Dr Helen Brough trained in Paediatric Allergy as a Clinical Lecturer at King’s College London University and Guy’s and St. Thomas’ Hospital. Following completion of a Master of Science (MSc) and Doctor of Philosophy (Ph.D), Dr Brough continues active involvement in research to prevent the development of allergies; with particular interest in the role of eczema leading to food allergy and the prevention and spread of food allergies in children already allergic to certain foods.
Eczema results from a combination of genetic (skin barrier function gene mutations) and environmental factors (infections, hard water, detergents and other irritants).There is a clear association between eczema and the development of food allergy, asthma and hayfever. Whereas in previous years the focus has been on the role of food allergies in causing or exacerbating eczema, in more recent years the role of an impaired skin barrier in eczema children becoming allergic through the skin; especially with the discovery of the eczema gene which codes for the skin barrier protein filaggrin (FLG).
Dr Helen Brough developed a technique to measure peanut protein in the environment to quantify exposure to this important food allergen through the skin. Dr Brough showed that peanut levels in dust in the babies’ cot and play-area were closely related to how much peanut was being consumed in the home. She also showed that in children with eczema or a mutation in the gene coding for filaggrin exposure to high levels of peanut in dust increased the risk of developing peanut allergy later in life. A large interventional study is now being planned to to confirm these findings. This research technique has also been incorporated into the LEAP (Learning Early About Peanuts) and EAT (Enquiring About Tolerance) study.
Dr Brough also leads the Pronuts study at King’s College London University. This study is evaluating whether in children who already have one nut allergy, the introduction of nuts and seeds to which they are not allergic may prevent the development of new nut allergies. Up until recently, the conventional approach to a child with a nut allergy was to recommend avoidance of all nuts and certain seeds (such as sesame seed). Our practice is now changing for a more proactive management of food allergy with the aim to prevent the spread and progression of food allergy. The Pronuts study is assessing the feasibility of performing challenges to several nuts and seeds and the introduction of the safe nuts and seeds into the diet on a regular basis. A larger interventional study (Pronuts2) is also being planned. Finally, Dr Brough is collaborating on an oral peanut desensitization research programme at Guy’s and St. Thomas’ NHS Foundation Trust and King’s College London, as part of a commercially sponsored multicentre study in Europe.