Food Allergy Program

Food allergy and allergic disorders of the intestinal tract are increasing in Canada and other industrialized countries. The impact of these disorders in children is profound. It is reported that 5 to 8% of infants and young children and up to 2% of adults have food allergy. These numbers have doubled over the past 15 to 20 years. Patients are at risk of serious disease and even death from anaphylactic reactions to food, leading to anxiety around these issues, increased burden on the health care system and significantly impacting the quality of life of patients and families.

In parallel with these food allergies, allergic disorders that affect the gastrointestinal (GI) tract are also increasing, in particular, a new disorder, ‘eosinophilic esophagitis’ (EoE). The cause of this disorder is unknown, but it typically affects people with other allergic disorders such as asthma, atopic dermatitis and food allergy. Despite these disturbing trends, there is a lack of basic research directed towards gastrointestinal food allergy.

The Food Allergy Program at Queen’s University is dedicated to the evaluation and treatment of patients with food allergic disorders, and to investigate the causes of these disorders. Our over-riding goal is to bring bench research back to impact on patient care.

The surface epithelium of the intestinal tract forms a critical barrier between what is swallowed and the body’s immune system that underlies it. It is believed that abnormal activation of the immune system is responsible for what is seen in allergic diseases. Whether this is due to abnormalities in the epithelial barrier, abnormalities of the immune system or both, remains to be investigated. Both genetic and environmental factors contribute to this problem, but the relative contribution of each of these is unknown. One aspect of our research explores how allergy may be triggered by environmental factors such as infection, in individuals susceptible to allergy.

As Director of the Food Allergy Program and Pediatric Gastroenterology, Dr. Justinich is in a unique position to identify and evaluate these patients. Dr. Justinich has developed and maintains a detailed database to help identify prevalence, risk factors, triggers, and the response to current and future treatments. Coupled with the clinical program is a basic science laboratory housed within the Queen’s University GI Diseases Research Unit (GIDRU). The laboratory was set up with the help of Queen’s University, the GIDRU, and funding from the Canadian Foundation for Innovation New Opportunities Grant and Ontario Innovation Trust. This fully equipped laboratory, along with the depth of collaborative expertise within GIDRU and in the greater Queens’s community, has the potential to significantly advance our knowledge of allergic GI inflammation.

The ultimate goal is to study the cause of GI allergy, to identify diagnostic tests and new treatments through this research program. Innovation in this area can only be accomplished through research.

Dr. Justinich
Dr. Justinich is a graduate of Queen’s University (Medicine ’84) with fellowship training in Pediatrics at the Children’s Hospital of Eastern Ontario (University of Ottawa), Pediatric Gastroenterology at Ste Justine Hospital (University of Montreal). His interest in food allergy led to development of unique food allergy programs at Connecticut Children’s Medical Center and AI DuPont Hospital for Children, and now at Queen’s University. These clinics were designed to specifically address the issue of gastrointestinal food allergy in complex patients with these difficult to manage problems. Through his research, publications and national and international presentations, Dr. Justinich has established himself as an expert in the field of gastrointestinal food allergy. He is widely recognized by his colleagues in Pediatric Gastroenterology and Allergy and Immunology for his efforts in this area. Dr. Justinich has participated with leaders in the food industry in the development of novel formulas designed specifically for patients with food allergic disorders. He has been an advisor to pharmaceutical companies designing and studying new allergy treatments.

Education
Teaching of medical students, residents, fellows and allied health workers as well as educating the public is an important component of the Food Allergy Program. Trainees in the research laboratory help develop skilled research personnel with an understanding of allergic disorders. Increased awareness and proper training of health care personnel will help diminish the impact of food allergy.

Research
From a basic research point of view, we study epithelial biology and models of food allergic disorders in cells maintained in culture. We do not work in experimental animals.

From a public health point of view, research into the causes of intestinal food allergy will help explain the increased prevalence of atopic disorders. This would have great importance to society because of the burden created by food allergy and other atopic disorders.

Our current areas of research include:
  1. How epithelial cells in the GI tract participate in the allergic response
  2. Mast cells and eosinophils in disorders of the esophagus
  3. How infectious agents trigger allergic responses
  4. How medications used to treat allergic disease in one site, such as asthma, may have different effects on the GI tract
  5. How nerves participate in allergic inflammation
  6. The connection between food allergy and autism spectrum disorders
 
References to recently published articles and abstracts can be found here.