Michigan Food and Atopic Dermatitis (M-FAD) Program - Molecular Analytics Project

Overview

This study will explore potential links between atopic dermatitis and food allergy. This information will be useful to determine atopic dermatitis and food allergy share unique biochemical or genetic identifiers useful for diagnosing and treatments in the future. This is a mechanistic study consisting of obtaining blood and skin samples from participants at baseline. Individuals may also undergo a clinically indicated oral food challenge and have blood and skin samples collected at various times during the oral food challenge. This study will create a molecular map of the pathology of atopic dermatitis and food allergy. This information will be deployed to evaluate the hypothesis that atopic dermatitis and food allergy share unique genetic transcriptional signals in which the study team can then further analyze pathological pathways and cell types.

Detailed description

This study will be funded by the National Institute of Health. Once the funds are received, the registration will be updated with this information.

Interventions

• Other Data and biospecimen collection
  Enrolled participants will have health-related information and blood specimens collected.
• Other Skin biopsies
  Participants will be asked to provide one or two skin biopsies (days 1 and 2) from the forearm, unless the participant is a healthy child (no food allergy and no atopic dermatitis), in which case there will be no skin biopsy.
• Other Oral Food Challenge (OFC) procedures
  Participants will have the choice of consenting to an OFC (approximately 2-4 hours) to peanut, tree nut, egg, milk, or sesame. If there is no allergy history, the study team will conduct an oral food challenge to one of the choices. The OFC will occur in the clinical research area. and done the same as a clinical care OFC. A transepidermal water loss monitor will be applied to participant's arm with a sticky pad and will stay on the arm for the challenge. Food doses will be given in small amount

Primary outcome measures

• Anaphylaxis occurrence rates in each group [Time frame: Approximately 4 hours (Day 1 during the food challenge)]

Secondary outcome measures (3)

• Anaphylaxis severity in each group [Time frame: Approximately 4 hours (Day 1 during the food challenge)]
• Reaction rates in each group [Time frame: Approximately 4 hours (Day 1 during the food challenge)]
• Anaphylaxis likelihood in each group based on the Brighton score [Time frame: Approximately 4 hours (Day 1 during the food challenge)]

Eligibility criteria

Food allergy-only group Inclusion Criteria:

• Have a known history of food anaphylaxis to peanut, tree nut, egg, milk, or sesame confirmed by an allergist.
• Have had skin and blood food allergy testing to the food allergen in question within the past 6 months. Meet the 80% likelihood positive predictive value threshold for allergy based on at least 1 of either the skin or blood immunoglobulin E (IgE) tests per current literature corrected for age. See protocol for more details.
• No history of atopic dermatitis

Food allergy plus atopic dermatitis group Inclusion Criteria:

\- Meet the "food allergy only group" inclusion criteria except this group must also have atopic dermatitis.

Atopic dermatitis without food allergy Inclusion Criteria:

• Have a present diagnosis of atopic dermatitis by an allergist and/or dermatologist.
• Have no history of food allergy, past or present.

Control Group Inclusion Criteria:

\- No history of food allergy or atopic dermatitis, past or present.

Exclusion Criteria for all groups:

• People younger than age 10 or older than age 55
• Any active cardiovascular disease, cancer, pulmonary disease except well-controlled asthma, or other condition that would preclude an OFC otherwise. Mild conditions that would not preclude an OFC are allowed (i.e., controlled hypertension or a surgically removed skin cancer that is resolved would not be exclusionary for this study, for example).
• Any medication use that cannot be stopped temporarily for the OFC that would interfere with the OFC result. Medications in this category include antihistamines (first or second generation) within 1 week.
• Any skin condition aside from atopic dermatitis per inclusion criteria groups that might impact the study, including such conditions as autoimmune skin conditions (such as psoriasis), congenital ichthyoses, hyper-IgE syndromes.
• Any recent change (within 6 months) of starting or stopping a biologic medication, such as dupilumab, tezepelumab, or others that might interfere with atopic dermatitis or food allergy.
• Any past or present history of oral immunotherapy (OIT) for any food allergen.
• Pregnancy - females of childbearing age will be asked and self-report pregnancy status.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Non-randomized

Model

Parallel assignment

Masking

Open label

Primary purpose

Basic science

Study locations

United States · 1 center

• University of Michigan — Ann Arbor

Identifiers

NCT: NCT06300697 · HUM00235532

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗