery by re­searchers holds out the hope of bet­ter di­ag­no­sis and treat­ment for al­ler­gies of all types – and may even lead to a cure some­day.

“I think it’s a big deal,” said Dr David Robin­son, an al­lergy spe­cial­ist at Vir­ginia Mason Med­i­cal Cen­ter in Seat­tle, US, and co-au­thor of the study, which is fea­tured on the cover of last week’s edi­tion of the jour­nal Sci­ence Trans­la­tional Medicine.

“Ul­ti­mately we’re in­ter­ested in fix­ing al­ler­gies and treat­ing peo­ple, but you have to un­der­stand it first.”

Led by re­searchers at Vir­ginia Mason’s Be­naroya Re­search In­sti­tute, the Seat­tle team is the first to find a way to dis­tin­guish the “bad” im­mune-sys­tem cells that trig­ger al­ler­gies from “good” im­mune cells that fight in­fec­tion.

They also showed that ef­fec­tive al­lergy ther­apy ban­ishes the bad cells from the body.

“If you are al­ler­gic, you have those bad cells,” said lead au­thor Erik Wam­bre. “If you are not al­ler­gic, you don’t.”

That means sci­en­tists should be able to de­velop a test to iden­tify peo­ple at risk of al­ler­gies, even at a very young age, he said.

For par­ents, that could elim­i­nate the pan­icked trips to the emer­gency room that are of­ten the first in­di­ca­tion that their child has a dan­ger­ous food al­lergy.

The abil­ity to mon­i­tor the level of bad cells in a pa­tient’s blood would also al­low doc­tors to quickly de­ter­mine whether treat­ment is work­ing.

But it’s the pos­si­bil­ity of stamp­ing out the bad cells al­to­gether that has the re­searchers most ex­cited.

“I’m pretty op­ti­mistic,” said Wam­bre. “My hope is that we might find a drug that will specif­i­cally de­stroy the (bad) cells, or at least stop them.”

Al­most 50 mil­lion Amer­i­cans suf­fer from nasal al­ler­gies, while about four mil­lion chil­dren have food al­ler­gies.

The Asthma and Al­lergy Foun­da­tion of Amer­ica es­ti­mates the to­tal amount spent on drugs, shots and other health­care at nearly US$18bil (RM77.07bil) a year.

Al­ler­gic re­ac­tions are trig­gered when the im­mune sys­tem mis­tak­enly sounds the alarm over harm­less sub­stances like pollen or dust or cat dan­der, un­leash­ing a cas­cade of chem­i­cals that cause the nose to drip, the si­nuses to clog and the air­ways to swell shut.

Iden­ti­fy­ing the cells re­spon­si­ble has been tough be­cause there are so few of them, Wam­bre ex­plained.

A mil­li­liter sam­ple of blood can con­tain more than a mil­lion white blood cells, but only a hand­ful fall into the “bad” cat­e­gory. Find­ing them is like try­ing to lo­cate an in­di­vid­ual among the nearly 700,000 peo­ple in Seat­tle, he said.

The key to the team’s suc­cess is a tech­nique pi­o­neered at Be­naroya by Wil­liam Kwok. The method uses mol­e­cules called tetramers tai­lored to latch onto spe­cific cell sur­face pro­teins – then to light up when they find a match.

Work­ing with blood from pa­tients with and with­out al­ler­gies, the re­searchers screened each sam­ple for 200 pro­teins or other char­ac­ter­is­tics – at a cost of thou­sands of dol­lars per test. It took them seven years to zero in on five key dif­fer­ences be­tween good and bad cells, Wam­bre said.

The paper re­ports re­sults from 80 pa­tients with al­ler­gies and 34 with­out, but the team has tested sam­ples from hun­dreds of pa­tients with a wide range of al­ler­gies – Robin­son in­cluded.

“I’m pa­tient zero for a lot of our stud­ies,” he said.

Af­ter years of im­munother­apy, his blood is free of the “bad” cells that used to plague him with sea­sonal grass al­ler­gies. The re­searchers also showed sim­i­lar re­sults in a small group of pa­tients in­volved in an ex­per­i­men­tal treat­ment for peanut al­ler­gies.

David Cousins, an al­lergy re­searcher at the Univer­sity of Le­ices­ter in the United King­dom, dis­cussed the sig­nif­i­cance of the dis­cov­ery in an ac­com­pa­ny­ing ar­ti­cle in the jour­nal.

The study is “an ex­cel­lent piece of re­search”, he said in an email. But he cau­tioned that more work will be re­quired to de­velop stan­dard tests to dis­tin­guish bad cells from good, and to show that the bad cells re­ally are com­mon to all types of al­ler­gic dis­eases.

“Ideally, the re­sults need to be con­firmed in sev­eral dif­fer­ent re­search lab­o­ra­to­ries to make sure the re­sults are ro­bust,” he said.

Robin­son, whose al­lergy symp­toms are gone, said many of his pa­tients aren’t as lucky. Af­ter years of al­lergy treat­ment, it’s not un­com­mon for peo­ple to re­lapse, par­tic­u­larly with food al­ler­gies.

That’s why the idea of a com­plete cure is so ap­peal­ing.

“The po­ten­tial may be there for turn­ing off the al­ler­gic process,” he said. “Hon­estly, we’re not sure how far this is go­ing to go at this point.” – The Seat­tle Times/Tri­bune News Ser­vice

Th­ese test tubes hold the mark­ers that can dis­tin­guish hu­man blood cells af­fected by al­ler­gens from nor­mal ones.— TNS

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