Physicians

Department / Division
Pediatrics / Pediatrics-Allergy/Immunology

Address
DUMC 2644
Durham, NC 27710

Appointment Telephone
919-684-9914

Office Telephone
919-681-2949

Fax Telephone
919-668-3750

Training

• MD, Medical College of Georgia School of Medicine, 2001

Residency

• Pediatrics, NewYork-Presbyterian Hospital, Cornell Campus, 2001-2005

Fellowship

• Allergy and Clinical Immunology, Yale University School of Medicine (Connecticut), 2005-2008

Clinical Interests
General pediatric allergy, asthma, and immunology, with a special focus on food allergy, atopic dermatitis, and eosinophilic disorders

Research Interests

The maladaptive immune responses that cause allergic disorders constitute a major public health problem, and affect well over 300 million people worldwide. Most allergic diseases are increasing in prevalence, and have a striking inverse relationship to industrialization (e.g., they are often considered to be an epidemic of the modern lifestyle). As a model of this paradigm, our research group focuses on food allergy, a particularly high-stakes example of a immune hypersensitivity response which has several interesting properties: (1) it is the most common cause of anaphylaxis in childhood, capable of producing life-threatening reactions after exposures of as little as a few milligrams; (2) it affects up to 6-8% of children in developed societies, and appears to be increasing in prevalence; (3) the natural history, even among individuals affected by multiple allergies, is antigen-specific (e.g., natural tolerance is the expected outcome in the case of egg and milk allergy, whereas nuts and seafood tend to remain allergenic); and (4) it is a disease which often develops early in life, and is strongly associated with coexistent atopic dermatitis and the subsequent development of other allergic diseases such as asthma (e.g., the “atopic march”).  

In this context, the following research questions remain top priorities:
1. How do food allergies begin in the first place? Why do they frequently begin within the first year or two of life?
2. Why do food allergies appear to be an increasingly common problem?
3. Why are allergies to some foods almost universally outgrown whereas others are not? What is the mechanism of this natural tolerance?
4. What is the best way to alter the abnormal immune response in order to produce an effective treatment? Is therapeutic tolerance possible?
5. Is it possible to prevent food allergies before they start?

The Duke Food Allergy Initiative was developed by Dr. Wesley Burks in 2003 to begin to address these questions through observational and interventional studies. We are a translational research group composed of faculty, postdoctoral clinical fellows, clinical research nurses and coordinators, and laboratory scientists. I am particularly interested in the programming of early life immune responses, why such programming influences the development of allergies versus immune tolerance, and how these pathways could be exploited initially therapeutically and ultimately preventatively. More information about our research program, including links to current clinical trials, can be found here: http://www.dukechildrens.org/services/duke_food_allergy_initiative

Industry Relationships and Collaborations (What's this?)

This physician has no reported relationships with industry.

Representative Publications
Kim EH, Bird JA, Kulis M, Laubach S, Pons L, Shreffler W, Steele P, Kamilaris J, Vickery B, Burks AW. Sublingual immunotherapy for peanut allergy: clinical and immunologic evidence of desensitization.  J Allergy Clin Immunol.  2011 Mar;127(3):640-6.e1. (2011) Abstract

Kulis M, Vickery BP, Burks AW. Pioneering immunotherapy for food allergy: clinical outcomes and modulation of the immune response. Immunol Res. 2011 Apr;49(1-3):216-26. (2011) Abstract

Varshney P, Jones SM, Scurlock AM, Perry TT, Kemper A, Steele P, Hiegel A, Kamilaris J, Carlisle S, Yue X, Kulis M, Pons L, Vickery B, Burks AW. A randomized controlled study of peanut oral immunotherapy: clinical desensitization and modulation of the allergic response.  J Allergy Clin Immunol.  2011 Mar;127(3):654-60. (2011) Abstract

Vickery BP, Chin S, Burks AW. Pathophysiology of food allergy. Pediatr Clin North Am. 2011 Apr;58(2):363-76, ix-x. (2011) Abstract

Vickery BP, Scurlock AM, Jones SM, Burks AW. Mechanisms of immune tolerance relevant to food allergy. J Allergy Clin Immunol. 2011 Mar;127(3):576-84; quiz 585-6. (2011) Abstract

Pochard P*, Vickery B*, Berin MC, Grishin A, Sampson HA, Caplan M, Bottomly K. Targeting Toll-like receptors on dendritic cells modifies the T(H)2 response to peanut allergens in vitro. J Allergy Clin Immunol. 2010 Jun 8. [Epub ahead of print] *co-first author (2010)

Scurlock AM, Vickery BP, Hourihane JO, Burks AW. Pediatric food allergy and mucosal tolerance. Mucosal Immunol. 2010 Jul;3(4):345-54. (2010) Abstract

Vickery BP, Pons L, Kulis M, Steele P, Jones SM, Burks AW. Individualized IgE-based dosing of egg oral immunotherapy and the development of tolerance. Ann Allergy Asthma Immunol. 2010 Dec;105(6):444-50. (2010) Abstract

Jones SM, Pons L, Roberts JL, Scurlock AM, Perry TT, Kulis M, Shreffler WG, Steele P, Henry KA, Adair M, Francis JM, Durham S, Vickery BP, Zhong X, Burks AW. Clinical efficacy and immune regulation with peanut oral immunotherapy.  J Allergy Clin Immunol.  2009 Jul 2. (2009) Abstract

Varshney P, Steele PH, Vickery BP, Bird JA, Thyagarajan A, Scurlock AM, Perry TT, Jones SM, Burks AW. Adverse reactions during peanut oral immunotherapy home dosing. J Allergy Clin Immunol. 2009 Dec;124(6):1351-2. (2009) Abstract

Vickery BP, Burks AW. Immunotherapy in the treatment of food allergy: focus on oral tolerance.  Curr Opin Allergy Clin Immunol.  2009 May 28. (2009) Abstract

Vickery BP. Skin barrier function in atopic dermatitis.  Curr Opin Pediatr.  2007 Feb;19(1):89-93. (2007) Abstract