Jyothi Tirumalasetty, MD, FAAAAI, FACAAI

All Publications

• The Immunobiology and Treatment of Food Allergy. Annual review of immunology Barshow, S., Tirumalasetty, J., Sampath, V., Zhou, X., Seastedt, H., Schuetz, J., Nadeau, K. 2024

  Abstract

  IgE-mediated food allergy (IgE-FA) occurs due to a breakdown in immune tolerance that leads to a detrimental type 2 helper T cell (TH2) adaptive immune response. While the processes governing this loss of tolerance are incompletely understood, several host-related and environmental factors impacting the risk of IgE-FA development have been identified. Mounting evidence supports the role of an impaired epithelial barrier in the development of IgE-FA, with exposure of allergens through damaged skin and gut epithelium leading to the aberrant production of alarmins and activation of TH2-type allergic inflammation. The treatment of IgE-FA has historically been avoidance with acute management of allergic reactions, but advances in allergen-specific immunotherapy and the development of biologics and other novel therapeutics are rapidly changing the landscape of food allergy treatment. Here, we discuss the pathogenesis and immunobiology of IgE-FA in addition to its diagnosis, prognosis, and treatment. Expected final online publication date for the Annual Review of Immunology, Volume 42 is April 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

  View details for DOI 10.1146/annurev-immunol-090122-043501

  View details for PubMedID 38360544

• Peanut allergy: risk factors, immune mechanisms, and best practices for oral immunotherapy success. Expert review of clinical immunology Tirumalasetty, J., Barshow, S., Kost, L., Morales, L., Sharma, R., Lazarte, C., Nadeau, K. C. 2023: 1-11

  Abstract

  Peanut oral immunotherapy (pOIT) is the only FDA-approved treatment for food allergy and its adoption amongst allergist immunologists and their patients is growing. pOIT is the subject of numerous clinical trials, however, the focus is often on treatment efficacy, safety, and tolerability, rather than identifying patients most likely to benefit from pOIT. Here, we review existing data on the clinical and immunological outcomes of pOIT that inform best practices for pOIT candidate selection.In this review, we describe the natural history of peanut allergy, summarize immunological and clinical outcomes of pOIT at different ages, discuss the optimization of pOIT in key age groups, and finally suggest an ideal age range at which to initiate pOIT for best outcomes.pOIT is currently underutilized by patients and allergist-immunologists. Developing guidelines for selecting appropriate patients and optimizing treatment may help to increase access to pOIT. Many aspects of pOIT need additional study to further our understanding of the optimal timing to start pOIT, with careful consideration to clinical, immunological, and quality of life outcomes.

  View details for DOI 10.1080/1744666X.2023.2209318

  View details for PubMedID 37129440

• The role of biologics in pediatric food allergy and eosinophilic gastrointestinal disorders. The Journal of allergy and clinical immunology Sindher, S. B., Barshow, S., Tirumalasetty, J., Arasi, S., Atkins, D., Bauer, M., Bégin, P., Collins, M. H., Deschildre, A., Doyle, A. D., Fiocchi, A., Furuta, G. T., Garcia-Lloret, M., Mennini, M., Rothenberg, M. E., Spergel, J. M., Wang, J., Wood, R. A., Wright, B. L., Zuberbier, T., Chin, A. R., Long, A., Nadeau, K. C., Chinthrajah, R. S. 2023; 151 (3): 595-606

  Abstract

  Continuing insight into the molecular mechanisms of atopic disorders has enabled the development of biologics to precisely target these diseases. Food allergy (FA) and eosinophilic gastrointestinal disorders (EGIDs) are driven by similar inflammatory molecular mechanisms and exist along the same atopic disease spectrum. Therefore, many of the same biologics are being investigated to target key drivers of mechanisms shared across the disease states. The enormous potential of biologics for the treatment of FA and EGIDs is highlighted by the significant increases in the number of ongoing clinical trials (more than 30) evaluating their use in these disease states, as well as by the recent US Food and Drug Administration approval of dupilumab for the treatment of eosinophilic esophagitis. Here we discuss past and current research into the use of biologics in FA and EGIDs and their potential role in improving treatment options in the future, with the need to have biologics widely clinically available.

  View details for DOI 10.1016/j.jaci.2023.01.007

  View details for PubMedID 36872039

• The Effects of Long-term Food Oral Immunotherapy on Compliance, Quality of Life, and Perceived Burden of Care Tirumalasetty, J., Sullivan, L., Martinez, K., Collins, W., Albarran, M., Gajare, P., Kost, L., Chinthrajah, S., Sindher, S., Cao, S. MOSBY-ELSEVIER. 2023: AB29

  View details for Web of Science ID 000991651900084

• Asthma, surgery, and general anesthesia: a review. The Journal of asthma : official journal of the Association for the Care of Asthma Tirumalasetty, J., Grammer, L. C. 2006; 43 (4): 251-4

  Abstract

  Over 20 million Americans are affected with asthma. Many will require some type of surgical procedure during which their asthma management should be optimized. Preoperative assessment of asthma should include a specialized history and physical as well as pulmonary function testing. In many asthmatic patients, treatment with systemic corticosteroids and bronchodilators is indicated to prevent the inflammation and bronchoconstriction associated with endotracheal intubation. The use of corticosteroids has not been shown to adversely affect wound healing or increase the rate of infections postoperatively. Preoperative systemic corticosteroids may be used safely in the majority of patients to decrease asthma-related morbidity.

  View details for DOI 10.1080/02770900600643162

  View details for PubMedID 16809236