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Department

Allergology, Internal Medicine

The department has as aim to improve the care (diagnosis and treatment) in patients with complex atopic disorders, work-related allergies, mastocytosis, treatment resistant urticarial/angioedema, drug allergy and severe allergic patients receiving immunotherapy. This is done with internal and external national and international collaborators.

About our Department

Our research

Immunotherapy
Immunotherapy has become a corner stone in the treatment of various type of IgE mediated allergy. During the last five years the department was involved in international studies on efficacy, health economics, new treatment modalities and contraindications for immunotherapy. The department was involved in the development of international guidelines regarding this topic. Currently, together with the department of general medicine we are examining whether transfer of immunotherapy to care-takers in the first line of care is safe and cost-saving.

Food Allergy
Over the past few we have a track record in the field of cashew nut allergy. Furthermore we established whether food introduction in young children is safe and whether healthy food was associated with fewer allergic symptoms in children. We are involved in the development of “new foods” (apples, pears, milk) that are believed to cause fewer allergic reactions. We are examining methylation pathways that are associated with food allergy risk.

Mastocytosis
The ErasmusMC together with the University Hospital Groningen, both participate in the “European Competence Network on Mastocytosis” (ECNM) We are involved in many large scale trials examining new treatments in patients with systemic mastocytosis, some of these trials were investigator initiated. We extensively studied the clinical phenotype in a large cohort of patients with systemic mastocytosis seen at the outpatient clinic at Erasmus MC. We perform genetic studies to establish the cause of familial mastocytosis. We performed a trial to find out whether prescription of NSAIDs in patients with mastocytosis is safe. We elaborated on the effect of mast cells on cardiovascular disease.

Chronic Urticaria
With the newly internationally recognized urticaria center as part of the “Urticaria Centers of Reference and Excellence” (UCARE) network as starting, we are establishing a new line on research together with pharmaceutical companies we are introducing new treatments in patients that are highly symptomatic. Moreover, we are interested in cost-effectiveness and personalized treatment with current biologicals. One paper on personalized treatment has been published recently (J Allergy Clin Imm 2018;142:1992-4)

Principal Investigators

 Name  Position   Research Domain 
 Prof.dr. R. Gerth van Wijk  Professor, head

 Immunotherapy/
 immunomodulationOccupational allergy

 Dr. P.L.A. van Daele  Associate Professor  Mastocytosis and other mast-cell related diseases, 
 Urticaria/angioedema
 Dr. N.W. de Jong  Associate Professor  Food allergy, 
 Drug hypersensitivity
 Drs. M.S. van Maaren  Medical Specialist  Drug hypersensitivity, 
 urticaria/angioedema
 Drs. M.A.W. Hermans  Medical Specialist  Mastocytosis

Research Lines

● EMC MM-01-039-07 with particular focus on research concerning occupational allergy, food allergy, mast cell and immunotherapy
● Occupational Allergy: Currently we elaborate on the risk of allergic (both skin and pulmonary) symptoms after exposure to metals
● Drug hypersensitivity: We have developed a questionnaire which we will translate into a user-friendly app to help physicians in deciding whether a presumed medication allergy is indeed likely or not and a laboratory tool to screen for type IV allergic drug reactions.

Projects

Project 1:
iAGE study NL61774.079.17: Immunogenic properties of heated and glycated cow’s milk protein – effect on resolution of cow’s milk allergy.

Project 2.
HoMaFa study NL61899.078.17: Comparative research through skin prick test between commercially available and homemade food allergens in patients with food allergies. 

Project 3.
Pear study NL70165.078.09: Comparative research through skin prick test and oral challenge between Hypoallergenic Migo Pear and Conference pear in patients with peer allergy.

• Project 4.
We are partnering in a large consortium study together with dr. H.H. Smits Dept of Parasitology, LUMC) and prof. Dr. Esther de Jong (Department of Cell biology and histology, AMC) to the modulatory effects of microbial molecules on the allergic immune response.


Publications

De Jong NW et al Eur J Pediatr. 2019;178(10):1507-17
Hermans MAW et al Clin Exp All 2018;48(11):1412-1420
Hermans MAW et al Allergy 2018;73:2055-62
Sampson HA et al JAMA 2017;318:1798-1809
Van der Valk JPM et al Plos One 2016;11:e0151055
Kiel MA et al. J Allergy Clin Immunol 2013; 132:353-60

Facilities

Advanced in vivo and in vitro diagnostics in food and drugs allergy, e.g. high and low risk food and drugs challenges in an either open or double blind fashion.

Collaborations

● We are partnering in a large consortium study together with dr. H.H. Smits Dept of Parasitology, LUMC) and prof. Dr. Esther de Jong (Department of Cell biology and histology, AMC)
● Together with WUR studies are developed and granted by the NWO-TTW, and consequently, positive relationships with industries and stake holders were build. Examples are Nutricia, Siemens Healthcare, Friesland Campina, ALK and Thermo Fisher.
● A regional network with other hospitals (SFG, Maasstad ZH, Ikazia, IJsselland ZH) and general practitioners has been establish to study and optimize a regional care pathway for patients treated with allergen immunotherapy. (BeterKeten project)
● Extensive collaboration focusing on Mastocytosis (NFU recognized) is set up between departments Allergology& Paediatric Allergology, Clinical Immunology, Dermatology & Paediatric Dermatology.
https://ace.adasco.nl/ace/5

News, events and awards

Awards and grants

● € 1.000.000 iAGE study NL61774.078.17 NWO-TTW NW de Jong
● €50,000 Novartis; €10,000 MPN Foundation: Prospectively investigating the role of mast cells in itching associated with MPN. MAW Hermans
● €100.000 European Fruit organization & WUR. Hypoallergenic Migo Pear Humane study. NW de Jong. 2018-2020

Education

BSc & MSc students

The department is actively involved in the education of bachelor students (BSc) in medicine (especially 2e and 3e year) and in the education of master students (MSc) specifically in infection and immunity.
Furthermore, the department is involved in a minor for 3rd year medical students. The minor aims to deepen the understanding of immunological processes - and clinical reasoning in allergic diseases.
Development of novel educational programs (e.g. E-learning modules, interactive sessions, flipping the classroom) and participation in The institute of Medical Education Research Rotterdam (iMERR). http://www.imerr.nl/