Wednesday, June 2, 2010

An Expert Disconnect at the Café Scientifique

Today we have a guest post from the allergy community, about an allergy event we both attended.

An Expert Disconnect at the Café Scientifique
By Heather Fraser

There were great expectations created in advance of “The Allergy & Asthma Epidemic, Can We Prevent or Cure It?" an “expert” panel discussion and Q&A event at the Café Scientifique, a series of public health presentations created by the Canadian Institute of Health Research. This Café was held on May 31, 2010 at the Royal Botanical Gardens in Hamilton and sponsored in part by AllerGen NCE Inc.

With such a promising title, the event was well attended by parents eager for any clue as to how and why their children have become severely allergic. Admittedly, expectations were perhaps too high for this two-hour presentation. But what followed was a disappointing tangle of information made nearly impenetrable by a profound disconnect between audience and panel experts.

Perhaps setting the awkward tone for the evening were the introductory remarks of panel moderator CEO of AllerGen Dr. Denburg, who is also Director of Immunology & Allergy at McMaster University in Hamilton. Dr. Denburg began by promising parents each an AllerGen metal water bottle if they filled out a survey form at the front door. The deflation was audible. The audience consisted of knowledgeable parents, support groups, and allergy writers virtually all of whom live with life threatening allergy daily.

Not altogether thwarted by this under-appreciation, the audience listened politely to each 10-minute info-bite from allergists Dr. Allan Becker from U. of Manitoba, Dr. Malcolm Sears from McMaster and Dr. Ann Clarke, from McGill. While each was a pleasant soft pedal on statistics and ongoing studies, none directly addressed the evening’s topic. Can we prevent or cure allergy/asthma?

Finally, Dr. Sears came out with it and asked rhetorically what is causing this rise in allergy and asthma? He didn’t know. However, he hoped that his AllerGen funded CHILD study into conditions surrounding children would reveal something important in the future. During the Q&A Dr. Sears was asked whether he was including vaccination in his study. Indeed, he said it was to be noted but that he did not think it was highly relevant.

It was this assertion, however, that hung in the air for a moment. Had Dr. Sears not read the conclusions of Dr. Becker’s 2008 landmark study on childhood vaccination? And why did Dr. Becker not challenge his colleague by referring to his co-authored U. Manitoba research that linked the DPT vaccination with the rise in asthma in children.

But then, the purpose of the evening was not meaningful exchange. In fact, the shower of fragmented info-bites failed to satisfy ~ a sliver of the stalled hygiene theory, a snippit of helminth hypothesis, a whiff of epigenetics, a trail mix of well known risk factors and old research, all of which were flung up into the air and none of which landed in any coherent fashion.

Dr. Denburg tried to tie some of the bits down by citing an Israel-UK study of peanut allergic kids and how he thought the early introduction of “bamba” a peanut food for children was protecting them from the allergy. What Dr. Denburg failed to add was that in Israel, as many kids have sesame allergy as UK kids have peanut allergy. No small irony exists in the opinion of Israeli doctors who blame the early introduction of sesame for the rise in this allergy. The fragments also seemed to lack balance.

Many things were assumed by the panel that might have been better considered. In addition to recognizing the intelligence of the audience, the doctors might have begun by defining allergy. Is allergy a disease? Or, as Margie Profet in 1991 proposed, is allergy an evolved response to acute toxicity, a novel concept that dovetails with the idea of epigenetics? No one clarified the four ways in which a person can become allergic in the first place: ingestion, inhalation, through the skin, injection. Of these possibilities, which one(s) might have resulted in the rise in these conditions in kids? The panel seemed to agree that the increase in allergy and asthma grabbed everyone’s attention in the early 90s. Was this not also a clue? Perhaps it was too obvious.

In considering the rise of food allergy, Dr. Becker reviewed Oral Allergy Syndrome where a pollen/pollutant and food can cross react. However, he did not attempt to explain how or why so many people especially children have become so sensitive. In fact, none of the experts stated an opinion. It all needs further study.

One parent had an idea, though, and asked the panel about the role of GMO foods in the rise of allergy. Dr. Clarke responded -- there may be dangerous hidden allergy triggers in a tomato spliced with the DNA of peanut, for example. But the question asked was not about triggers. Audience members knew that the parent wanted an opinion about the increased toxicity in foods and about the role of toxicity in the creation of allergy.

The disconnect between the panel experts and the audience was painful and served to underline the actual purpose of the event. The evening was less about satisfying parents than it was about promoting AllerGen NCE Inc. AllerGen is a corporation that helps fund the research of allergy doctors in exchange for co-ownership of any commercially viable results.

But this scenario is not new nor is commercial interest bad. What is new is the shifting sand beneath the presumptive relationship of leader and follower. Parents blog, write, read, talk, publish, podcast, upload, download, facebook, tweet, communicate fluidly with each other and have come to their own conclusions about the rise in allergy and asthma. Impatient changes in society are emerging to which the experts and their commercial stake holders should begin to pay much closer attention.

Thank you Heather Fraser for this guest post. Heather is the author of The History of the Peanut Allergy Epidemic

Opinions expressed by this guest poster are not necessarily my views.

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