In order to understand and compare both, the natural and the induced tolerance development in food allergy, we will focus on two different patient groups:
- The “EFA cohort", which comprise infants and children with and without atopic dermatitis and suspected food allergy who are undergoing oral food challenge for food allergy diagnosis. In this cohort we will investigate the natural tolerance development in order to identify biomarkers as predictors for resolution of food allergy. We will focus on peanut and hen's egg allergy in order to examine allergies with rare and frequent tolerance development.
- The “SOTI cohort", which comprise patients with challenge-proven peanut allergy who underwent oral immunotherapy and are currently in long-term follow-up. In this cohort we will investigate the induced tolerance development.
First step: We aim to identify “natural resolution factors" first cross-sectional comparing patients with known food allergy from the EFA cohort who subsequently gained natural tolerance with those who stayed allergic upon re-challenge.
Second step: We will compare successfully treated peanut allergic patients in long-term follow-up from the SOTI-Cohort (patients who underwent oral immunotherapy) who gained induced tolerance with patients who gained natural tolerance or allergic ones. In this way we will be able to compare the factors involved in induced tolerance development with those involved in natural tolerance development.
Finally in the third step, the same biomarkers will be investigated longitudinally in patients from the EFA cohort to proof the usefulness of the identified biomarkers for prediction.
As main result, the identification of natural and inducible “resolution factors" will enable us to better understand tolerance development in food allergy and to predict the individual time course in food allergic patients. This would allow identifying patients who would profit from immunotherapeutic approaches in the future and the development of novel therapeutic options.
