The National Institutes of Health has awarded the Icahn School of Medicine at Mount Sinai an $8.5 million renewal grant to continue groundbreaking work aimed at understanding and improving long-term outcomes for children with congenital heart disease—the most common type of birth defect in the United States.

In a world-first, a team of researchers at the National Institutes of Health (NIH) and Emory School of Medicine, Atlanta, has successfully performed a coronary artery bypass — a normally open-heart surgery — without cutting the chest wall. The team employed a novel intervention to prevent the blockage of a vital coronary artery, which is a very rare but often lethal complication following a heart-valve replacement. The results suggest that, in the future, a less traumatic alternative to open-heart surgery could become widely available for those at risk of coronary artery obstruction.

Immunoglobulin E (IgE) responses against environmental and dietary antigens are at the heart of the pathogenic allergy response, maintained by compartments of memory B cells (MBCs) and by type 2-polarized memory B cells (MBC2s) that are destined to produce IgE antibodies. But can the IgE trajectory of these MBCs be reversed? Kelly Bruton and colleagues now show in mice and human cells that the pathogenic IgE fate of MBCs and MBC2s is dependent on IL-4/ IL-13 signaling. In the absence of this signaling or with exposure to type 1 adjuvants, MBCs re-exposed to allergens reverted to a non-IgE fate and produced an innocuous recall response to the allergen. Reprogramming of MBCs was sustained even after treatment. “Collectively, our findings elucidate a malleable fate of the pathogenic IgE-fated recall response and highlights the potential to therapeutically reprogram refractory lifelong allergies,” Bruton et al. write.