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[whatdidwelearn]

People with food allergies give thanks

Nature Reviews Immunology has highlighted a breakthrough discovery by Dr. Manel Jordana´sresearch group. The work concerns the role of eosinophils in the initiation of adaptive immune responses in the gastrointestinal tract, with particular interest to peanut allergy. The research led by Dr. Derek K. Chu has been recently published in the Journal of Experimental Medicine. The elegant paper, entiteled “Indigenous enteric eosinophils control DCs to initiate a primary Th2 immune response in vivo” challenges our perseption of eosinophils in immune responses. Although eosinophils are typically considered to be effector cells, this research shows that they are not always latecomers to the Th2 response but that “Eosinophils get the party started”.

Dr. Jordana's research is focused on different aspects of Th2 responses including the initiation (sensitization), the acute (anaphylaxis) and the maintenance phases. Dr. Jordana joined the faculty of McMaster University in 1988, and has since supervised over 75 trainees, and co-authored 160 scientific papers, reviews and book chapters.

I had a chance to interview both Dr. Derek Chu and Dr. Manel Jordana regarding their recent success.

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I meet Dr. Jordana in his office— a gallery of awards, theses and even photos with previous students receiving acknowledgements, it is easy to say he’s a dedicated mentor.  For the past few years, Dr. Jordana has been mentoring Dr. Derek Chu, who recently graduated from the MD/PhD program at McMaster. The two researchers had together challenged the dogma of allergic diseases in terms of peanut allergy.

“Derek came to me after one of my classes in first year and he asked to join my lab, I said no. He came back the next year and asked again, same answer. He asked me, again, in his third year and I agreed.”

“For Derek there was an incentive, yes he got to learn about peanut allergy, but he did it for himself”

Derek is standing by the waiting chairs as I bustle into a soft atmosphere in Williams across from the McMaster Children’s Hospital; where he completes his residency for internal medicine. I am in the biggest stretch only slightly off the predetermined time, while Derek must have been right on the dot.

We grab a coffee, sit down and talk about his current position—keep in mind he had come far from being the student in the lab only allowed to read and do literature reviews.

He surprises me, “I completed my MD/PhD in six years. You could say I had an interesting schedule with medical school and research together”.

The wisp of air I breathe out crosses the steam coming from my coffee— I ask Derek how he got the idea.

“The former PhD student in the lab, Ramy and Alba, gave me guidance and let me watch experiments… I learned from those experiences”.

“At first, I was only allowed to read and watch experiments”, he added with a smile.

I would like readers to keep in mind that the paradigm of allergy had already been set as an antibody mediated sensitization with mast cells acting as effector cells.

Dr. Jordana had the best way of describing the role eosinophils play before the big dance, “The message is these eosinophils contribute to allergy and tolerance… when they are critically silent, we have tolerance”

I asked him if it would be possible to reverse allergies or alleviate allergies in people from newer treatments being tests like anti-IL5, “Keep in mind that desensitization is different than tolerance… giving incremental doses of the allergen is desensitization, it can be positive in some cases. Reversal of these allergies remain a huge challenge, these are years of immune education, but I can tell you anti IL-5 has no side effects”

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Manel Jordana maintains a great lab environment and actively engages students and scientists in his lab at McMaster University (Immunology research centre)

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“What we want to stress is in the GI tract, and specifically in the small intestine, eosinophil derived peroxidase (EPO) regulates adaptive immune responses” (enter link to dereks figure)

“We seem to be moving backwards— before it was all about T-cells, then all about dendritic cells, now eosinophils.”

So what was Derek doing back in 2006-2007 during his third year?

He may as well been looking at eosinophil/parasite interactions in the gut during that time, it’s the first topic of discussion in his Journal of Experimental Medicine article.

“Ramy said the most important thing to do was read and really stressed that, so it became a habit. I read all my lab’s previous labs work, anything I could get my hands on, really”.

“At that time, no one had any idea what these resident eosinophils were doing in the gut…and we had these GATA knock out mice, which were deficient for eosinophils”

Derek even found the community at McMaster Immunology Research Centre (MIRC) being a positive environment to nurture his side project.

“I found it amazing there are all these resources at MIRC… I would talk about my ideas to others and find out if they were willing to collaborate”

I asked him what he reads off of these days, during 12 hour days and long clinical rounds, “Just an HTC One, an older model…I have all the reading apps, like Read by QxMD”

Derek really makes you wonder about the thorough nature of his reading, “The first paper cited is from Paul Erlich, a paper from 1879”

The article, titled originally in German as, “Beitrage zur Kenntnis der granulierten Bindegewebszellen und der eosinophilen Leukocyten” explains interesting eosin patterns in “eosin-ophilen”, immunology’s favourite pink cell.

This is proof, that a small seed of an idea could become a weeping willow.

Derek understands his new roles in his residency, hoping to use the resources he has to study peanut allergy further—further helping a cause he faced as a child.

Dr. Jordana points to my left where there is an epipen box, “Derek was not the first student who had peanut allergies. We kept epipens everywhere”

“We’ve never had to use it because we made every precaution”.

I asked Derek if being part of the 3.5 million Canadians suffering from peanut allergies fazed him during researching peanuts.

“I wore a bubble if preparing peanuts to give to the mice but did not give injections, as a precaution… I had a reaction in Florida when I was young and luckily my parents were aware”

As I leave Dr. Jordana’s office, there’s a poster hanging in the bottom mirror of his office, “People with food allergies give thanks after eating”… That’s food for thought.

-sm

So What Did We Learn? Feel free to comment below!