The UAB Division of Pediatric Allergy & Immunology faculty are dedicated to research in the field of allergy and immunology and advancing knowledge in the diagnosis and care of patients with allergic diseases such as drug allergy, food allergy, asthma and atopic dermatitis, and those with primary and secondary immunodeficiencies. Since 1990, the division has been home to the UAB Allergy & Immunology Fellowship Program, which continues to graduate one or two fellows annually. The faculty have ongoing collaborations with clinical immunologists at the National Institutes of Health (NIH) that have resulted in the identification of novel immunodeficiency diseases in several patients and extended knowledge in the clinical manifestations, diagnosis and treatment of these disorders.

Prescott Atkinson, M.D., Ph.D., has a long-standing collaboration with the UAB Diagnostic Mycoplasma Lab studying the role of these parasitic bacteria in chronic diseases such as asthma and in opportunistic infections in patients with primary and secondary immunodeficiencies. A recent publication shows the invasive potential of one member of the mouth flora, Mycoplasma salivarium, in patients with severe antibody deficiencies, and a paper under review is a first-time review of the antibiotic sensitivities of a series of M. salivarium isolates.

The current focus of Dr. Atkinson’s laboratory lies in identifying key genes involved in surface protein glycosylation and biofilm production in the emerging sexually transmitted organism Mycoplasma genitalium (MG), to identify new methods of controlling this frequently antibiotic-resistant infection. With its 482 protein coding genes, MG arguably has the smallest genome of any naturally occurring bacteria, and the transposon library contains 97 sublines in which individual genes have been knocked out by transposon mutagenesis. The organism produces a biofilm in culture, which we have shown protects it from antibiotics (Daubenspeck et al, Front Microbiol. 2020). Analysis in the lab of the MG biofilm has for the first time demonstrated that it has a ladder-like structure, indicating that it is composed of repeating blocks of sugars (Fig 2), shown to be predominantly N-Acetyl-Glucosamine (GlcNAc) by mass spectrometry (Figure 3). By screening the library sublines, we have identified over 10 mutants in which biofilm production is impaired, providing us with a way to dissect the steps involved in biofilm production and possibly new avenues of treatment.

An additional area of research in the lab is focused on the Mycoplasma mycoides-derived Syn 3.0 synthetic bacterium created by the J. Craig Venter Institute (JCVI), with whom we have a Materials Transfer Agreement. This organism has a completely synthetic genome comprising only 473 genes and, unlike the parent strain, Syn 3.0 does not produce biofilm. In collaboration with colleagues at the JCVI, we are characterizing the surface protein glycosylation and will be analyzing the effects of adding back genes that were deleted in the creation of this minimal organism in order to define genes required for its two glycosylation systems.

A diagnosis of penicillin allergy is usually acquired in childhood, and up to 20% of the population carries a diagnosis of penicillin allergy. Studies have shown that less than 5% of patients with a diagnosis of penicillin allergy are truly allergic. The high rate of penicillin allergy in the population carries a high cost to society due to the higher use of alternate, more expensive antibiotics, which may also be less effective, and the use of such alternate antibiotics risks increasing antibiotic resistance in circulating strains of pathogenic bacteria. Since early 2020, Amy CaJacob, M.D., and Katie Grisanti, M.D., have served as allergy champions for a UAB-wide effort to protocolize a beta-lactam delabeling program. A newly formed drug hypersensitivity consult service is expected to launch in the first quarter of 2022 at UAB Hospital. We have obtained funded positions for a full-time dedicated allergy Advanced Practice Provider and nurse. Through stratified risk assessment, skin testing and challenge protocols, we expect to improve patient outcomes while reducing the need for broad-spectrum antimicrobials. We anticipate this program expanding to pre-operative and emergency department areas in the future.

Access Microbiol. 2021 Apr 9;3(4):000221. Septic polyarthritis with Mycoplasma salivarium in a patient with common variable immunodeficiency: case report and review of the literature. Arthur H Totten‏‏, Li Xiao‏, Donna M Crabb‏, Amy E Ratliff‏, Ken B Waites‏, Tracy Hwangpo‏, T Prescott Atkinson‏.

N Engl J Med. 2021 Apr 10. Oncolytic HSV-1 G207 Immunovirotherapy for Pediatric High-Grade Gliomas. Gregory K Friedman‏, James M Johnston‏, Asim K Bag‏, Joshua D Bernstock‏, Rong Li‏, Inmaculada Aban‏, Kara Kachurak ‏, Li Nan‏, Kyung-Don Kang‏, Stacie Totsch‏, Charles Schlappi‏, Allison M Martin‏, Devang Pastakia‏, Rene McNall-Knapp‏, Sameer Farouk Sait‏, Yasmin Khakoo‏, Matthias A Karajannis‏, Karina Woodling ‏, Joshua D Palmer‏, Diana S Osorio‏, Jeffrey Leonard‏, Mohamed S Abdelbaki‏, Avi Madan-Swain‏, T Prescott Atkinson‏, Richard J Whitley‏, John B Fiveash‏, James M Markert‏, G Yancey Gillespie‏.

Pediatr Blood Cancer. 2021 Oct 11;e29394. Filgrastim desensitization in a patient with Hodgkin lymphoma. Hannah Jeter‏, Kathleen Grisanti‏, Amelia Jantz‏, Aman Wadhwa‏, Emily Waite‏.

Prescott Atkinson, M.D., Ph.D.

• Dr. Atkinson serves on the Accreditation Council for Graduate Medical Education (ACGME) Review Committee for Allergy & Immunology and is a member of the ACGME Allergy & Immunology Milestones Workgroup.
• He is a member of the Alabama Newborn Screening Advisory Board.
• He was elected as the new president of the United States Organization for Mycoplasmology.
• He is a member of the Board of Regents of the Alabama Museum of Natural History and vice president of the Alabama Paleontological Society.

Amy CaJacob, M.D.

• Dr. CaJacob serves as the medical director of Camp WheezeAway.
• She is the outgoing president of the Alabama Society of Allergy, Asthma and Immunology.

Suthida Kankirawatana, M.D.

• Dr. Kankirawatana serves as a member of the Alabama Newborn Screening Advisory Board.

The UAB Allergy & Immunology Fellowship Program strives to train and educate fellows to be empathic and prepared to practice as an allergist in any setting. Our fellows receive intensive clinical training in allergic and immunologic diseases in children with division faculty. During their training, fellows participate in research and quality improvement projects under the mentorship of UAB research faculty and are also encouraged to pursue electives in specialties with considerable overlap in our field. Fellows and division faculty meet twice weekly for didactic seminars in basic and clinic science and attend a monthly journal club/case presentation session with community allergist/immunologists. 

2021–2022 Fellows

Brent Griffin, M.D.
First-Year Fellow
Residency: Dwight D. Eisenhower Army Medical Center

Reena Patel, D.O.
Second-Year Fellow
Residency: Palm Beach Consortium for Graduate Medical Education

Program Directors

Prescott Atkinson, M.D., Ph.D.
Program Director

Amy CaJacob, M.D.
Associate Program Director

Katie Grisanti, M.D.
Associate Program Director

Program Coordinator

Scott Defreese