Pediatric Allergy & Immunology - UT Southwestern

Pediatric Allergy & Immunology
2011 Academic Review
The Division of Allergy and Immunology in the Department of Pediatrics was
established approximately nine years ago. Originating in the Department of Internal
Medicine, it now spans both departments, with three Pediatric-based and two Internal
Medicine-based faculty members, each board certified in Allergy and Immunology.
Pediatric allergy specialists, Drs. Indulekha Warrier and Drew Bird see children
with allergic disorders and asthma at Children’s Medical Center, staffing eight allergy
clinics per week. In addition, there are eleven pediatric volunteer faculty who rotate
monthly to staff one clinic per week.
Rebecca Gruchalla, M.D., Ph.D.
Professor, Internal Medicine and Pediatrics,
Director, Pediatric Allergy & Immunology,
William A. Sellars, MD, and Joyce M. Sellars
Distinguished Chair in Allergy and Immunology
The pediatric division’s focus and expertise continues to be in the areas of primary
immunodeficiency, food allergy, allergic rhinitis and asthma. Dr. Maite de la Morena
has established a primary immunodeficiency program at Children’s. She sees inpatient
consultations for immunodeficiency disorders and has three clinics per week during
which she evaluates these patients.
Dr. David Khan is the Program Director of the Allergy and Immunology fellowship
program. Both he and Dr. Rebecca Gruchalla, Division Director, see adults and
children with asthma and allergic disorders at the Aston Center at UT Southwestern.
The division continues to participate in both clinical and basic science research efforts.
As both a clinical and a mechanistic site in the Inner City Asthma Consortium (ICAC), it continues to expand its research
efforts in pediatric asthma. The division also collaborates with various basic scientists on campus, including Drs. Michelle
Gill, Assistant Professor of Pediatrics and Internal Medicine, Nitin Karandikar, Professor of Pathology, Immunology,
Neurology and Neurotherapeutics, and David Farrar, Associate Professor of Immunology and Molecular Biology.
The Primary Immunodeficiency Program at Children’s was awarded recognition by the Jeffrey Modell Foundation as
a Center of Excellence for diagnosis and treatment of primary immunodeficiency diseases. The Immunology Program
serves a large geographic referral area encompassing North Texas, eastern New Mexico, Oklahoma, western Louisiana and
southern Arkansas. This comprehensive program provides both diagnostic and state-of-the-art treatment opportunities for
patients with primary immunodeficiency diseases. Furthermore, the Immunology Program is committed to the education
of physicians and other healthcare providers, trainees, the general public, patients and families regarding diagnosis,
manifestation, natural history and treatment of primary immunodeficiency diseases.
Faculty
J. Andrew (Drew) Bird, M.D.
Assistant Professor, Pediatrics and Internal Medicine
Dedman Family Scholar in Clinical Care
M. Teresa (Maite) de la Morena, M.D.
Associate Professor, Pediatrics and Internal Medicine
Director, Jeffrey Modell Diagnostic Center for Primary
Immunodeficiency Diseases
Rebecca Gruchalla, M.D., Ph.D.
Professor, Internal Medicine and Pediatrics
Division Director
William A. Sellars, MD., and Joyce M. Sellars
Distinguished Chair in Allergy and Immunology
David A. Khan, M.D.
Professor, Internal Medicine and Pediatrics
Director, Allergy & Immunology Fellowship Program
Director, Asthma and Allergy Clinic, Parkland Memorial
Hospital
Indulekha Warrier, M.D.
Assistant Professor, Pediatrics and Internal Medicine
One of Only 71 accredited programs
for Fellowship Training in Allergy and Immunology.
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Research Activities
Under Dr. Gruchalla’s direction, the division continues to expand both its clinical and basic science research efforts in
asthma. UT Southwestern was among 11 institutions selected by the National Institutes of Health to receive $56 million
over five years as part of the Inner City Asthma Consortium (ICAC). The ICAC investigates novel treatments and causes
of asthma in urban children. Ongoing studies include a
prospective, longitudinal evaluation of environmental factors
that influence the development of asthma.
The consortium is administered by the University of Wisconsin-
Madison. In addition to UT Southwestern, research is being
conducted at:
• Boston University,
• Children’s Memorial Hospital in Chicago,
• Children’s National Medical Center in Washington, D.C.,
• Henry Ford Health System in Detroit,
• National Jewish Health in Denver,
• Johns Hopkins University in Baltimore,
• Mount Sinai School of Medicine in New York,
• St. Louis Children’s Hospital, and
• University of California, San Francisco.
In addition to three current studies, a very important trial funded by this consortium was published in March 2011 in the
New England Journal of Medicine, co-authored by Dr. Gruchalla. The article, “Impact of the Addition of Omalizumab
to Guidelines Based Therapy of Inner-City Asthma: A Randomized Controlled Trial,” found that a new anti-asthma
medication, omalizumab, improved asthma control in the 419 children and young adults studied, nearly eliminated seasonal
exacerbations of asthma, and reduced the need for controller medication when used in concert with NIH-based treatment
guidelines. The study was a multi-institutional one involving UT Southwestern scientists and eight other academic medical
institutions. In addition to the numerous ICAC clinical studies, ICAC-related basic research collaborations also are ongoing
with UT Southwestern investigators, Drs. Michelle Gill, David Farrar and Nitin Karandikar.
The Primary Immunodeficiency Program is engaged in both clinical and basic research. In collaboration with the Stem
Cell Transplant at Children’s Medical Center, children with primary immunodeficiency diseases can be transplanted at
our institution and are part of the Primary Immunodeficiency National Transplant Consortium (PIDTC). In terms of basic
research, three areas of interest are as follows:
1. To understand the molecular etiologies that may contribute to clinical heterogeneity in patients with primary
immunodeficiency diseases. We are currently collaborating with Dr. Nicolai van Oers, Associate Professor of
Immunology, Microbiology and Pediatrics at UT Southwestern, who has profiled the microRNA expression pattern in
patients with Primary Immunodeficiency Diseases.
2. To understand the long-term natural history of patients with X-linked hyper IgM syndrome. Dr. de la Morena has
received funding through the Jeffrey Modell Foundation for this multinational collaborative study.
3. To identify novel genes in primary immunodeficiency disease through exome sequencing. This project is done in
collaboration with Dr. Ward Wakeland, Professor and Chairman of Immunology at UT Southwestern. The PIDs
continue to provide unique opportunities to further our understanding of the biology of normal human immune
function.
Clinical Activities
Asthma and Allergy
The Asthma and Allergy outpatient clinic is equipped to diagnose and manage the whole spectrum of allergic diseases. There
are nine half day clinics per week to provide care for patients. An average of 200 patients are seen per month for evaluation
and management of various atopic diseases, including, but not limited to, asthma, allergic rhinitis, atopic dermatitis, food
allergy, insect sting allergy and drug allergy. Procedures such as skin prick testing for environmental and food allergens,
hymenoptera venom allergy testing and testing for drug allergies are performed by trained personnel. Other services offered
are immunotherapy - both traditional and rush - and anti-IgE immunoglobulin administration.
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A Pulmonary Function Lab is available for spirometry as well as exhaled nitric oxide studies for the evaluation and
management of patients with asthma. Providers work closely with educators from the Asthma Education and Asthma
Management programs to provide a comprehensive management strategy for patients with severe asthma. Special procedures
such as drug challenges and food challenges are also performed in the outpatient clinic.
A combined Allergy/Immunology and Otolaryngology sinus clinic (CASCADE) has been established to provide
comprehensive care for patients with chronic sinusitis. One half-day clinic per month is offered at both the Dallas and
Legacy campus. To facilitate care, patients who are seen in these clinics have a complete evaluation of allergen sensitization
patterns and immunological system, as well as an otolaryngological evauluation in one setting.
A multidisciplinary High Risk asthma clinic was established in the summer of 2011 to provide comprehensive asthma care
to patients with severe asthma and other co-morbid conditions. Two half-day clinics are offered at the Dallas campus where
patients are evaluated by multiple providers including an allergist, pulmonologist, nutritionist, psychologist and asthma
educators to provide comprehensive asthma care and education.
An active inpatient consult service is available for evaluation of patients with allergic diseases. Consults are usually requested
in cases of suspected drug-allergy, anaphylactic reactions and severe asthma.
Food Allergy
In September of 2010, the Food Allergy Center (FAC) at Children’s, which is directed by Dr. Drew Bird, officially opened its
doors. This multidisciplinary center, in association with UT Southwestern, is the only academically affiliated pediatric food
allergy program in North Texas. As such, the Center provides comprehensive care for patients who have been diagnosed
with food allergies and conducts research that is instrumental in developing treatments, therapies and, ultimately, a cure for
food allergies. Its staff also works tirelessly throughout the region to educate parents, healthcare providers, school personnel
and community stakeholders to help children and families navigate the many challenges associated with this complex
health issue.
In 2011, the FAC continued to expand its influence within North Texas. Highlights from the year include the following:
Clinical Care
• Nearly 1,000 clinic visits were conducted.
• 134 food challenges were performed with assistance from Maria Crain,
PNP. The food challenge process entails giving the child incremental
doses of a particular food over one hour and monitoring the child for an
additional period of time. If the child can tolerate a full serving of the
potentially allergenic food without having an allergic reaction, the food
may be introduced into the child’s diet.
Research
• A total of 12 children are currently enrolled in a peanut oral immunotherapy
trial aimed at understanding how the immune system develops tolerance to
peanut in peanut allergic children receiving therapy.
• Two multi-center trials examining the safety of giving the flu vaccine to a
child with an egg allergy. The influenza vaccine contains a small amount of
egg protein, and, as such, is administered cautiously to children with egg
allergies.
• Investigating changes in the quality of life for families dealing with food
Dr. Drew Bird
Director, Food Allergy Center
allergies who attend instructional cooking classes. This study seeks to better understand how cooking classes offered
through our Center by a registered dietitian improve the quality of life for children affected by food allergies.
• More than 100 families have participated in our interactive nut identification quiz. The goal of this study is to provide
insight into the ability of those with tree nut allergies to accurately identify the nuts to which they are allergic, as well
as those to which they are not.
Advocacy and Education
• One of the first overnight camps specifically for children with food allergies was hosted at Camp Sweeney in Gainesville,
Texas. Thirty-five children attended camp where safe meals were prepared avoiding a cumulative total of more than 30
different allergens.
• The second annual Food Allergy Collaborative hosted Wesley Burks, M.D., Kiser-Arena Professor and Chief of the
Division of Pediatric Allergy and Immunology at Duke University Medical Center in Durham, North Carolina, and an
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international food allergy expert. More than 100 attendees heard from Dr. Burks and Dr. Bird. The event was hosted
by Children’s in conjunction with the Food Allergy Initiative in an effort to raise food allergy awareness and research
support.
• FAC nurses addressed several audiences eager to receive more guidance on handling food allergies. The Dallas
Association of Parent Education learned from an FAC Nurse about the basic pathophysiology of a food allergy reaction,
along with a review of the most current food allergy statistics.
• The Food Allergy Center partnered with Whole Foods Market to conduct themed instructional cooking classes for
parents dealing with food allergies. This class is open to the community and provides inspirational ideas on how to
handle different situations such as back-to-school lunches and snacks, holiday time and quick dinner meals all avoiding
the top eight allergens.
• The FAC participated in Children’s Red Balloon Run and Relay, produced in partnership with Passion for Children’s. The
Food Allergy Family Experience Council spearheaded the efforts to include their close family and friends to support the
advocacy of food allergy. More than $3,000 was raised and all profits made from the run will go towards scholarships
for Food Allergy Camp 2012.
• The Food Allergy and Anaphylaxis Network is the world leader in food allergy information, resources and programs.
Dr. Bird was named the Honorary Medical Walk Chair for the Dallas Food Allergy and Anaphylaxis Network Walk.
• A panel discussion was held at Region X for parents with children struggling with food allergies going back to school.
The panel consisted of experts from the FAC informing parents how to keep their children safe at school and providing
guidance for effective communication to school personnel.
Immunology
Clinical Care
• Directed by Dr. Maite de la Morena, the Immunology Outpatient Clinic
at Children’s serves as a referral center for primary immunodeficiency
diseases for North Texas, southern Oklahoma, Arkansas, Louisiana and
New Mexico. Patients with recurrent, persistent or unusual infections are
evaluated for an inherited disorder of immune function. The clinic has
expertise for management of all established primary immunodeficiency
disorders (>155 disorders currently recognized). Referrals for periodic
fever syndromes and evaluations for immunosuppressed states post
transplantations also are seen in clinics.
• Assisted by Erin Orwat, RN, more than 600 patients are seen per year.
The Immunology program currently follows more than 200 patients with
established primary immunodeficiency diseases. Around 50 patients are
receiving infusions of gammaglobulin regularly. Inpatient consultation
services for evaluation of immunodeficiency are available seven days a week.
• In collaboration with the Stem Cell Transplant Program at Children’s,
children with primary immunodeficiency diseases can be transplanted at
our institution. This provides a unique collaboration between transplanters
and immunologists. Diseases that have been transplanted include: SCID,
X-hyper IgM, Wiskott Aldrich syndrome, Chronic Granulomatous Disease,
Interferon Gamma defect, Chediak-Higashi syndrome, and Hemophagocytic Lymphohistiocytosis.
Dr. Maite de la Morena
Director, Immunology Outpatient Clinic
Research
• MicroRNA in PID: We are currently analyzing the microRNA profile of patients with Primary Immunodeficiency
Disease. Despite the known relevance of microRNA for the development and functioning of the immune system, little
is known about changes in their expression in patients with PID. An R21 funded project has allowed for the analysis of
71 patients with established immunodeficiency. This study is performed in collaboration with Dr. Nicolai van Oers at
UTSW. Publications from such analysis are currently submitted for publication.
• Identification of novel genes in patients with primary immunodeficiency diseases through exome sequencing. A total
of six families are participating in the analysis of rare immunodeficiency phenotypes in which a molecular diagnosis
is unknown. This analysis is currently being performed in collaboration with Dr. Ward Wakeland and Dr. Nicolai van
Oers, Associate Professor of Immunology, Microbiology and Pediatrics at UT Southwestern.
• The United States Immunodeficiency Network, (USIDNET) is a National Registry for patient with established
immunodeficiency diseases. USIDNET, a program of the Immune Deficiency Foundation (IDF), is funded in part
by the National Institute of Allergy and Infectious Diseases (NIAID) and the National Institutes of Health (NIH), an
agency of the Department of Health & Human Services.
• Long-term outcomes in patients with X-Linked hyper IgM syndrome. (Pending IRB approval)
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Advocacy and Education
• On October 30, 2011 faculty, nursing and administrative staff got together with PID patients and their families to
celebrate the 4 th annual Kids Day event at the Dallas Zoo. Close to 200 people participated in this gathering which is
sponsored by the Jeffrey Modell Foundation.
Education and Training
The Allergy and Immunology division provides the major instruction to pediatric residents in the evaluation and
management of children with allergic diseases, asthma and immunodeficiency diseases. It also provides didactic teaching
for the pediatric residents on the basics of allergy and immunology and directs teaching for the pediatric residents in the
regular departmental clinical conferences and as part of the inpatient consultation service.
Pediatric residents see outpatients in our clinics under the supervision of one of the members of the division faculty. Relevant
articles about specific allergic and immunologic disorders are provided to residents at the beginning of each rotation, and
residents attend clinical conferences offering didactic teaching for fellows.
An Allergy and Immunology elective is available for pediatric residents and fourth-year medical students. The objectives of
the elective are to:
• Develop a working differential diagnosis of allergies, asthma and primary immunodeficiencies;
• Learn how to conduct a complete physical exam, including the upper and lower airways;
• Examine and discuss patients from all major allergy and immunology categories: allergic rhinitis, asthma, urticaria, drug
allergy, food allergy and primary immunodeficiency.
In addition to medical student and resident training, the division has one of only 71 accredited programs for fellowship
training in Allergy and Immunology; Dr. David Khan is the Program Director. The Allergy/Immunology (A&I) fellowship
training program continues to train high-quality A&I specialists. Our view is that successful training in allergy and
immunology should consist of balanced exposure to training experiences involving adults and children, no matter what the
training background or the long-term plans of any particular fellow-in-training. Drs. Rebecca Gruchalla and David Khan,
the program director, oversee the adult teaching clinics at Parkland, while Drs. Maite de la Morena, Indulekha Warrier
and Drew Bird oversee the teaching clinics at Children’s. Further staffing of both adult and pediatric clinics is provided by
our 29 volunteer-clinical faculty members. Approximately 40 percent of A&I fellows have come from pediatric house staff
programs, and approximately half of the outpatient clinics attended by A&I fellows occur at Children’s.
Presentations/Teaching Activities
Rebecca Gruchalla, M.D., Ph.D.
• “Inner-city mold exposure and inner-city asthma, Workshop: Inner-city Allergens as Causes and Exacerbations of
Asthma, American Academy of Allergy, Asthma and Immunology Annual Meeting, San Francisco, March 2011
J. Andrew Bird, M.D.
• “Food Allergies in Children,” Current Trends in Family Medicine CME Conference, UT Health Science Center, Tyler,
TX, February 2011
• “Update on Oral Desensitization and Tolerance,” 13 th Annual Texas Allergy, Asthma and Immunology Society
(TAAIS), Allergy for the Allergist, Houston, TX, May 2011
• “Review of the Diagnostic Guidelines for the Diagnosis and Management of Food Allergy,” Florida Dietetic
Association, Fort Lauderdale, FL, July 2011
• “Diagnosis and Management of Food Allergy,” Pediatric Grand Rounds, UT Southwestern, October 2011
• “Food Allergy, Oral Food Challenges, and Vaccines,” American College of Allergy, Asthma and Immunology Annual
Meeting, Boston, MA, November 2011
M. Teresa (Maite) de la Morena, M.D.
• “Primary Immunodeficiency Diseases,” Dallas Internist Club, Dallas, TX, March 2011
• “Management Strategies and Outcomes for CD40Ligand,” Primary Immune Deficiency Treatment Consortium
(PIDTC) Meeting, San Francisco, CA, April 2011
• “Recurrent Candidiasis: Lessons from Primary Immunodeficiency Diseases,” Allergy/Immunology Grand Rounds,
Presbyterian Hospital, Dallas, TX, May 2011
David A. Khan, M.D.
• “Management of the Drug Allergic Patient: Utilizing Ancient Techniques in the 21 st Century,” Allergy & Immunology
Grand Rounds, National Institute of Health (NIH), Bethesda, MD, February 2011
• “Difficult Drug Allergy Cases,” American Academy of Allergy, Asthma and Immunology Annual Meeting, San
Francisco, CA, March 2011
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• “Chronic Urticaria and Angioedema: Difficult Cases,” Allied Health
Workshop, American Academy of Allergy, Asthma and Immunology
Annual Meeting, San Francisco, CA, March 2011
• “Drug Challenges: Indications, Procedures, Risk and Safety Outcomes,”
American Academy of Allergy, Asthma and Immunology Annual
Meeting, San Francisco, CA, March 2011
• “Injectable Epinephrine Should be Prescribed for All Patients Receiving
Allergy Immunotherapy (Con)”, Pro/Con Debate, American Academy of
Allergy, Asthma and Immunology Annual Meeting, San Francisco, CA,
March 2011
• “Management of the Drug Allergic Patient: Utilizing Ancient Techniques
in the 21 st Century,” Illinois Allergy Society, Chicago, IL, April 2011
(invited lecturer)
• “Urticaria: Updates From the Upcoming Practice Parameter” and
“Exercise-Induced bronchospasm: Burden and Prevalence,” Eastern
Allergy Conference, Palm Beach, FL, June 2011
• “Cutaneous Drug Reaction’s” and “Diagnostic Testing in Drug Allergy,”
Louisiana State Allergy & Immunology Society, New Orleans, LA, June
2011
• “Management of Refractory Chronic Urticaria,” Allergy & Immunology
Grand Rounds, Wilford Hall Medical Center, San Antonio, TX, June
Drs. Rebecca Gruchalla and Michelle Gill
2011
• “Management of the Drug Allergic Patient: Utilizing Ancient Techniques in the 21 st Century,” Internal Medicine
Grand Rounds, St Louis University, St Louis, MO, August 2011
• “Induction of Drug Tolerance Procedures: Patient Selection, Choosing a Protocol and Safety Considerations” and
“Diagnostic Testing in Drug Allergy: Beyond Penicillin Skin Tests,” Kaiser Permanente Allergy & Immunology
Annual Meeting, Berkeley CA, September 2011
• “Asthma Management: Beyond The Lungs,” Northwest Allergy & Asthma Nurses Association Annual Meeting,
Redmond, OR, October 2011
• “Approach to the Patient with Refractory Chronic Urticaria,” Boston City-Wide Allergy & Immunology Rounds,
Boston MA, October 2011 (invited lecture)
• “Basic Immunology and Genetics: Literature Review,” American College of Asthma, Allergy and Immunology
Annual Meeting, Boston MA, November 2011
• The Great Chronic Idiopathic Urticaria Raft Debate: After Antihistamines, What’s Best For Next In Line Treatment:
Hydroxychloroquine and Dapsone,” American College of Asthma, Allergy and Immunology Annual Meeting,
Boston, MA, November 2011
• “Drug Challenges: Easing the Fear of Graded Dose Challenges,” American College of Asthma, Allergy and
Immunology Annual Meeting, Boston, MA, November 2011
• “Adverse Drug Reactions and Managements: Antibiotics,” “Betalactam Reactions: Desensitizations” and “Drug
Allergy Testing and Desensitization: Non-betalactam Antibiotics,” World Allergy Congress Annual Meeting, Cancun
Mexico, December 2011
Awards and Honors
J. Andrew (Drew) Bird, M.D.
• Best Pediatric Specialists in Dallas, D Magazine
• National Institutes of Health Pediatric Loan Repayment Program Award (2010–2012)
Rebecca Gruchalla, M.D., Ph.D.
• Best Pediatric Specialists in Dallas, D Magazine
• Top US Doctors, U.S. News & World Report
David Khan, M.D.
• Top US Doctors, U.S. News & World Report
M. Teresa (Maite) de la Morena, M.D.
• Best Pediatric Specialists in Dallas, D Magazine
Publications
Articles
1. Alvares ML, Khan DA. Allergic rhinitis with negative skin tests. Curr Allergy Asthma Rep;11:107-14.
2. Belkaya S, Silge RL, Hoover AR, Medeiros JJ, Eitson JL, Becker AM, de la Morena MT, et al. Dynamic modulation of
thymic microRNAs in response to stress. PLoS One;6:e27580.
3. Bird JA, Abramson S. Roundtable Discussion: Pediatric Asthma and Allergy. Journal of Asthma & Allergy Educators
2011;2(5):253-4.
4. Bird JA, Kulis M, Kamilaris N, et al. Effect of Peanut Oral Immunotherapy (OIT) on Other Food Allergen-Specific IgE
Levels J Allergy Clin Immunol 2011;127(2):AB25.
5. Busse WW, Morgan WJ, Gergen PJ, Mitchell HE, Gern JE, Liu AH, Gruchalla RS, et al. Randomized trial of omalizumab
(anti-IgE) for asthma in inner-city children. N Engl J Med;364:1005-15.
6. Chin SJ, Kim EH, Bird JA, et al. Basophil Suppression in Peanut Allergic Patients Undergoing Sublingual Immunotherapy
(SLIT). J Allergy Clin Immunol 2011;127(2):AB28.
7. Cox L, Nelson H, Lockey R, Calabria C, Chacko T, Finegold I, Nelson M, Weber R, Bernstein DI, Blessing-Moore J, Khan
DA, et al. Allergen immunotherapy: a practice parameter third update. J Allergy Clin Immunol;127:S1-55.
8. Davis LS, Bhutani S, Barnett SR, Khan DA. Early gene expression changes with rush immunotherapy. Clin Mol
Allergy;9:12.
9. de la Morena MT, Gatti RA. A history of bone marrow transplantation. Hematol Oncol Clin North Am;25:1-15.
10. Golden DB, Moffitt J, Nicklas RA, Freeman T, Graft DF, Reisman RE, Tracy JM, Bernstein D, Blessing-Moore J, Cox L,
Khan DA, et al. Stinging insect hypersensitivity: a practice parameter update 2011. J Allergy Clin Immunol;127:852-4
e1-23.
11. Greenhawt MJ, Li JT, Bernstein DI, Blessing-Moore J, Cox L, Khan D, et al. Administering influenza vaccine to egg
allergic recipients: a focused practice parameter update. Ann Allergy Asthma Immunol;106(1):11-6.
12. Gruchalla RS. Inner-city asthma: control can be achieved! J Allergy Clin Immunol;128:64-5.
13. Kavosh ER, Khan DA. Second-generation H1-antihistamines in chronic urticaria: an evidence-based review. Am J Clin
Dermatol;12:361-76.
14. Khan DA. Hereditary angioedema: Historical aspects, classification, pathophysiology, clinical presentation, and
laboratory diagnosis. Allergy Asthma Proc;32:1-10.
15. Kim EH, Bird JA, Kulis M, et al. Sublingual immunotherapy for peanut allergy: clinical and immunologic evidence of
desensitization. J Allergy Clin Immunol;127:640-6 e1.
16. Kim EH, Bird JA, Kulis M, et al. Evidence of Desensitization by Sublingual Immunotherapy in Peanut-Allergic Children.
J Allergy Clin Immunol 2011;127(2):AB72.
17. Paranjpe P, Schull D, Bird JA. Assessing the Impact of an Educational Intervention Upon the Quality of Life of Food
Allergic Children. J Allergy Clin Immunol 2011;127(2):AB111.
18. Webb L, Petersen M, Boden S, LaBelle V, Bird JA, et al. Single-dose influenza vaccination of patients with egg allergy in
a multicenter study. J Allergy Clin Immunol;128:218-9.
Book Sections
1. De la Morena MT. Congenital Immunodeficiencies. In: Fuhrman P, Zimmerman J, eds. Pediatric Critical Care. 4th ed.
Philadelphia: Elsevier Saunders; 2011.
Grants
Non-governmental Organization Grants and Contracts
M. Teresa (Maite) de la Morena, M.D.
Natural History Study of Long Term outcomes of patients with X-linked Hyper IgM Syndrome
Jeffrey Modell Foundation Inc.
09/15/11 - 09/15/13
J. Andrew (Drew) Bird, M.D.
Peanut Oral Immunotherapy for Treatment of Peanut Allergy
Dedman Family Scholar in Clinical Care
01/01/09 - Present
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