Erin Steinbach, MD, PhD, assistant professor of medicine in the UNC Division of Rheumatology, Allergy and Immunology, has been honored with an AAAAI Foundation Faculty Development Award for her project focused on understanding the complexities of severe peanut allergies.
Researchers have long been baffled by peanut allergies, the leading cause of death from severe food-related allergic reactions. It seems that eaten peanut has the unique ability to allow more allergens to breach the intestinal barrier, a state known as increased intestinal barrier permeability or ‘leaky gut,’ and this may be the reason that peanut allergies are more often fatal. Dr. Erin Steinbach has dedicated her life’s work to shedding light on the mechanisms behind the increased intestinal barrier permeability during an allergic reaction to peanut. Her hope is to provide key insights for the development of new treatments and a deeper understanding of the condition.
The Peanut Puzzle
While peanut-induced severe allergic reactions are notorious for their life-threatening consequences, the reasons behind the heightened intestinal permeability in affected individuals have remained elusive.
The intestines are lined with a single-cell layer of epithelial cells (intestinal epithelial cells or IECs) that regulate what nutrients get in while keeping bacteria and allergens out. Dr. Steinbach’s preliminary research uses a novel Collaborative Cross CC027 mouse model of peanut allergy. This model, developed without the need for adjuvants (substances increasing an immune response), mirrors the oral route of peanut allergy development in humans, making it a powerful tool for studying the underlying causes of increased IEC permeability.
Dr. Steinbach is able to take IECs from these mice and from biopsies from patients with peanut allergy and grow “enteroids” (small intestines in a petri dish) in a single-cell layer to mimic the intestinal barrier. When she exposed the enteroids to peanut, she observed a significant increase in permeability only in the samples taken from mice or patients with peanut allergy.
By studying the peanut-allergic IECs, Dr. Steinbach found they were different from non-allergic IECs. For example, the peanut-allergic stem cells changed how they got energy from nutrients, and peanut-allergic IECs made a lot of a molecule called angiopoietin-like 4 (ANGPTL4). Findings lead Dr. Steinbach to believe severe allergic reactions to peanut happen because peanut-allergic IECs are reprogrammed to behave in a way that makes the intestinal barrier leaky.
AAAAI Foundation Award
The work Dr. Steinbach completes through the AAAAI Foundation Faculty Development Award will foster the development of novel therapies targeting the intestines for severe allergic reactions and add to the existing knowledge of a diverse group of diseases associated with increased intestinal barrier permeability. Additionally, as a training award, Dr. Steinbach will develop the skills needed to run a successful research program through formal coursework, seminars, and guidance from her mentoring and advisor teams. She will develop a unique skillset for competing successfully for R01-level grants that will support her transition to an independent physician scientist career.
Dr. Steinbach will join other award recipients at the AAAI Foundation Annual Benefit in Washington, D.C., in February to be honored for their achievements.