Erik Wambre, PhD, Principal Researcher at Benaroya Research Institute at Virginia Mason talks about halting life threatening allergies.
Interview conducted by Ivanhoe Broadcast News in July 2018.
Tell us about your research and what you discovered.
Dr. Wambre: So, in my lab we are looking at human cells and what they are doing when they are in contact with an allergen or pathogen. A few years ago what we observed is that the cells involved in allergy have a unique feature on their surface. These characteristics were only observed in patients with allergy. For us, it was a key discovery. It means that if you are non-allergic, you don’t have the cells and those cells are really involved in the pathogens of the disease. So, technically, we can use these features as a biomarker. A biomarker is a unique signature that you can measure in humans. This also means that we have a therapy target. If we can destroy or block these cells, you should have an improvement in your symptoms. Right now, all of our research is focusing on this type of cell. We tried to use that as a new marker to predict the outcome of immunotherapy and, again, we are now looking for new pathways that will block or destroy those cells to improve our current vaccine strategy.
So now that you’ve identified this particular cell, it allows you to make it possible to develop therapy?
Dr. Wambre: Exactly. We try to find why they are unique, why patients with allergy developed this type of cell, so we can try to see whether it’s because of their genetics or in their immune condition. Then we try to see how we can use these cells in clinical practice to improve the diagnoses of the treatment.
This is huge for people with allergies, of which I am one.
Dr. Wambre: Exactly. This is huge because for many years we didn’t know that this cell, known as a Type2 immune response, was involved in allergy. You have to know that Type2 is also good for you because it protects you against parasites, bacteria, and also cancer. Everybody has Type2 immune cells, but for many years we were unable to discriminate between the good cells protecting you against those bacteria and viruses from the bad cells that were involved in your allergy. So, now we have a clear way to distinguish these two types of cells and to block the bad type of cell, not the good one.
How will a doctor use this information?
Dr. Wambre: Right now, this information is mainly involved in the new vaccine development. Currently, there are a lot of companies that try to develop new vaccine strategies, especially in food allergy, and what we try to do is follow patients that are receiving those treatments. At the beginning, all the patients with an allergy have lots of these cells. When they receive any type of new therapy, we try to see whether this number of cells decreases after time, and usually it’s a good sign of clinical improvement. It’s called a companion biomarker, a marker that you use together with your treatment. For physicians, it’s very important because they know whether they can continue the treatment to the patient, or if they should stop earlier and maybe use another approach to treat the patient. We save time and also money, so for the patient it’s really a great thing.
How do you eventually see your discovery helping patients?
Dr. Wambre: I think it will help patients in a way where we can potentially diagnose food allergy earlier. You probably know that, right now, parents first know that their kids have food allergy when they are at the emergency room. You just eat a tiny bit of peanut for the first time and you react, and I know there is no way to predict that earlier. The fact that the T cells are really extreme in the allergy cascade means that if you have this type of cell, you are most likely to develop that type of allergy. Right now, we unfortunately don’t know—we couldn’t predict which type of allergy, whether it would be food allergy or grass allergy, but we are working on it to being able to determine the type of allergy you will be sensitized to.
That’s where kids could be screened and if they have this cell, then the parents would know?
Dr. Wambre: Exactly. One of our ideas we are working on right now, and we have a few clinical trials to investigate this question, is to see whether a one year old kid will be for sure allergic to something if they have this type of cell. If that’s the case, it would be a good sign that the parents should be careful when they introduce peanut, for example, for the first time. Parents will also see that they should talk to an allergist and investigate whether their kids are allergic or not.
This is lifesaving?
Dr. Wambre: Yes, that is the idea. The idea is really what we call translational immunology. We try, from the discovery we’ve made in the lab, to translate that to clinical practice and help physicians with the way they diagnose the disease and also the parents by saving money and time. Time is especially important for food allergy because it seems that the therapy works very well when the kids are young. It’s called plasticity–your immune system is still open to change. When you are adult, it seems to be more difficult to do something like this. Not impossible, but it seems to be more difficult. We try also to investigate why, but yeah, this could be life changing for the patient.
Where are you right now in your research and clinical practice with this discovery?
Dr. Wambre: Right now, we collaborate a lot with biotech and their big pharma company, trying to see whether this type of cell represents the unique target for the vaccine. For them, it’s very important because, as I said, they can predict the successful de-sensitization of the treatment. We have to keep in mind that immunotherapy is run pretty long; a recent study seemed to show that you need a minimum of three years of treatment. After those three years of treatment, only half or maybe seventy percent of the patients will have a benefit. But thirty percent of those patients after three years won’t have a benefit. This biomarker can be used to see whether the patient after three years should continue the treatment, or stop and take a totally different approach to improve their disease.
You had said that now you’re expanding with this cell into cancer research. Can you tell a little bit about that?
Dr. Wambre: Yes. We tried to apply the same technology that we used to discover the H2A cells in cancer and the idea is the same thing—we try to find a unique type of cell that could be in your bloodstream and if you have this type of cell, it might be a sign that you may have a cancer. The idea is to use just a little bit of blood, so it’s noninvasive, and if this type of cell would be there, that would be a sign that you may have a cancer somewhere. Right now, our research is focusing on all the new immunotherapy approved in cancer, which means lung cancer, kidney cancer, and skin cancer. This is so our technology is also used to try to predict the side effects. Unfortunately, in some of the patients there are a few side effects that can appear after the treatment, which trials will predict earlier. So, for the physician it’s important because we save time and time in cancer is very important.
Tell me how you found this cell?
Dr. Wambre: I like this word: serendipity. We were just trying to determine the features and characteristics of these cells. And the first time we observed one marker that was abrogated in this type of cell where the marker shouldn’t have been, it was discovered as another type of cell. I was thinking it was an artifact due to the technology, the machine we are using. So, I kind of didn’t really pay attention. I thought, oh, it was an artifact. Then I tried again with another system in vivo, and without the change of cells I observed these features again. Again, I was thinking it was a mistake, so I asked a few technicians and scientists to look at it with different methodology and their conclusion was always the same thing. These cells express this marker, and thought it didn’t make sense. We investigated much more and I was thinking if they have these unique features, they may have more. And we find five unique signatures in this type of cell. When you just focus on these signatures, you find a unique type of cell found only in allergic patients. So for us, it was a great discovery because we can clearly think about the biomarker and therapy target.
What haven’t I asked you that you would like to include in the story?
Dr. Wambre: My dream is to find the molecules that will block those cells. One feature I didn’t highlight is that this type of therapy seems to play a role in every type of allergy and most likely also in asthma. It’s a dream, but maybe if we find this molecule and we block those cells, we will treat not only one allergy, but maybe all of them. As you probably know, when you are allergic to one thing, usually you are what we call fully sensitized–you are allergic to multiple things beside that. And currently we only treat one allergy at a time. So, if you are grass allergic, we treat your grass allergy, but we don’t touch your dust mite allergy. Yet, if we block this type of cell, we might block all types of allergy, even asthma.
Are food allergies increasing?
Dr. Wambre: Yeah. So currently food allergies are a growing issue. We don’t really know why, but there are more and more kids affected by this type of disease and it’s an issue for the kids, but also for the family’s way of life. It’s a very important disease that we would like to focus our attention on. The other thing is, right now, food allergy doesn’t have any FDA approved treatment compared to other types of allergy. We might soon have a new approach, but the FDA did not approve it yet. That’s why most of our research is focused on food allergy now. We try to understand why the prevalence is growing, why now, and how to stop it.
It sounds like you made a big start.
Dr. Wambre: We don’t know why it’s growing, but if we can understand why this type of cell involved in allergy is generated, and we can block that earlier, it would be a nice improvement for the patients.
END OF INTERVIEW
This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.
If you would like more information, please contact:
Kay Branz
206-342-6903
Sign up for a free weekly e-mail on Medical Breakthroughs called
First to Know by clicking here.
