In Profile: Dr. R. Sharon Chinthrajah, Clinical Assistant Professor

What is your background and role at the Center?

I joined the Sean N. Parker Center for Allergy & Asthma Research at Stanford University in August 2013 after completing my subspecialty training in Pulmonary/Critical Care and Allergy/Immunology at Boston Medical Center. I obtained my MD from Drexel University College of Medicine in 2004 and completed my Internal Medicine training at California Pacific Medical Center in 2007 and chief residency in 2008. As Director of the Clinical Translational Research Unit of the Center, I oversee all the clinical trials, see patients, teach fellows, and am an investigator on many of our clinical trials in food allergy and asthma. I also see patients in the Stanford Pulmonary and Allergy clinics. I am very excited to be at the Center and am especially thrilled that we have formally incorporated asthma care and research into the Center’s mission. Asthma and food allergies have common underlying mechanisms and many patients with food allergies often have a history of other allergies or asthma. In fact, about 65% of the patients with food allergies at our Center also have asthma. Working with patients with both asthma and allergy, I am able to fully utilize both my training in Pulmonary and Critical Care and Allergy/Immunology.

What do you think makes the Center unique?

The Center has an extremely collaborative environment and this is what makes us so unique. Our vision is to create an interdisciplinary and interdependent Center at Stanford for allergies and asthma. These are complex diseases and in order to find a cure we need the expertise of researchers from a number of scientific fields. In addition to a strong clinical team, we have expert scientists in the biological sciences, biostatistics, and bioinformatics, among others. We also collaborate with scientists all across the United States and around the world. The Center has access to state-of-the-art high-throughput instruments, such as CyTOF (Cytometry by Time of Flight mass spectrometry) and single cell qPCR (quantitative polymerase chain reaction), which are able to quantitate multiple parameters simultaneously. Using these tools and other innovative technologies, we are able to obtain enormous amounts of information on a cellular, genetic, and molecular level and correlate it to clinical profiles. This information helps provide a detailed profile of the immune characteristics of patients before, during, and after immunotherapy. With the use of big data analytics, we can uncover hidden patterns and find correlations between immune profile and disease states. Our Center is also unique in that we place great emphasis on community outreach. We hold community events throughout the year and educate and inform the public regarding the clinical research and basic science that is being conducted at the Center. Our community outreach works both ways as they are very involved in helping patients navigate our clinical trials. We place a strong emphasis on creating a strong and supportive environment for the patients enrolled in our trials.

Although most of our clinical trials are currently focused on food allergies, we are working to expand our trials to include other allergic diseases and asthma. This is necessary to fully understand the mechanisms underlying immunological diseases, how allergic diseases overlap and how they are distinct. Ultimately, this will enable us to find better ways to prevent, diagnose, and treat these diseases. Our goal is to find comprehensive solutions to allergic diseases and asthma. We have the infrastructure and the scientific expertise to advance knowledge in the field of immunology.

What excites you specifically about food allergy and asthma research and the work being done in the field?

These are exciting times for research in asthma and allergies. Armed with a better understanding of the basic mechanisms underlying allergic responses, we are now seeing this knowledge being applied to enable better diagnostics and treatments. There have been some exciting developments in the last few years and I expect further developments for the prevention, diagnosis, and treatment of food allergies and asthma in the coming years.

Omalizumab, an anti IgE antibody, was approved by the FDA in 2003 for treating patients with moderate to severe allergic asthma. Since then, we have identified key molecules, such as IL-4, IL-5, and IL-13, involved in the pathogenesis of these diseases. This has led to the development of innovative drugs aimed at blocking the effects of these molecules. After a gap of about 12 years, two new drugs for treating asthma were recently approved – mepolizumab (June 2015) and reslizumab (March 2016). Both of these drugs block IL-5. The approval of these drugs represent a significant milestone for the treatment of asthma. Other drugs, such as dupilumab are in advanced phase 3 clinical trials. This investigational therapy blocks IL-4 and IL-13 signaling, two molecules also required for allergic response. Other promising drugs are also under investigation.

There have also been some major advancements in food allergy treatments. Immunotherapy (delivered either orally, sublingually, or via a patch through the skin) has shown great promise in clinical trials and it is likely that it will be approved for use within the next few years. Additionally, our Center has shown that the inclusion of omalizumab, an anti-IgE antibody, as pretreatment before immunotherapy or in conjunction with immunotherapy significantly decreases the time taken to desensitize individuals. The use of omalizumab also enables individuals to be treated simultaneously for allergy to multiple allergens.

A recent study from the United Kingdom by Gideon Lack showed that early introduction of foods prevents allergic response in patients at high risk of developing allergies. This was a revolutionary finding and has fundamentally changed our thinking about the development of food allergies.

There are many research groups, including ours, that are finding better ways to prevent, diagnose, and treat allergies and asthma. We are also moving towards understanding the similarities and differences in immune profile between different individuals with similar symptoms so that we can personalize care for safer and more effective treatments. Major shifts in our current treatments for allergy and asthma are occurring and I am very excited to be involved in immunology research at this time.