Slide presentation by Dr. Edward Brooks from Texas Public Radio's Think Science event held at the Pearl Studio on May 17, 2019.

1. Edward Brooks
UT Health

2. Every day we come into contact with proteins in our
environment that could stimulate an immune reaction, including
foods, pets, and plants. These environmental proteins are
innocuous, but when the immune system overreacts and
recognizes these proteins as harmful, a hypersensitive state
results. This state of hypersensitivity is known as allergy, and
the proteins that trigger allergy are known as allergens.

3. The Atopic March
In utero
 Genetic predisposition
 Maternal influence-fetal programming
 Environmental factors
Infancy
 Eczema (dry itchy skin)
 Food Allergy
Toddler
 Asthma
School Age
 Asthma
 Allergic rhinitis (Sinus allergies)

4. Beginning in the 1960’s, the dramatic rise in allergic diseases has
led to the “allergy epidemic”. The rise in allergic diseases has been
prominent in “developed” countries such as Western Europe,
Australia, and the United States. Current estimates suggest that
anywhere from 10-40% of the population in these developed
countries have some form of allergy.

5. The Hygiene Hypothesis
protective effect with exposure to:
 farms
 pets
 day care
 large family size
 bacterial exposures
 frequent infections (fewer antibiotics)

6. THI/TH2 balance in infancy
TH2 predominance
Allergic
TH1 predominance
Non-allergic
Adapted from David L. Rosenstreich, M.D CDN Proceedings 2003.

7. Progression of THI/TH2 balance during
normal infancy
TH2 predominance
Allergic
TH1 predominance
Non-allergic

8. Progression of THI/TH2 balance during
normal infancy
TH2 predominance
Allergic
TH1 predominance
Non-allergic

14. Adapted from David L. Rosenstreich, M.D CDN Proceedings 2003.

15. Adapted from David L. Rosenstreich, M.D CDN Proceedings 2003.

16. The Hygiene Hypothesis

17. Allergic Inflammation
B Cell TH2 Cell
Antigen Presenting Cell
IgE
Mast
Cell
IL-4
IL-13
IL-3
IL-4
IL-6
IL-9
IL-13
TNF-a
IL-4
IL-3
IL-5
GM-CSF
VCAM ICAM
Vascular Endothelium
Eosinophil Neutrophil
Eotaxin

18. Specific IgE Testing
Skin Prick Testing Blood Testing

19. Inhalent Allergens
 Provoked by exposure to environmental
allergens
 Perennial (year round)
(mites, molds, pets)
 Seasonal (intermittent) (pollens)

20. Israel:
 Egg
 Milk
 Sesame seeds
Singapore:
 Birdsnest
 Seafood
 Egg
 Milk
France:
 Egg
 Peanuts
 Milk
 Mustard
USA:
 Milk
 Egg
 Peanuts
 Tree nuts
 Seafood
Australia:
 Milk
 Egg
 Peanuts
 Sesame seeds
Italy:
 Milk
 Egg
 Seafood
Major Food Allergens
Sampson et al.

21. Natural History of milk allergy