Updated on Jun 30, 2022 | Featured, Research
Scott H. Sicherer, MD, left, and Hugh A. Sampson, MD
In a significant departure from past medical practice, new guidelines from the National Institute of Allergy and Infectious Diseases (NIAID) call on parents to introduce peanut containing foods to infants as young as 4 to 6 months as a way to prevent potentially life-threatening peanut allergy. The guidelines, issued in January, were developed by an expert national panel that included two allergist-immunologists from the renowned Elliot and Roslyn Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai.
“About 4 million babies are born each year in the United States, and we know that two to two-and-a-half percent will develop peanut allergy,” says Hugh A. Sampson, MD, Director of the Jaffe Food Allergy Institute and the Kurt Hirschhorn Professor of Pediatrics. “We are not going to eradicate peanut allergy, but our goal with the new guidelines is to get the number of affected children down to about one percent.” Dr. Sampson was a member of the NIAID panel along with Scott H. Sicherer, MD, the Elliot and Roslyn Jaffe Professor of Pediatrics and Chief of the Division of Pediatric Allergy and Immunology.
Peanut allergy has grown alarmingly in recent years. According to a Mount Sinai study, allergy from peanut affected 1 in 250 children in the United States in 1997. By 2002, the incidence had jumped to 1 in 125 children, and to 1 in 70 children by 2008. The advocacy group Food Allergy Research and Education reports that food allergies result in 200,000 emergency room visits each year. “Peanut allergy tends to be severe, is potentially fatal, and is usually lifelong,” says Dr. Sicherer, “so having a strategy to prevent it, particularly one that is inexpensive to implement, offers tremendous benefits.”
For decades, allergists recommended that high-risk infants avoid exposure to peanuts through the first three years, but a landmark international allergy study, first published in 2015, proved to be a game-changer, showing that early introduction to peanut-containing food among allergy-prone infants reduced their chance of developing a peanut allergy by up to 80 percent.
The new guidelines, which were based largely on these findings, define which infants are at high, moderate, and low risk for developing peanut allergy and recommend to allergists and caregivers how to proceed with the introduction of peanut-containing food based upon risk and age. The guidelines also caution parents not to give whole peanuts to infants, and they offer peanut-containing food suggestions and methods to introduce these foods. To learn more about the guidelines, visit niaid.nih.gov.
Updated on Jun 30, 2022 | Research
The findings by Mount Sinai researchers were published in the January 31, 2017 issue of Nature Cell Biology and featured on the cover.
Updated on Jun 30, 2022 | Featured, Research
In Huffington Post’s new video series “Experimenters,” data scientist Eric Schadt, PhD, founding director of the Icahn Institute for Genomics and Multiscale Biology, discusses his mission to revolutionize health care.
Updated on Jun 30, 2022 | Research, Your Health
If you are like many of my patients, you may be wondering, “Am I getting enough vitamin D?” Shanna R. Levine, MD, Instructor of General Internal Medicine, The Mount Sinai Hospital, explains why this is a valid concern.
Updated on Jun 30, 2022 | Featured, Research
The sarcophagus of a 3,500-year-old mummy was opened at the Egyptian Museum in Cairo.
At the intersection of medicine, archaeology, and the plot of an Indiana Jones movie lies a course of study pursued by Jagat Narula, MD, PhD, MACC.
Dr. Narula’s highly eminent day jobs include serving as the Chief of Cardiology at Mount Sinai St. Luke’s and Mount Sinai West; Director of Cardiovascular Imaging for the Mount Sinai Health System; Philip J. and Harriet L. Goodhart Professor of Medicine, Icahn School of Medicine at Mount Sinai; and Editor-in-Chief of The Journal of the American College of Cardiology: Cardiovascular Imaging. But for more than six years, he has also traveled the world studying mummies with the Horus Group, named for the Egyptian god of the sky and the hunt. The multidisciplinary research group includes cardiologists, radiologists, pathologists, geneticists, basic scientists, anthropologists, and archaeologists. “We call ourselves the paleocardiologists,” Dr. Narula says, “just talking about the old or ancient stuff.” Their studies, which have been published in journals like The Lancet and Global Heart, began with a simple question: Is heart disease—atherosclerosis, or the hardening and narrowing of the arteries—a disease of the modern age and industrialization?
The group has now studied more than 100 Egyptian mummies in Cairo and Berlin using a CT scanner and has found that a third of them showed vascular disease up to 3,500 years ago. The hardening of the arteries was identified by the calcium that had deposited in their arteries. Now that kind of throws you off, as to why mankind suffered from heart disease so long ago,” Dr. Narula says. “But then you start finding out about their lifestyles. These mummies were from the elite of Egypt. These are the people who used to be carried on palanquins; there was no exercise for them.” They consumed meat frequently and feasted on bird e.gs; agriculture was well developed, and food was available all day, every day. In essence, the Egyptian elite lived like modern humans—though riding in sedan chairs, not SUVs—and their cardiovascular health paid the toll.
Jagat Narula, MD, PhD, MACC
Next the group studied the mummies of 70 Peruvians from the Andes foothills who were buried 1,000 years ago and had been naturally preserved. “You are now looking at folks who are not sedentary like the Egyptians; 50 percent of them are vegetarians, and 50 percent of them consume leaner meat, such as alpaca.” In this hardy population, the team still found that one-fifth had atherosclerosis. At first, Dr. Narula says, the researchers wondered, “Does that mean we are doomed to have this disease?” But they noticed mummies with black lungs that resulted from long exposure to the smoke of cooking fires. The team made similar observations in five sets of mummified remains in the Aleutian Islands. People in that society kayaked, hunted, and ate fish and meat, but they lived in subterranean households that were warmed with fires and had minimal ventilation through the ceiling, so they were exposed to “indoor pollution.” He maintains that atherosclerosis, today or thousands of years ago, is a result of risk factors.
In their next project, in March, the Horus Group will study mummified remains in Torino, Italy. “During the day we work, and in the evenings and mornings we sit down and discuss the data,” Dr. Narula says. “It’s a very congenial group of about 15 people.” But the mission is a serious one. Dr. Narula sees the study of mummies as a “very convincing” way to promote global cardiovascular wellness and the awareness of risk factors, including cholesterol, smoking, hypertension, diabetes, obesity, and stress. “Mummy research shows us that the risk factors remain the basis for heart disease,” Dr. Narula says. But heart disease is not inevitable: “Prevention or taking care of risk factors should take care of disease.”
Updated on Jun 30, 2022 | Featured, Research
From left: Stephen Ellis, Senior Director, Informatics, The Charles Bronfman Institute for Personalized Medicine; Steven Coca, DO; Judy Cho, MD, Ward-Coleman Chair in Translational Genetics, and Director, The Charles Bronfman Institute for Personalized Medicine; and Girish N. Nadkarni, MD.
Clinical researchers in the Division of Nephrology and The Charles Bronfman Institute for Personalized Medicine are leading a new initiative within the Mount Sinai Health System to dramatically accelerate the prescreening process to identify eligible candidates for clinical trials.
The Icahn School of Medicine at Mount Sinai is the first academic institution in the nation to partner with Clinithink, a software developer that has designed a tool known as CLiX ENRICH, a set of algorithms capable of quickly processing large volumes of quantitative and qualitative data from electronic medical records, including physician notes.
Traditionally, researchers spend weeks or months manually sifting through medical records to locate highly eligible patients for potential trial enrollment, a process that increasingly requires submission of qualitative data that can only be extracted through careful analysis of physician notes. “This software ultimately creates customizable lists of patients sorted into tiers, starting from the most eligible patients to least eligible,” says Steven Coca, DO, Associate Professor of Medicine (Nephrology) and executive sponsor of program evaluation.
In a recent proof-of-concept demonstration for an ongoing trial of a drug for patients with diabetic kidney disease, CLiX ENRICH found 97 highly eligible patients in less than three weeks compared with just six patients found over three months using standard methods.
Says Girish N. Nadkarni, MD, Assistant Professor of Medicine (Nephrology) and lead investigator for the CLiX ENRICH evaluation: “Typically, the problem is not enrolling patients quickly enough. Now, our problem is having sufficient number of staff to enroll all of the eligible patients.”
