Dr. Chen is a board-certified, fellowship-trained specialist in allergy and immunology and internal medicine. She is a clinical assistant professor in the Department of Internal Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine at Stanford University School of Medicine.
With training in pediatric and adult allergy/immunology, Dr. Chen provides expertise in food allergy, chronic urticaria, angioedema, and allergic rhinitis. She excels at addressing the impact of allergies on quality of life and productivity among the general population.
Driven by a desire to help people and deliver exceptional care, Dr. Chen takes great pride in the effectiveness and efficiency of her services, her attention to detail, and the excellent patient satisfaction scores she earns. She has trained and worked in a broad range of clinical care settings, including private practice, the Veterans Administration, major health systems, and academic medical centers, like Stanford Health Care.
Dr. Chen has extensive research experience, from study start-up to manuscript preparation. She has conducted clinical research, including the evaluation of heated milk and egg protein tolerance in milk and egg allergic patients, as well as clinical trials for other novel treatments for food allergy. Dr. Chen has authored numerous scholarly publications on topics including food allergy, urticaria, and angioedema. She has presented the findings of her research to the American Academy of Allergy, Asthma, and Immunology Annual Scientific Meeting and other conferences.
Her work has appeared in the journals Pediatric Allergy; the Annals of Allergy, Asthma, and Immunology; JAMA; as well as book chapters on immunology.
Dr. Chen has received honors and awards for her scholarship. She is a member of the American Academy of Allergy, Asthma, and Immunology; the American College of Allergy, Asthma, and Immunology; and, the Allergy, Asthma, and Immunology Foundation of Northern California. She has volunteered her clinical services at homeless shelters in the Bay Area.
- Allergy and Immunology
Clinical Assistant Professor, Medicine - Pulmonary, Allergy & Critical Care Medicine
Board Certification: American Board of Allergy and Immunology, Allergy and Immunology (2018)
Fellowship: UCSD Allergy and Immunology Fellowship (2018) CA
Board Certification: American Board of Internal Medicine, Internal Medicine (2016)
Residency: UCLA Medical Center Internal Medicine (2016) CA
Medical Education: University of California at San Francisco School of Medicine (2013) CA
- Asian American Patients With Allergic Diseases: Considerations for Research and Clinical Care. The journal of allergy and clinical immunology. In practice 2022; 10 (4): 950-952
Increased duration of pollen and mold exposure are linked to climate change.
2021; 11 (1): 12816
Pollen and molds are environmental allergens that are affected by climate change. As pollen and molds exhibit geographical variations, we sought to understand the impact of climate change (temperature, carbon dioxide (CO2), precipitation, smoke exposure) on common pollen and molds in the San Francisco Bay Area, one of the largest urban areas in the United States. When using time-series regression models between 2002 and 2019, the annual average number of weeks with pollen concentrations higher than zero increased over time. For tree pollens, the average increase in this duration was 0.47weeks and 0.51weeks for mold spores. Associations between mold, pollen and meteorological data (e.g., precipitation, temperature, atmospheric CO2, and area covered by wildfire smoke) were analyzed using the autoregressive integrated moving average model. We found that peak concentrations of weed and tree pollens were positively associated with temperature (p<0.05 at lag 0-1, 0-4, and 0-12weeks) and precipitation (p<0.05 at lag 0-4, 0-12, and 0-24weeks) changes, respectively. We did not find clear associations between pollen concentrations and CO2 levels or wildfire smoke exposure. This study's findings suggest that spore and pollen activities are related to changes in observed climate change variables.
View details for DOI 10.1038/s41598-021-92178-z
View details for PubMedID 34140579
Homologies between SARS-CoV-2 and allergen proteins may direct T cell-mediated heterologous immune responses.
2021; 11 (1): 4792
The outbreak of the new severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a public health emergency. Asthma does not represent a risk factor for COVID-19 in several published cohorts. We hypothesized that the SARS-CoV-2 proteome contains T cell epitopes, which are potentially cross-reactive to allergen epitopes. We aimed at identifying homologous peptide sequences by means of two distinct complementary bioinformatics approaches. Pipeline 1 included prediction of MHC Class I and Class II epitopes contained in the SARS-CoV-2 proteome and allergens along with alignment and elaborate ranking approaches. Pipeline 2 involved alignment of SARS-CoV-2 overlapping peptides with known allergen-derived T cell epitopes. Our results indicate a large number of MHC Class I epitope pairs including known as well as de novo predicted allergen T cell epitopes with high probability for cross-reactivity. Allergen sources, such as Aspergillus fumigatus, Phleum pratense and Dermatophagoides species are of particular interest due to their association with multiple cross-reactive candidate peptides, independently of the applied bioinformatic approach. In contrast, peptides derived from food allergens, as well as MHC class II epitopes did not achieve high in silico ranking and were therefore not further investigated. Our findings warrant further experimental confirmation along with examination of the functional importance of such cross-reactive responses.
View details for DOI 10.1038/s41598-021-84320-8
View details for PubMedID 33637823
Radiation Recall Dermatitis Triggered by Prednisone
2020; 105 (6): E16-E18
View details for Web of Science ID 000641138200004
Oral immunotherapy for peanut allergy: The pro argument.
The World Allergy Organization journal
2020; 13 (8): 100455
Food allergy (FA) is a growing public health problem with personal, social, nutritional, and economic consequences. In the United States, it is estimated that 8% of children and 10.8% of adults have food allergies. Allergies to peanuts are particularly worrisome as unlike allergies to other allergenic foods, such as milk and egg, which are commonly outgrown by 5 or 10 years of age, 80% of peanut allergies persist into adulthood. The first drug for peanut allergy, Palforzia, was approved by the US Food and Drug Administration (FDA) in January 2020. For other food allergies, the current standard of care for the management of FA is suboptimal and is limited to dietary elimination of the offending allergen, vigilance against accidental ingestion, and treatment of allergic reactions with antihistamines and epinephrine. However, dietary avoidance can be challenging, and it is estimated that approximately 40% of patients with food allergies report at least one food allergy-related emergency department in their lifetime. Reactions, even from minimal exposures, can be life-threatening. Oral immunotherapy (OIT) has been the best researched therapeutic approach for treating FA over the last decade, with clinical trials investigating its efficacy, safety, and ability to improve participants' quality of life (QoL). A number of studies and meta-analyses have shown that OIT treatment is effective in raising the threshold of reactivity to peanuts and other foods in addition to producing a measurable serum immune response to such therapy. Although OIT-related adverse events (AEs) are common during treatment, serious reactions are rare. In fact, while the majority of patients experience AEs related to dosing, most continue daily dosing in hopes of achieving protection against the culprit food. Moreover, the majority of participants report improvement of QoL after OIT and are positive about undergoing OIT. These results show patients' commitment to OIT and their optimism regarding the benefits of treatment. As a first step in therapeutic options to protect from reactions to unintentional ingestion of allergenic foods, and importantly, to address the many psychosocial aspects of living with FA, OIT shows promise. Future research will focus on identifying optimal OIT regimens that maintain protection after therapy and allow for regular food consumption without allergic symptoms. Education and informed shared decision making between patients and providers are essential in optimizing current therapy regimens.
View details for DOI 10.1016/j.waojou.2020.100455
View details for PubMedID 33005286
View details for PubMedCentralID PMC7519204
Homologies between SARS-CoV-2 and allergen proteins may direct T cell-mediated heterologous immune responses.
The outbreak of the new Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a public health emergency. Asthma does not represent a risk factor for COVID-19 in several published cohorts. We hypothesized that the SARS-CoV-2 proteome contains T cell epitopes, which are potentially cross-reactive to allergen epitopes. We aimed at identifying homologous peptide sequences by means of two distinct complementary bioinformatics approaches. Pipeline 1 included prediction of MHC Class I and Class II epitopes contained in the SARS-CoV-2 proteome and allergens along with alignment and elaborate ranking approaches. Pipeline 2 involved alignment of SARS-CoV-2 overlapping peptides with known allergen-derived T cell epitopes. Our results indicate a large number of MHC Class I epitope pairs including known as well as de novo predicted allergen T cell epitopes with high probability for cross-reactivity. Allergen sources, such as Aspergillus fumigatus , Phleum pratense and Dermatophagoides species are of particular interest due to their association with multiple cross-reactive candidate peptides, independently of the applied bioinformatic approach. In contrast, peptides derived from food allergens, as well as MHC class II epitopes did not achieve high in silico ranking and were therefore not further investigated. Our findings warrant further experimental confirmation along with examination of the functional importance of such cross-reactive responses.
View details for DOI 10.21203/rs.3.rs-86873/v1
View details for PubMedID 33052330
View details for PubMedCentralID PMC7553154
Radiation recall dermatitis triggered by prednisone.
2020; 105 (6): E16–E18
View details for PubMedID 32716998
- Conflicting verdicts on peanut OIT from the ICER and FDA Advisory Committee; where do we go from here? The Journal of allergy and clinical immunology 2019
Analysis of Allergen-Specific T Cell and IgE Reactivity to Different Preparations of Cow's Milk-Containing Food Extracts
2019; 8 (7)
cow's milk allergy (CM) is among the most common food allergies in young children and is often outgrown by adulthood. Prior to developing a tolerance to CM, a majority of CM-allergic children may tolerate extensively-heated CM. This study aims to characterize the IgE- and T cell-reactivity to unheated CM and the progressively more heated CM-containing foods.CM-containing food extracts from muffin, baked cheese, custard and raw, pasteurized CM commercial extract were tested for skin prick test reactivity, IgE binding and T cell reactivity as assessed by IL-5 and IFNγ production.the skin prick test (SPT) reactivity was significantly decreased to muffin extract compared to raw, pasteurized CM. Both IgE- and T-cell reactivity were readily detectable against food extracts from all forms of CM. Western blot analysis of IgE reactivity revealed variability between extracts that was protein-specific. T cell-reactivity was detected against all four extracts with no significant difference in IL-5 or IFNγ production between them.our data indicate that despite reduced clinical reactivity, extracts from heated CM-containing foods retain immunogenicity when tested in vitro, particularly at the T cell level.
View details for DOI 10.3390/cells8070667
View details for Web of Science ID 000478902000060
View details for PubMedID 31269726
View details for PubMedCentralID PMC6679079
Acquired Donor Peanut Allergy From Lung Transplantation Resulting in Respiratory Failure: A Case Report
2018; 50 (10): 4085–86
This case report describes a patient who acquired a donor peanut allergy after lung transplantation. A 53-year-old woman with alpha-1 antitrypsin deficiency underwent left-sided lung transplant from a donor with a history of anaphylaxis to peanut. Two weeks after the transplant, the patient developed acute respiratory failure immediately after consuming a peanut butter and jelly sandwich. The donor's serum confirmed high titers of peanut-specific immunoglobulin E (IgE). The recipient patient had never had allergies to peanuts or other nuts before her transplant. After the transplant, she had negative serology but positive skin testing to peanuts. This case illustrates the importance of considering donor food allergies when caring for solid organ transplant recipients.
View details for DOI 10.1016/j.transproceed.2018.08.001
View details for Web of Science ID 000454972000202
View details for PubMedID 30447764
- Mast cell disorders Protean manifestations and treatment responses ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY 2018; 121 (1): 128–30
- Marijuana and stoned fruit ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY 2018; 120 (5): 536–37
Preventing Peanut Allergy
PEDIATRIC ALLERGY IMMUNOLOGY AND PULMONOLOGY
2018; 31 (1): 2–8
The rising prevalence of food allergy and specifically peanut allergy has had significant implications for affected patients, families, and society. The current standard of care remains strict avoidance and the use of emergency medications for accidental ingestions. There is recent evidence-based information to suggest that one approach to preventing peanut allergy lies in early introduction of peanut. This represents a paradigm shift from previous recommendations and has led to updated guidelines in the United States, Europe, and Australasia on the introduction of potentially allergenic foods in the infant diet. This new approach to prevention has some practical obstacles and challenges associated with its implementation. There is also growing interest in the role of maintaining a healthy skin barrier in prevention of sensitization and food allergy. Other approaches, including pro- and prebiotics, prenatal maternal dietary avoidance, breastfeeding, and the use of specific formulas, have not shown reproducibly favorable results. As children with peanut allergy are unlikely to outgrow their food allergy, early oral immunotherapy in those with established peanut allergy is being investigated with the hopes of altering the natural history of an otherwise lifelong disease.
View details for DOI 10.1089/ped.2017.0826
View details for Web of Science ID 000423131000001
View details for PubMedID 29588872
View details for PubMedCentralID PMC5867507
- Baked milk and baked egg oral immunotherapy IMMUNOTHERAPY 2017; 9 (15): 1201–4
Emerging Therapies in Hereditary Angioedema
IMMUNOLOGY AND ALLERGY CLINICS OF NORTH AMERICA
2017; 37 (3): 585-+
Remarkable progress has been made in the treatment of bradykinin-mediated angioedema with the advent of multiple new therapies. Patients now have effective medications available for prophylaxis and treatment of acute attacks. However, hereditary angioedema is a burdensome disease that can lead to debilitating and dangerous angioedema episodes associated with significant costs for individuals and society. The burden of treatment must be addressed regarding medication administration difficulties, treatment complications, and adverse side effects. New therapies are being investigated and may offer solutions to these challenges. This article reviews the emerging therapeutic options for the treatment of HAE.
View details for DOI 10.1016/j.iac.2017.03.003
View details for Web of Science ID 000406819300012
View details for PubMedID 28687111
View details for PubMedCentralID PMC5585075
The current state of food allergy therapeutics
HUMAN VACCINES & IMMUNOTHERAPEUTICS
2017; 13 (10): 2434–42
The prevalence of IgE mediated food allergy is an increasing public health concern. The current standard of treatment is strict avoidance of the offending food(s). There are no FDA approved treatments for food allergy. This review will provide an overview of strategies currently under investigation for the treatment of food allergy. The main focus of research has been directed at various forms of immunotherapy, including oral, sublingual and epicutaneous delivery routes. While oral immunotherapy (OIT) has shown the greatest promise for efficacy in terms of amount of protein that can be ingested, it has also demonstrated less tolerability and a less favorable safety profile as compared to sublingual immunotherapy (SLIT) and epicutaneous immunotherapy (EPIT), which offers the least protection but has the best safety and tolerability profile. Investigation is also underway for modified antigens that may be used for immunotherapy and for adjuncts that may help facilitate immunotherapy, including biologics such as anti-IgE therapy, and also probiotics. There are also a number of preclinical concepts that are being evaluated to manipulate the antigens and/or the immune system that may one day be translatable to patients.
View details for Web of Science ID 000415981300041
View details for PubMedID 28846472
View details for PubMedCentralID PMC5647972
- Elevated Lactate Levels in a Non-Critically Ill Patient JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION 2015; 313 (8): 849–50
Voriconazole Antifungal Prophylaxis After Lung Transplantation And Risk Of Squamous Cell Carcinoma Of The Skin
AMER THORACIC SOC. 2015
View details for Web of Science ID 000377582800432