Diana Oh

IR-2/11AP
11/14/17
Turn in Number: 10
Research Proposal
Diana Oh
Independent Research I
2017-2018

Can I Eat That? Solving the Allergy Epidemic

Overview of Research
I will be researching the effectiveness of oral immunotherapy and sublingual
immunotherapy on desensitizing Immunoglobulin-E mediated food allergies. Both of therapies
consists of exposing the immune system to specific allergens in small dosage, increasing the
dosage periodically. The methods of exposure differ between the two treatments: oral
immunotherapy introduces the allergen through a food source, while sublingual exposes through
a serum. The treatments come with life threatening risks, but remain the most optimal option
toward complete desensitization. Specifically, I will be investigating the difference in allergen
tolerance before and after immunotherapy in IgE mediated food allergies.

Background and History of the Issue

Nearly fifty million Americans suffer from some form of an allergic disease, the most
concerning being food allergies since they provoke more deadly reactions. From 1997 to 2011,
the number of children under the age of eighteen with food allergies increased by fifty percent;
food allergies are becoming more prevalent and increasingly fatal. Despite its dangers, there is
no cure for allergies; antihistamines and epinephrine act as emergency mediators for reactions,
but do not build tolerance to the allergen. Thus, researchers search for a cure that desensitizes the
immune system to the antigen completely, preventing all future reaction.
IgE mediated allergy reactions result from an immune response to a normally
non-harmful substance, initiating an inflammatory response. Immunotherapy, specifically oral
and sublingual, are rising treatments for food allergies. Immunotherapy exposes the allergen to
the immune system, causing it to overreact, eventually desensitizing the immune system to a
specific allergen. Oral immunotherapy consists of feeding small amounts of a food source
containing the antigen, increasing the dosages periodically. Instead of a food source, sublingual
immunotherapy uses antigen containing serums. The antigens consumed during the treatment can
evoke an allergy reaction. Despite the risk of a deadly reaction, with more research and
standardized procedures, immunotherapy is a viable option as a treatment, as it works to cure.

Problem Statement and Rationale

Food allergies negatively impact the lives of 4.2 million children in the United States
alone, with hospitalization rates for allergies tripling from the late 1990’s to the 2000’s, and the
number of annual emergency room visits totalling 30,000. However, even though forty percent
of children with food allergies suffer from deadly reactions, no permanent cure has been
discovered. Immunotherapy is a promising permanent treatment for food allergies; thus more
research should be done. My research will help supplement what is currently known about
immunotherapy, and increase the possibility of immunotherapy being implemented into clinics
for patient use. Therefore, my research benefits those, especially children, with IgE mediated
food allergies, who may be able to undergo such treatment if it were used in clinical practice.
 Diana Oh
IR-2/11AP
11/14/17
Turn in Number: 10

Research Methodology
Research Question and Hypothesis
Research Question: ​What is the effect of oral and sublingual immunotherapy on the
desentization of an allergen in IgE-mediated food allergies?
Hypothesis​: Patients treated with either oral or sublingual immunotherapy for
IgE-mediated food allergy will build partial tolerance to the tested allergen, and overtime achieve
complete tolerance to the allergen so no visible reaction occurs.

Basis of Hypothesis
Clinical trials done by various organizations found that oral immunotherapy yielded
mixed results among children under eighteen. Some children were able to tolerate slightly higher
amounts of the antigen tested for, however, none reached complete desensitization. Research has
found that, overall, the level of allergen-specific IgE drop below baseline when immunotherapy
is administered. Additionally, the mast cell response to the antigen decreased, as seen through
skin prick tests results. Both which are main components in triggering allergic reactions; with
lower levels of both of these molecules, there is a lower chance that a reaction will be triggered.
These results were seen in immunotherapy for both egg and milk antigens.

Research Design
The research will be a causal-comparative study

Operational Definitions
Desensitization- An increase in the amount of food antigen required to cause a reaction.
Complete Tolerance- The ability to consume unrestricted amounts of food antigen after
the removal from immunotherapy dosing.
IgE mediated food allergy- An immune response to a normally non-harmful food protein
that is triggered through the production of the antibody, immunoglobulin-E.

Product Overview
A final paper will describe and explain the outcomes of the research, which will be
distributed online, so researchers and patients of all levels have access.

Logistical Considerations
In the beginning of the process, gaining special permission and access to resource
material was an issue. However, with the addition of several databases, the problem has been
resolved for now. In the future, an advisor will be able to provide more reference materials as
well. Many articles must be printed for this research, which was a problem that has been since
solved. The project will require large amounts of editing from human resources, which will be
resolved when a research advisor is secured.