Shirley Jiang, MD

All Publications

• Shrimp oral immunotherapy outcomes in the phase 2 clinical trial: MOTIF. Frontiers in allergy Jiang, S. Y., Cao, S., Martinez, K., Sharma, R., Raeber, O., Fernandes, A., Bogetic, D., Kaushik, A., Gupta, S., Manohar, M., Maeker, H. T., Chin, A. R., Long, A. J., Feight, C., Woch, M., Nadeau, K. C., Chinthrajah, R. S., Sindher, S. B. 2025; 6: 1458131

  Abstract

  Shrimp is a common but understudied food allergen with relatively high rates of emergency department visits. Here we report the shrimp OIT outcomes in the MOTIF (NCT03504774) clinical trial and discuss some of the challenges with performing this study.In this phase 2 clinical trial, 12 shrimp allergic participants aged 7-55 years (median age 21.5 years) were enrolled to receive shrimp OIT. Shrimp OIT was performed up to a maintenance dose of 1,000 mg shrimp protein by week 28 with desensitization to shrimp assessed by double-blind placebo-controlled food challenge at week 52 followed by switching to avoidance and assessing sustained unresponsiveness (SU) at week 58. The primary endpoint was the change in CD28 in CD4+ allergen specific (CD154+) T-cells at baseline and 52 weeks.Shrimp OIT induced desensitization to a cumulative 4,043 mg shrimp protein in 58.3% (7/12) of the intention to treat and 87.5% (7/8) of the per protocol group after 52 weeks of shrimp OIT. Most shrimp OIT participants who remained in the study after desensitization (87.5%, 7/8) achieved SU. Although adverse events were common during shrimp OIT (75%), most were mild (Bock grade 1, 88%) and there were no severe (Bock grade 3+) reactions or use of epinephrine. No significant differences in CD28 expression were observed after shrimp OIT.Shrimp OIT is safe and effective for the treatment of shrimp allergy. Most participants were successful and achieved SU after 6 weeks of avoidance.

  View details for DOI 10.3389/falgy.2025.1458131

  View details for PubMedID 40766832

  View details for PubMedCentralID PMC12321884

• Safety Outcomes of a One-Bag Chemotherapy/ Monoclonal Desensitization Protocol and Outpatient Transition Jiang, S., Afzal, S., Zhu, L., Tran, N., Arroyo, A., Liu, A. MOSBY-ELSEVIER. 2025: AB2

  View details for Web of Science ID 001466121700005

• Atopic Dermatitis and Bullying Among US Adolescents. Pediatrics Jiang, S. Y., Goldsobel, A. 2024; 154 (Suppl 4): S22

  View details for DOI 10.1542/peds.2024-069114HC

  View details for PubMedID 39620810

• Folliculocentric Mycosis Fungoides Masquerading as Angioedema and Allergic Contact Dermatitis. The journal of allergy and clinical immunology. In practice Jiang, S. Y., Yeh, J., Novoa, R., Wang, E., Chen, M. 2024

  View details for DOI 10.1016/j.jaip.2024.04.017

  View details for PubMedID 38727652

• Lime-Induced Phytophotodermatitis: A Rash That Requires Explicit Questioning. The journal of allergy and clinical immunology. In practice Jiang, S. Y., Wright, C. M., Hinton, A., Green, G., Moyer, A. R., Gerstbacher, D., Kushner, L. E., Wang, M. E., Schor, J. S., Trietsch, J., Chu, D., McGhee, S. 2024

  View details for DOI 10.1016/j.jaip.2024.02.035

  View details for PubMedID 38506786

• Medicine resident perceptions regarding b-lactam antibiotic prescribing in patients with penicillin allergy JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE Jiang, S. Y., Tang, M., Desai, K., Song, P., Eng, J., Otani, I. M. 2023; 11 (2): 638-642

  View details for DOI 10.1016/j.jaip.2022.10.012

  View details for Web of Science ID 000993763200001

  View details for PubMedID 36280135

• Severity of COVID-19 in Patients on Biologics for Allergic Disease: A Retrospective Study of Two Tertiary Healthcare Systems Pathak, C., Jiang, S., Cao, S., Collins, W., Eggert, L., Chinthrajah, R. S., Akuthota, P. AMER THORACIC SOC. 2022

  View details for Web of Science ID 000792480402262

• COVID-19 and Biologics in Severe Asthmatic Patients: A Multicenter Retrospective Analysis Jiang, S. Y., Pathak, C., Cao, S., Collins, W., Eggert, L., Akuthota, P., Chinthrajah, R. S. AMER THORACIC SOC. 2022

  View details for Web of Science ID 000792480400274

• Allergy to Local Anesthetics is a Rarity: Review of Diagnostics and Strategies for Clinical Management CLINICAL REVIEWS IN ALLERGY & IMMUNOLOGY Jiang, S., Tang, M. 2023; 64 (2): 193-205

  Abstract

  Local anesthetics (LA) are commonly used in procedures and in topical agents for pain management. With the increasing use of LA drugs, the management of LA reactions is more frequently encountered in the office and in operating rooms. True allergic reactions involving IgE-mediated reactions and anaphylaxis are rare; they have only been identified in case reports and account for less than 1% of adverse LA reactions. Most reactions are non-allergic or are a result of hypersensitivity to other culprits such as preservatives, excipients, or other exposures. LA reactions that are misclassified as true allergies can lead to unnecessary avoidance of LA drugs or delays in surgical procedures that require their use. A detailed history of prior LA reactions is the first and most crucial step for understanding the nature of the reaction. Reactions that are suspicious for an immediate hypersensitivity reaction can be evaluated with skin prick and intradermal testing with subsequent graded challenge. Reactions that are suspicious for a delayed hypersensitivity reaction can be evaluated with patch testing.

  View details for DOI 10.1007/s12016-022-08937-x

  View details for Web of Science ID 000788416000001

  View details for PubMedID 35482282

  View details for PubMedCentralID 3205381

• Self-reported food allergy-associated anxiety during oral immunotherapy declines with time Jiang, S., Cao, S., Collins, W., Fast, K., Hampton, Q., Landes, G., Martinez, K., Tang, H., Sindher, S., Chinthrajah, S. MOSBY-ELSEVIER. 2022: AB140

  View details for Web of Science ID 000778999300423

• Non-immunoglobulin E-mediated allergy associated with Pfizer-BioNTech coronavirus disease 2019 vaccine excipient polyethylene glycol ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY Jiang, S. Y., Smith, E. M., Vo, V., Akdis, C., Nadeau, K. C. 2021; 127 (6): 694-+

  View details for Web of Science ID 000722894500019

• COVID-19 VACCINE-ASSOCIATED ANAPHYLAXIS: BASOPHIL ACTIVATION IN A SPECIFIC IGE AND IGG NEGATIVE PATIENT Jiang, S., Smith, E., Vo, V., Sampath, V., Snow, T., Shah, M., Heider, A., Akdis, C., Nadeau, K. ELSEVIER SCIENCE INC. 2021: S63

  View details for Web of Science ID 000716419400171

• Utility of oral food challenges in identifying IgE-mediated allergy in shrimp-sensitized individuals Jiang, S. Y., Kumar, D., Martinez, K. R., Fast, K., Cao, S., Hampton, Q., Jain, S. N., Long, A., Woch, M., Nadeau, K. C., Chinthrajah, R. S., Sindher, S. B. WILEY. 2021: 341

  View details for Web of Science ID 000718612200634

• Non-IgE mediated allergy associated with Pfizer-BioNTech COVID-19 vaccine excipient polyethylene glycol. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology Jiang, S. Y., Smith, E. M., Vo, V., Akdis, C., Nadeau, K. C. 2021

  View details for DOI 10.1016/j.anai.2021.09.012

  View details for PubMedID 34547440

• Asthma phenotypes, associated comorbidities, and long-term symptoms in COVID-19. Allergy Eggert, L. E., He, Z., Collins, W., Lee, A. S., Dhondalay, G., Jiang, S. Y., Fitzpatrick, J., Snow, T. T., Pinsky, B. A., Artandi, M., Barman, L., Puri, R., Wittman, R., Ahuja, N., Blomkalns, A., O'Hara, R., Cao, S., Desai, M., Sindher, S. B., Nadeau, K., Chinthrajah, R. S. 2021

  Abstract

  BACKGROUND: It is unclear if asthma and its allergic phenotype are risk factors for hospitalization or severe disease from SARS-CoV-2.METHODS: All patients over 28 days oldtesting positive for SARS-CoV-2 between March 1 and September 30, 2020, were retrospectively identified and characterized through electronic analysis at Stanford. A sub-cohort was followed prospectively to evaluate long-term COVID-19 symptoms.RESULTS: 168,190 patients underwent SARS-CoV-2 testing, and 6,976 (4.15%) tested positive. In a multivariate analysis, asthma was not an independent risk factor for hospitalization (OR 1.12 [95% CI 0.86, 1.45], p=0.40). Among SARS-CoV-2 positive asthmatics, allergic asthma lowered the risk of hospitalization and had a protective effect compared to non-allergic asthma (OR 0.52 (0.28, 0.91), p=0.026); there was no association between baseline medication use as characterized by GINA and hospitalization risk. Patients with severe COVID-19 disease had lower eosinophil levels during hospitalization compared to patients with mild or asymptomatic disease, independent of asthma status (p=0.0014). In a patient sub-cohort followed longitudinally, asthmatics and non-asthmatics had similar time to resolution of COVID-19 symptoms, particularly lower respiratory symptoms.CONCLUSIONS: Asthma is not a risk factor for more severe COVID-19 disease. Allergic asthmatics were half as likely to be hospitalized with COVID-19 compared to non-allergic asthmatics. Lower levels of eosinophil counts (allergic biomarkers) were associated with a more severe COVID-19 disease trajectory. Recovery was similar among asthmatics and non-asthmatics with over 50% of patients reporting ongoing lower respiratory symptoms three months post-infection.

  View details for DOI 10.1111/all.14972

  View details for PubMedID 34080210

• Asthma as a predictor of more severe outcomes in COVID-19 infection Eggert, L., Cao, S., He, Z., Dhondalay, G., Jiang, S., Collins, W., Sindher, S., Nadeau, K., Sharon Chinthrajah, R. MOSBY-ELSEVIER. 2021: AB44

  View details for Web of Science ID 000629158000139

• Outcome of Double-Blind Placebo-Controlled Food Challenges in Shrimp-Sensitized Participants Jiang, S., Kumar, D., Cao, S., Fitzpatrick, J., Long, A., Woch, M., Johansson, J., Nadeau, K., Chinthrajah, S., Sindher, S. MOSBY-ELSEVIER. 2021: AB88

  View details for Web of Science ID 000629158000283

• Asthma phenotypes, associated comorbidities, and long-term symptoms in COVID-19 European Journal of Allergy and Clinical Immunology Eggert, L. E., He, Z., Collins, W., Lee, A. S., Nadeau, K., Chinthrajah, R. 2021

  View details for DOI 10.1111/all.14972

• The Role of Regulatory T Cells in Pulmonary Arterial Hypertension. Frontiers in immunology Tian, W., Jiang, S. Y., Jiang, X., Tamosiuniene, R., Kim, D., Guan, T., Arsalane, S., Pasupneti, S., Voelkel, N. F., Tang, Q., Nicolls, M. R. 2021; 12: 684657

  Abstract

  Pulmonary arterial hypertension (PAH) is a chronic, incurable condition characterized by pulmonary vascular remodeling, perivascular inflammation, and right heart failure. Regulatory T cells (Tregs) stave off autoimmunity, and there is increasing evidence for their compromised activity in the inflammatory milieu of PAH. Abnormal Treg function is strongly correlated with a predisposition to PAH in animals and patients. Athymic Treg-depleted rats treated with SU5416, an agent causing pulmonary vascular injury, develop PAH, which is prevented by infusing missing CD4+CD25highFOXP3+ Tregs. Abnormal Treg activity may also explain why PAH disproportionately affects women more than men. This mini review focuses on the role of Tregs in PAH with a special view to sexual dimorphism and the future promise of Treg therapy.

  View details for DOI 10.3389/fimmu.2021.684657

  View details for PubMedID 34489935

• MPEG1/Perforin-2 Haploinsufficiency Associated Polymicrobial Skin Infections and Considerations for Interferon-gamma Therapy FRONTIERS IN IMMUNOLOGY Merselis, L. C., Jiang, S. Y., Nelson, S. F., Lee, H., Prabaker, K. K., Baker, J. L., Munson, G. P., Butte, M. J. 2020; 11: 601584

  Abstract

  Macrophage expressed gene 1 (MPEG1) is highly expressed in macrophages and other phagocytes. The gene encodes a bactericidal pore-forming protein, dubbed Perforin-2. Structural-, animal-, and cell-based studies have established that perforin-2 facilitates the destruction of phagocytosed microbes upon its activation within acidic phagosomes. Relative to wild-type controls, Mpeg1 knockout mice suffer significantly higher mortality rates when challenged with gram-negative or -positive pathogens. Only four variants of MPEG1 have been functionally characterized, each in association with pulmonary infections. Here we report a new MPEG1 non-sense variant in a patient with the a newly described association with persistent polymicrobial infections of the skin and soft tissue.A young adult female patient was evaluated for recurrent abscesses and cellulitis of the breast and demonstrated a heterozygous, rare variant in MPEG1 p.Tyr430*. Multiple courses of broad-spectrum antimicrobials and surgical incision and drainage failed to resolve the infection. Functional studies revealed that the truncation variant resulted in significantly reduced capacity of the patient's phagocytes to kill intracellular bacteria. Patient-derived macrophages responded to interferon gamma (IFN-γ) by significantly increasing the expression of MPEG1. IFN-γ treatment supported perforin-2 dependent bactericidal activity and wound healing.This case expands the phenotype of MPEG1 deficiency to include severe skin and soft tissue infection. We showed that haploinsufficiency of perforin-2 reduced the bactericidal capacity of human phagocytes. Interferon-gamma therapy increases expression of perforin-2, which may compensate for such variants. Thus, treatment with IFN-γ could help prevent infections.

  View details for DOI 10.3389/fimmu.2020.601584

  View details for Web of Science ID 000589675900001

  View details for PubMedID 33224153

  View details for PubMedCentralID PMC7670069

• INNATE IMMUNE DEFICIENCY ASSOCIATED WITH RARE MPEG1 VARIANT Jiang, S., Garcia-Lloret, M. ELSEVIER SCIENCE INC. 2020: S78

  View details for Web of Science ID 000591726500230

• Complementary methods for functional testing of variants Goel , R., Jiang , S., Thauland , T., Butte , M., Henrickson , S. under review at Elsevier. 2020

  Abstract

  Book chapter in Genetics 101 for the Practicing Immunologist, a book edited by Dr. Jolan Walter

• CTLA-4 HAPLOINSUFFICIENCY: THE CASE FOR WHOLE EXOME SEQUENCING IN COMMON VARIABLE IMMUNE DEFICIENCY (CVID) Jiang, S., Tsai, M., Butte, M. ELSEVIER SCIENCE INC. 2019: S115-S116

  View details for DOI 10.1016/j.anai.2019.08.376

  View details for Web of Science ID 000496175500343

• A case of thyroid storm: unusual presentation in a young man Jiang , S., Hernandez , E. UCLA Proceedings. 2019
• Leukotriene B-4 Activates Pulmonary Artery Adventitial Fibroblasts in Pulmonary Hypertension HYPERTENSION Qian, J., Tian, W., Jiang, X., Tamosiuniene, R., Sung, Y. K., Shuffle, E. M., Tu, A. B., Valenzuela, A., Jiang, S., Zamanian, R. T., Fiorentino, D. F., Voelkel, N. F., Peters-Golden, M., Stenmark, K. R., Chung, L., Rabinovitch, M., Nicolls, M. R. 2015; 66 (6): 1227-1239

  Abstract

  A recent study demonstrated a significant role for leukotriene B4 (LTB4) causing pulmonary vascular remodeling in pulmonary arterial hypertension. LTB4 was found to directly injure luminal endothelial cells and promote growth of the smooth muscle cell layer of pulmonary arterioles. The purpose of this study was to determine the effects of LTB4 on the pulmonary adventitial layer, largely composed of fibroblasts. Here, we demonstrate that LTB4 enhanced human pulmonary artery adventitial fibroblast proliferation, migration, and differentiation in a dose-dependent manner through its cognate G-protein-coupled receptor, BLT1. LTB4 activated human pulmonary artery adventitial fibroblast by upregulating p38 mitogen-activated protein kinase as well as Nox4-signaling pathways. In an autoimmune model of pulmonary hypertension, inhibition of these pathways blocked perivascular inflammation, decreased Nox4 expression, reduced reactive oxygen species production, reversed arteriolar adventitial fibroblast activation, and attenuated pulmonary hypertension development. This study uncovers a novel mechanism by which LTB4 further promotes pulmonary arterial hypertension pathogenesis, beyond its established effects on endothelial and smooth muscle cells, by activating adventitial fibroblasts.

  View details for DOI 10.1161/HYPERTENSIONAHA.115.06370

  View details for PubMedID 26558820