Mary H. Weiser Food Allergy Center

If you suspect you have a food allergy, one of the only ways doctors can positively confirm the suspicion is through something called a food allergy challenge.

You give a child, or an adult, the food they might be allergic to in a controlled office setting and see if they react.

“It’s unpleasant, doesn’t feel good, it’s potentially risky and it’s very expensive,” explained Charles Schuler, M.D., an allergist at Michigan Medicine.

“They take a lot of time to set up and they require a lot of logistical support, too."

For years now, Schuler and his team have been investigating ways to make the food allergy testing process easier, safer and cheaper to do.

And now they may have figured it out.

In a previous paper, the team detailed their development of a novel device they called TEWL, short for transepidermal water loss, which accurately measures water loss in the skin during an allergic reaction.

Now, in their published pilot study featured in JAMA Open Network, the team found that by using TEWL’s reported measurements, along with one other symptom of an allergic reaction, it can accurately be used as a stopping criteria during a live food allergy challenge to prevent the onset of a severe allergic reaction or anaphylaxis.

Using TEWL during food allergy challenges

“Overall, the best way to evaluate a food allergy is with an in-office food challenge. However, kids and parents are sometimes hesitant to perform food challenges because they're scared about a reaction,” said George Freigeh, M.D., M.A., the first author on the paper and a clinical assistant professor of internal medicine and of pediatrics at U-M.

“Anything that we can do to reduce the severity of a food challenge reaction is welcome because it may make these procedures more accessible to people that are concerned.”

Two years ago, in a previous study, the group saw transepidermal water loss numbers dramatically shoot up immediately during food anaphylaxis.

“After those findings we wanted to evaluate whether or not, when that number rose, could we accurately act on it or not?,” said Schuler.

The question became that, if they stopped the food allergy challenge based on those numbers and one additional allergic reaction symptom (i.e., sneezing, runny nose, itchy mouth, etc.), could that change the outcome of reaction severity while still preserving an accurate diagnosis?

The non-invasive monitor is placed hallway up the forearm, doesn’t hurt the patient and requires no needle to measure the leakiness of the skin barrier.

“The device sits on the skin and measures water loss as a flux or rate (grams/square meter/hour of water lost) via humidity and temperature sensors,” explained Schuler, also an assistant professor in internal medicine at the Mary H. Weiser Food Allergy Center at U-M.

“When the rate of water loss goes up, a reaction is likely imminent. When we paired that finding with a single objective symptom, we could stop challenges at a point where anaphylaxis was avoidable in many cases.”

The pilot clinical trial enrolled children 5 and under to test out the technology, noting young children as a particularly key group to test the device with since it’s harder for them to express what they’re feeling, making oral food allergy challenges tricky.

“For young children, their expressive language is limited – it makes it hard for parents and allergists alike to understand what their symptoms are," said Schuler. 

"We needed something like this as an objective and external way to observe what’s happening inside their bodies during a food challenge.”

Not only did the team find children happily wore the device, but upon observation, they saw that if they took a measurement two minutes before food dosing and then compared it to another one taken two minutes after the patient ate the food (which were peanuts), there was a distinct difference in the water retention measurements found in the skin during that time if the patient was headed towards a reaction.

“What we found in most of the participants was that if they at any time also had one objective symptom of an allergic reaction (i.e., one hive, or runny nose) we could use this monitored change we saw as a surrogate second symptom."

When the team acted on those numbers, most kids didn’t need additional treatment later, avoiding the use of epinephrine, a drug used to stop severe allergic reactions.

Overall, less medicine was needed to intervene.

“What we found was that, by the consortium of food allergy research and world allergy grading criteria, there was a very significant decrease in reaction severity and symptoms experienced and we saw significantly lower reaction rates by multiple scoring guidelines.”

Based on these groundbreaking results, the group is now going to seek funding to develop an evolved version of TEWL that could be wireless, have a friendly user face and be usable in various environments beyond Michigan Medicine.

Paper cited: "Transepidermal Water Loss in Oral Food Challenges in Children With Peanut Allergy," JAMA Open Network. DOI: 10.1001/jamanetworkopen.2025.43371

Funding/disclosures: The Gerber Foundation. James Baker, M.D., Blue Willow Biologics, Inc.; IgGenix; Moderna, Inc.; Moonlight Therapeutics; Stallergenes Greer International AG; Ukko LLC.

Tech transfer(s)/Conflict(s) of interest: The team has a pending patent application, which covers the use of TEWL as a novel anaphylaxis monitoring modality.

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The Mary H. Weiser Food Allergy Center (MHWFAC) research team has hired a new clinical research coordinator.

Danyah Alomari, a biochemistry graduate from Eastern Michigan University and a phlebotomist, will support scientists by guiding new study participants through onboarding and paperwork, recording data from each subject visit and assisting with food allergy challenges. 

Ms. Alomari will be working on MHWFAC sponsored trials, including M-FAD, which is studying the link between childhood eczema and food allergies. 

To view a list of our food allergy clinical trials, click here. 

Ms. Ravi is a member of the lab of MHWFAC researcher Gary Huffnagle, PhD.  She studies the host-microbe interactions of two dairy-associated bacteria: Pseudomonas lundensis and Lactobacillus johnsonii.

"This fellowship will support the completion of the final aim of my dissertation and propel my current research," she said. "In the long term, I aim to work in live biotherapeutics, playing a role in incorporating beneficial bacteria like Lactobacillus johnsonii into personalized healthcare solutions.

The Rackham Predoctoral Fellowships provide financial support, mentorship and other resources.  They are among the most prestigious awards granted by Rackham Graduate School. 

The paper discusses how different routes of exposure to food antigens can contribute to allergic sensitization, and describes how mast cells ultimately drive the allergic reaction to these food allergens.

Read the abstract here. 

For Stacey Saiontz (A.B. in political science, 1996), life took an unexpected turn when her infant son, Jared, was diagnosed with multiple life-threatening food allergies.

After graduating from U-M, Saiontz earned a J.D. from the American University Washington College of Law and went on to work in commercial litigation in Washington, D.C., and New York state.

“But when Jared was born with 26 anaphylactic food allergies,” says Saiontz, “I decided to pause my career as a litigator. Once I made that decision, I wanted to support people in the food allergy community, so I began to do advocacy work.”

Fueled by the desire to help Jared and other people who have food allergies live life to the fullest, the Saiontz family has been advocating for legal changes and championing food allergy research for almost two decades.

Uniting advocacy and research

Saiontz’s love for U-M and her commitment to advocacy intersected in the mid-2010s when she met Mary H. Weiser — a nationally recognized advocate for people with food allergies and founder of the U-M center now named in her honor — while working with the national nonprofit organization FARE (Food Allergy Research and Education).

“We were both very involved with FARE, and Mary Weiser informed me that U-M was developing a food allergy center,” says Saiontz. “She explained the center’s goals, and I saw that it combined two of my family’s passions: finding a cure for food allergies and our love for the University of Michigan.”

Founded in 2015, the Mary H. Weiser Food Allergy Center is renowned for cutting-edge research aimed at understanding, preventing, and treating food allergies. The center also promotes food allergy education and community services to improve the lives of people affected by food allergies in the United States and around the world.

Saiontz now serves on the center’s advisory board and witnesses firsthand how it leads the way in food allergy research, patient care, and education.

“There is so much on the horizon right now in terms of finding potential cures and developing treatments that will help people prevent reactions and live with food allergies,” she says. “If you have food allergies, the Weiser Center gives you hope.”

Now, the family is furthering their commitment with an impactful gift to the Mary H. Weiser Food Allergy Center that will help Jared and other people facing food allergies live life safely and to the fullest.

Early advocacy

Early in Jared’s childhood, Saiontz made it a priority to teach him that he had the power to improve life for himself and others. She began to include him in efforts in their Chappaqua, N.Y., community and beyond.

“When my son was still young — I think he was four years old — I began to bring him with me to Albany and D.C. to advocate and teach him that he can use his voice to effect change,” says Saiontz.

These lessons had a significant impact on Jared, who began to notice opportunities for change while he was still a small child.

During a trip to a playground outside their community, Jared saw signs asking children to protect their friends with allergies by eating in designated areas instead of on play equipment. He told his parents he wanted to advocate for similar signs at their playground. With help from Saiontz, Jared brought the idea to local leaders and created wording for signs that were successfully installed on Chappaqua playgrounds.

When Jared began school, bus drivers weren’t permitted to use epinephrine auto-injectors to provide emergency treatment for severe allergic reactions, so Saiontz chose to drive him to and from school.

A few years later, Jared took initiative to propose a law to his local state senator after a food allergic kindergartner mentioned he was struggling with not being able to ride the school bus. Saiontz supported Jared in meeting with legislators in Albany to advocate for legal changes. Jared’s efforts were successful, resulting in the passage of a law that now allows school bus drivers to administer life-saving medication, making rides safer for food-allergic children in New York state.

On the federal level, the Saiontzes joined with other advocates to support the passage of the FASTER Act in 2021. They testified before the FDA on the importance of recognizing sesame as one of the top nine food allergens in the United States. Because of this legislation, foods that contain sesame must now be clearly labeled. The FASTER Act also expanded food allergy research.

Building impact

The generous gift that Saiontz and husband, Marc, recently made to support food allergy education, research, and care at the Weiser Center will have an immediate impact at the center and for patients in Michigan and beyond.

An important part of Saiontz’s decision to take her support to the next level as a donor was her work with James Baker, M.D., the Ruth Dow Doan Professor of Biologic Nanotechnology, professor emeritus of internal medicine and biomedical engineering, director of the Michigan Nanotechnology Institute, and director of the Mary H. Weiser Food Allergy Center.

“I’ve always been very impressed with Baker’s leadership, insight, and his vision for the center,” says Saiontz.

Continuing the journey

The Saiontz family continues to advocate for people who are living with food allergies.

Jared has created a nonprofit organization called Pack the Pantry for Everyone that helps people who are facing both food insecurity and food allergies access safe food. The nonprofit offers free allergy protocols to food pantries as well as a flyer in English and Spanish that helps people tell pantries about their allergies.

This effort has had an impact on U-M’s campus. Over the past few years, Jared has worked with the Maize & Blue Cupboard, a food pantry that serves the U-M community, to adopt the allergy protocols and provide safe food to community members with food allergies.

Saiontz continues to be inspired to help people who have food allergies.

“I want to ensure my child and others can live life the same as everybody else,” she says. “They might not be able to be as spontaneous, or they might have to take some precautions, but it is possible to live a completely full life with food allergies. That's the most important reason I got involved with the Weiser Center. The research that the Weiser Center is doing is amazing, and combined with what they are doing in the clinic, they’re really able to help so many people, not only in Ann Arbor, but around the world.”

She also recognizes the importance of medical research in creating a healthier future for everyone.

“You don’t want anyone to have to live with a life-threatening condition, whether it’s food allergies, cancer, or a different disease,” she says. “Being able to make a difference in helping researchers develop potential cures or to find ways to make life better for people living with these different conditions or diseases — I can’t think of a better thing to donate to.”

If you are interested in learning more about supporting the Mary H. Weiser Food Allergy Center, please visit the center’s giving page.

About the Look to Michigan campaign

This gift is part of the Look to Michigan fundraising campaign, which aims to create transformative answers to health care’s biggest challenges for the benefit of people in our state and beyond. Building on 175 years of leadership in medicine and as part of the University of Michigan’s Vision 2034 strategic framework for impact, we are breaking new ground in patient care, research, medical and graduate education, health equity, and health care facilities. Together, we can improve and save lives. For more information, visit michiganmedicine.org/look-to-michigan.
 

More than 100 attendees from the research and clinical realms attended the two-day event, which featured an array of distinguished speakers from academia and industry.  Reporter Jenifer Goodwin covered the conference for Allergic Living magazine, including an interview with MHWFAC Director James R. Baker, Jr., MD:

Baker is more optimistic than ever that science is on the cusp of major food allergy breakthroughs, Goodwin writes. He’s even ready to rethink that once taboo word. “Can we develop tolerance in a way that would be perceived as ‘a cure’ by our patients? I think it’s time to start discussing this.”  

Click below to read the entire article.

Allergic Living article April 2025