About

Antonella Cianferoni, MD, PhD, is a Professor of Pediatrics (Allergy/Immunology) at the Children's Hospital of Philadelphia. She is a pediatric allergist and immunologist with a focus on human food allergy immunopathogenesis. Her research interests include the role of iNKT cells in food allergy pathogenesis, specifically how food-derived lipids contribute to food allergy sensitization and influence chronic atopic states like eosinophilic esophagitis (EoE). Dr. Cianferoni has developed advanced techniques to study this rare cell population in humans and has obtained NIH funding for her research. Her work has demonstrated that milk-derived lipids activate iNKTs via the TCR to produce Th2 cytokines and that differences in iNKT cells exist between children with food allergies and healthy controls. She focuses on defining the role of iNKTs in food allergy using human and animal models, aiming to provide insights into modulating these cells for treatment. Her clinical expertise includes practicing as a pediatric allergist with a special interest in food allergy, managing a large cohort of children with eosinophilic esophagitis, and serving as the Medical Director of the Food Allergy Immunotherapy Program at CHOP. Her research environment at CHOP and the University of Pennsylvania has provided her with mentorship from leaders in immunology and allergy, contributing to her contributions to the field.

Research topics

• Family medicine
• Surgery
• Medicine
• Immunology
• Pathology
• Dermatology

Selected publications

• What is new on the horizon for the biologic therapies world: New treatments at the starting blocks — A WAO State of the Art

  World Allergy Organization Journal · 2026-03-01 · 1 citations

  articleOpen access

  Background: Advances in the understanding of type 2 inflammation have driven the development of novel biologics and small molecules for allergic diseases. New therapies targeting cytokines, receptors, and intracellular pathways offer opportunities to refine disease management and modify long-term outcomes. Methods: The World Allergy Organization (WAO) Biologics Therapies in Allergic Diseases Committee conducted this state-of-the-art review. We analyzed current literature on investigational monoclonal antibodies, nanobody-based agents, kinase inhibitors, and small molecules with potential applications in asthma, chronic rhinosinusitis with nasal polyposis, atopic dermatitis, and chronic spontaneous urticaria. Mechanistic considerations, therapeutic targets, and clinical trial outcomes were evaluated to highlight emerging trends in biologic and small-molecule therapy. Results: Biologics targeting IL-4, IL-5, IL-13, IL-31, TSLP, and IgE continue to expand therapeutic options across allergic disorders. Innovations such as Fc-engineered antibodies, bispecific antibodies, and nanobody platforms enhance efficacy, extend half-life, and improve tissue penetration. Novel intracellular inhibitors, including JAK, SYK, and STAT6 degraders, show promise as oral alternatives to injectable therapies. Clinical trials report high efficacy and favorable safety profiles, though variability remains across diseases and endotypes. Pediatric data are limited, and the long-term safety and cost-effectiveness of this approach require further evaluation. Conclusions: Emerging biologics and small molecules are transforming the therapeutic landscape of allergic diseases, providing targeted and personalized interventions. Advances in molecular engineering, particularly nanobody technology and intracellular inhibitors, hold promise for improving patient outcomes and reducing treatment burden. Future research should prioritize long-term safety and standardized approaches to optimize integration of these therapies into clinical practice.

  PublisherDOI

• Age-Appropriate Low Dosing for Food Protein-Induced Enterocolitis Syndrome Oral Food Challenges: Proposing a Standardized Approach

  The Journal of Allergy and Clinical Immunology In Practice · 2026-04-01

  articleOpen access

  Current oral food challenge (OFC) protocols for food protein-induced enterocolitis syndrome (FPIES) exhibit significant variability, creating potential for inconsistent diagnostic outcomes and severe reactions. Based on the published evidence and our clinical experience, we propose a practical, standardized OFC dosing protocol that emphasizes patient safety, goals based on age-appropriate servings (AASs), and clinical monitoring. A recent systematic review reported that most patients with persistent FPIES who underwent OFCs reacted to just 25% of an AAS, with low rates of severe reactions. Thus, we recommend that most patients undergoing a medically supervised FPIES OFC receive a cumulative dose of 25% AAS, followed by observation for a minimum of 4 hours. Supervised challenges should be followed by gradual up-titration to an AAS at home. A lower dose may be considered for patients with a history of severe FPIES symptoms to trace amounts of food. For patients with atypical FPIES, we recommend a slightly modified protocol, using graded dosing per IgE-mediated food allergy protocols, followed by extended FPIES OFC monitoring. Anticipated outcomes from implementation of this standardized OFC protocol include improved diagnostic accuracy, enhanced patient safety, and a structured approach to food reintroduction. Standardizing practices for FPIES OFCs will also permit harmonization of data to advance research.

  PublisherDOI

• Reply to Bakirtas et al.

  Pediatric Allergy and Immunology · 2025-07-01

  letter

  The peer review history for this article is available at https://www.webofscience.com/api/gateway/wos/peer-review/10.1111/pai.70155.

  PublisherDOI

• Systematic review of feeding difficulties in children with eosinophilic esophagitis: An <scp>EAACI</scp> Task Force report

  Pediatric Allergy and Immunology · 2025-04-01 · 5 citations

  reviewOpen access

  The term "feeding difficulties" (FD) encompasses a range of phenotypes characterized by inadequate food intake and/or inappropriate eating habits for a given age. Eosinophilic esophagitis (EoE) is a chronic, immune-mediated condition often affecting children. It leads to esophageal dysmotility, potentially impacting feeding/eating. However, little is known regarding the true prevalence of feeding/eating difficulties in children with EoE. The main objective of this systematic review was to address this knowledge gap and determine the impact of FD in children with EoE. We searched eight international databases for all published studies from inception until March 2024. All publications were screened against pre-defined eligibility criteria and critically appraised by established instruments. The substantial heterogeneity of included studies precluded meta-analyses, so a narrative synthesis of quantitative data was performed. A total of 3442 abstracts were assessed, 29 underwent full-text screening. Ten studies met eligibility criteria and were analyzed. Across these, 18 different terms to define FD and 6 diagnostic tools were used. All included papers reported quantitative data on the FD prevalence in children with EoE, ranging from 13% to 75.3%. Concomitant IgE food sensitization/allergy was common (26.2%-88%) but its impact on FD occurrence was unclear. The current literature suggests that FD is prevalent among children with EoE, particularly those with associated IgE-mediated food allergies. However, the heterogeneity of terminologies and diagnostic tools makes drawing conclusions challenging, as it might have impacted outcomes. Further research and guidance on the diagnosis and management of FD in children with EoE are needed to appropriately identify and manage such patients.

  PublisherOA PDFDOI

• Dupilumab Is Efficacious in Children With Eosinophilic Esophagitis (EoE) Weighing ≥15kg Independent of Individual Atopic Comorbidity History: 16-Week Results From the Phase 3 EoE KIDS Study

  Journal of Allergy and Clinical Immunology · 2025-02-01

  articleOpen access1st authorCorresponding
  PublisherOA PDFDOI

• Author response for "An update on the diagnosis and management of non‐IgE‐mediated food allergies in children"

  2025-02-20

  peer-review
  PublisherDOI

• An update on the diagnosis and management of non‐IgE‐mediated food allergies in children

  Pediatric Allergy and Immunology · 2025-03-01 · 14 citations

  review

  The spectrum of non-IgE mediated conditions includes well-defined conditions like Food Protein-Induced Enterocolitis Syndrome (FPIES), Eosinophilic Oesophagitis (EoE), Food Protein-Induced Enteropathy, and Food Protein-Induced Allergic Proctocolitis, but also the more controversial food protein-induced dysmotility disorders like food protein-induced gastroesophageal reflux disease (FPGORD) and food protein-induced constipation (FPC). Typically, non-IgE mediated reactions are delayed, with symptom onset from hours to days after exposure to a culprit food. The diagnosis is mostly clinical, and food elimination followed by reintroduction is the primary diagnostic method. Apart from EoE, the diagnosis of these conditions remains challenging, and there is a need to develop specific diagnostic tests. Acute FPIES presents with distinct symptoms, but misdiagnosis is common due to poor recognition. In contrast, some presentations, particularly FPGORD and FPC, overlap with the common, often benign disorders of gut-brain interaction, previously known as functional gastrointestinal disorders. This raises concerns about overdiagnosis and can lead to an unnecessary restrictive diet in infants and breastfeeding mothers. A systematic approach to an elimination diet and the support of a registered dietitian/nutritionist are recommended to ensure nutritional adequacy, suitable alternatives, promote timely introductions when appropriate, support breastfeeding where required as well as prevent nutritional deficiencies and feeding difficulties. This publication aims to provide an update on the spectrum of non-IgE-mediated food allergic conditions and intends to provide clinicians with practical guidance on the diagnosis and management of each condition. The authors acknowledge the need for further research in a range of areas to inform best evidence-based practice.

  PublisherDOI

• Efficacy and Safety of AR101 in Oral Immunotherapy for Peanut Allergy: Results of ARC001, a Randomized, Double-Blind, Placebo-Controlled Phase 2 Clinical Trial

  UNC Libraries · 2025-01-16 · 1 citations

  articleOpen access
  PublisherDOI

• Dupilumab is efficacious for eosinophilic esophagitis irrespective of prior swallowed budesonide or fluticasone, or prior treatments used alongside swallowed topical corticosteroids: results from the phase 3, randomized, placebo-controlled, LIBERTY EoE TREET trial

  Expert Review of Gastroenterology & Hepatology · 2025-02-01 · 4 citations

  articleOpen access

  BACKGROUND: Standard treatments for eosinophilic esophagitis (EoE) may present adherence, tolerance, and efficacy challenges. Dupilumab 300 mg weekly is approved for the treatment of EoE in patients ≥ 1 year old, weighing ≥ 15 kg. This analysis aimed to evaluate dupilumab efficacy in patients from the LIBERTY EoE TREET trial (NCT03633617), with prior history of different EoE interventions. RESEARCH DESIGN AND METHODS: This analysis included patients from Parts B/B - C of LIBERTY EoE TREET. Dupilumab efficacy was analyzed according to prior swallowed budesonide or fluticasone use and in those patients with previously trialed food elimination diet, esophageal dilation, or baseline proton pump inhibitor use, as stratified by prior swallowed topical corticosteroid (STC) use or STC inadequate response/intolerance/contraindication. RESULTS: Dupilumab improved the proportion of patients achieving peak intraepithelial eosinophil count ≤ 6 eosinophils/high-power field, absolute change in Dysphagia Symptom Questionnaire score, and other histologic, symptomatic, and endoscopic endpoints vs. placebo at Week (W) 24, irrespective of prior swallowed budesonide/fluticasone use. Improvements were maintained at W52. Similar results were observed across the other subgroups. CONCLUSION: Dupilumab was efficacious in patients with EoE irrespective of prior treatments/interventions. CLINICAL TRIAL REGISTRATION: www.clinicaltrials.gov identifier is NCT03633617.

  PublisherOA PDFDOI

• Sa1247: DUPILUMAB IS EFFECTIVE IN TREATING EOE IN PATIENTS WEIGHING 15 KG AND ABOVE: RESULTS FROM THE PHASE 3 KIDS STUDY

  Gastroenterology · 2025-05-01

  article
  PublisherDOI

Recent grants

• The role of iNKTs in eosinophilic esophagitis.

  NIH · $376k · 2011–2014

Frequent coauthors

• Jonathan M. Spergel

  Children's Hospital of Philadelphia

  221 shared

• Amanda B. Muir

  Children's Hospital of Philadelphia

  73 shared

• Terri Brown‐Whitehorn

  51 shared

• Chris A. Liacouras

  University of Pennsylvania

  50 shared

• Terri F. Brown‐Whitehorn

  University of Pennsylvania

  48 shared

• Anna Nowak‐Węgrzyn

  University of Warmia and Mazury in Olsztyn

  44 shared

• Carina Venter

  Children's Hospital Colorado

  42 shared

• Graham Roberts

  St Mary's Hospital

  39 shared

Awards & honors

• NIH K12 grant
• NIH K08 grant