Dr. Commins Research
Dr. Scott Commins’ research focuses, in part, on alpha-gal allergy (a syndrome).
Anaphylaxis, or shock, is a severe allergic reaction that can progress quickly and may be fatal if appropriate medical action is not taken. His team has identified a group of patients who develop delayed anaphylaxis 3-6 hours after eating beef, pork or lamb and the allergy appears to begin after tick bites, even in people who have tolerated these meats their entire lives. Because of the delay, their symptoms would normally be regarded as ‘spontaneous’ or ‘of unknown cause.’
Dr. Commins’ team is investigating why the delay occurs and why patients are suddenly becoming allergic to red meat. Answers to these questions will provide real insight for patients suffering from any food allergy, as we begin to unravel the factors that control anaphylaxis and allergic responses overall.
A major area of research for the Commins group, which prominently includes Dr. Shailesh Choudhary as head of the laboratory, relates to the tick-acquired mammalian meat allergy, often referred to as the ‘alpha-Gal syndrome’ (AGS). Since the initial description of the syndrome nearly a decade ago, the Commins group has continued to play an important role in increasing our understanding of the pathophysiology and manifestations of the syndrome.
Current interests relate to understanding the connection to tick bites and formally assessing this environmental factor through a CDC-funded case-control study. From a mechanistic perspective, Dr. Choudhary is working to conduct experiments using the recently published alpha-gal deficient murine model for AGS. This mouse develops allergic reactions to mammalian meat following sensitization with tick saliva. The Commins group works closely with Dr. Shahid Karim, whose lab prepares tick salivary gland extract from Amblyomma americanum ticks (aka “lone star” ticks). The goal of these experiments is to identify the factor(s) in tick saliva that could be triggering AGS in humans.
Emerging areas of interest include accumulating evidence that IgE sensitization alpha-gal could have implications for disorders that are not traditionally considered to be ‘allergic diseases’. To pursue the hypothesis that alpha-gal could be relevant to heart disease the Commins team is collaborating with Dr. Joseph Turek and colleagues at Duke University Medical Center.
A major new interest relates to the possibility that alpha-gal could be an important cause of IBS-like symptoms among subjects who live in areas where the lone star tick is endemic. To better understand risk factors for alpha-gal sensitization we are collaborating with Dr Sarah McGill in the GI division at UNC. We are also working closely with Dr Scott Smith (Vanderbilt University) to understand more about the alpha-gal allergy response itself and whether there are clues that can be used to inform all patients with food allergies.
Finally, Dr. Commins is excited about emerging collaborative initiatives across several campuses owing to his team’s inclusion in the Creativity Hub award from the Office of the Vice Chancellor for Research to foster fluid, cross-disciplinary research, to establish campus networks that nurture research innovation and risk-taking, and to promote a pervasive culture that drives discovery and curiosity.
The Vector-Borne Disease: Epidemiology, Ecology & Response (VEER) Hub is comprised of academic investigators and public health practitioners from the University of North Carolina at Chapel Hill and collaborators from partner universities, military installations and health care agencies who are committed to the protection of people, animals, and livelihoods from vector-borne diseases (VBD) — an epidemic affecting the entire state, but particularly those living in rural and underserved communities in North Carolina.
Dr. Commins, along with Dr. David Peden in Pediatrics, is co-leading the UNC study site for a national NIH/NIAID sponsored study of allergic reactions to the mRNA COVID-19 vaccines. The purpose of the SARS Vaccination study is to investigate if people with a history of serious allergic reactions or those with mast cell disorders are more at risk of having a reaction after receiving either the Pfizer-BioNTech COVID-19 vaccine or the Moderna COVID-19 vaccine and what factors may promote allergic reactions to either vaccine to include measurements of biomarkers. This study is now open for enrollment for people ages 18-69 years old with a history of serious allergic reactions or a mast cell disorder, or a history of no allergies at all.