Bright Futures

As a parent, you want your kids to enjoy the best childhood they can, but for many American children, asthma and allergies can hold them back — and numbers are on the rise.

About one in 10 U.S. children have asthma, and one in five have environmental allergies. Food allergies are also a growing public health concern that affects one in 13 children, or about 2 students per classroom. Fortunately, researchers at Phoenix Children’s are working to find ways to prevent the development of asthma and improve treatment options for children with food allergy.

In this article, we highlight two unique studies taking place at Phoenix Children’s that could offer new hope for children coping with allergies.

We spoke with Phoenix Children’s allergists and immunologists, Cindy Salm Bauer, MD, the medical director and section chief of Phoenix Children’s Allergy and Immunology Clinic, and Benjamin Wright, MD, about their involvement in these multicenter studies.

Preventing Asthma in High-Risk Kids (PARK) Study

Asthma is one of the top chronic pediatric illnesses and is the third leading cause of hospitalizations and emergency department visits among children under the age of 15 years.

Phoenix Children’s and several other major hospitals across the country are working together to try to reduce the risk of asthma developing in children. The PARK study, short for Preventing Asthma in High-Risk Kids, hopes to find out if the asthma treatment medication Xolair® can prevent lasting, severe asthma and new allergies from developing.

Xolair® is FDA approved for children 6 and older with moderate to severe persistent asthma. It blocks the body’s IgE, which is the immunoglobulin produced against allergens. This study will focus on its use in preschool-aged children (ages 2 to 3 years) who don’t quite have lasting asthma, but who are at high risk for it. 

“Most children have had their first asthma symptoms by age 5 and often we can predict well before that age who is going to develop asthma,” Dr. Bauer said. “We know that high-risk children typically come from a family with a history of allergies and/or asthma and they often wheeze from time to time in response to viral infections. When allergy testing is performed, these young children will show reactions to animal dander, pollens or other airborne allergens. The PARK study aims to see if we can prevent these high-risk children from having lasting asthma and less allergies.”

This randomized, double-blind trial is supported by a 7-year, $20 million asthma prevention grant from the NIH’s National Institute of Allergy and Infectious Diseases. By the end of the study, it aims to enroll 250 children who will either receive Xolair or a placebo and who will be followed for four years – two years on the treatment, then two years off.

Dr. Bauer and her research team at Phoenix Children’s have tracked the wheezing and coughing episodes in each and every participant since the study’s onset.

“It is undoubtedly a significant commitment in time and effort for families to participate in PARK,” she notes. “But we are all kept motivated knowing that soon we will know whether this intervention is the first to successfully prevent the progression to lasting childhood asthma.”

MAGIC Study

Down the hall at Phoenix Children’s, Dr. Wright and his team have partnered with Mayo Clinic and Stanford University in a phase 2, double-blind study to learn how to better treat patients with milk allergy.

Milk allergy is often confused with lactose intolerance because it can cause similar symptoms, however milk allergy can cause life-threatening reactions called anaphylaxis. Milk oral immunotherapy has been explored as a possible treatment for milk allergy. The goal of oral immunotherapy is to desensitize patients through a gradual increase in the allergen. Unfortunately, this treatment sometimes causes gastrointestinal side effects, such as abdominal pain.

The study that began in January 2022 aims to find out whether a medication, dupilumab, also known as Dupixent, combined with milk oral immunotherapy can make the treatment more effective and tolerable.

Phoenix Children’s has already enrolled several patients in the study. The study includes multiple food challenges that are necessary to prove the treatment is working, but these challenges can also provoke allergic reactions. Patients are seen at the hospital campus so medical staff can intervene if anaphylaxis occurs.

“I can’t think of a place safer than Phoenix Children’s to perform this study. The Allergy/Immunology Clinic is in the same building as any emergency services or support that might be needed.”

This study also incorporates a special test to monitor for changes in the esophagus and stomach.

“Some patients will swallow a small capsule that contains a nylon string,” Dr. Wright said. “The string unravels as the capsule is digested. One hour later we remove it and perform tests on the fluid from the string to see if the milk oral immunotherapy is causing an allergic reaction in the gastrointestinal tract.”

Currently, there are no proactive FDA-approved therapies for milk allergy, but Dr. Wright said this study offers promise for patients.

“Something has to change regarding the standard of care for those with food allergies, and I’m excited about studies like this that can offer our patients more options when it comes to their condition,” Dr. Wright said. “Typically, if you have a reaction to a food, then you have to avoid that food. We want our patients to lead normal lives, eliminate stigmas and not have to worry anymore.”

Why choose Phoenix Children’s for your child’s allergies and asthma

Providing patients with the best possible care means staying at the forefront of medical research, something Dr. Bauer said has been of upmost importance for the Phoenix Children’s Allergy and Immunology Clinic.

“The growth of allergy and immunology research over the last decade has helped set us apart and enabled us to offer pediatric patients novel diagnostic, treatment and preventive opportunities,” she said. “You can’t have a successful clinic without research and vice versa. As we have grown, one research opportunity has brought us another and then another!”

Dr. Wright says that research adds a creative element to medicine.

“Research allows me to think outside the box,” he said. “How can I help this patient that nobody else can help? How can I offer something that will be a cure and not just a bandage? We want to fix problems and that’s what research offers us here at Phoenix Children’s.”

Learn more about the PARK and MAGIC studies

If you’re interested in these research studies and would like to learn if your child is eligible to participate, please contact Melissa Pecak BSN, RN at mpecak@phoenixchildrens.com or 602-933-4629.