August 5, 2025 • 43 mins
Meenal Lele is the founder and CEO of Hanimune Therapeutics, which she founded with the aim of developing food allergy preventative products. The company's goal is to create solutions for parents preventing food allergies and doctors seeking better options to support tolerance. The company's commercial branch Lil' Mixins provides products making early allergen introduction to infants in a safe and controlled manner.
In our conversation we explore her groundbreaking innovations in creating "non-allergenic" peanuts and other top allergens and the vital connection between the gut microbiome, allergy development, and mental health. We also explore how anxiety plays a role in allergy management and treatment, and her perspective on how reducing anxiety around this might benefit patients.
Lele's book The Baby and the Biome is a great resource for anyone interested in prevention and microbiome health.
The Baby and the Biome a book by Meenal Lele and Cezmi Akdis - Bookshop.org US
Resource Hub – Lil Mixins
Hanimune Therapeutics
Preventing Food Allergies in Infants Guide by foodallergyprevention.org and FARE: Clinician-Guide_FAPrev_2.24.pdf
Special thanks to Kyle Dine for permission to use his song The Doghouse for the podcast theme!
www.kyledine.com
Find Dr. Whitehouse:
-thefoodallergypsychologist.com
-Instagram: @thefoodallergypsychologist
-Facebook: Dr. Amanda Whitehouse, Food Allergy Anxiety Psychologist
-welcome@dramandawhitehouse.com
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Meenal Lele (00:00):
one of the weird things about becoming a parent,
I think, or at least for me, wasthat in a way that you never did
before, you don't just careabout your own kid.
You become very, empathetic withall other parents and all other
children.
When this happened to my son, mybrain was really going
immediately to, but what aboutthe kids who won't have a parent
(00:21):
who is studying this stuff andwho won't know how to navigate
the system?
How are we going to do somethingabout that?
Speaker (00:27):
Welcome to the Don't Feed the Fear podcast, where we
dive into the complex world offood allergy anxiety.
I'm your host, Dr.
Amanda Whitehouse, food allergyanxiety psychologist and food
allergy mom.
Whether you're dealing withallergies yourself or supporting
someone who is, join us for anempathetic and informative
journey toward food allergy calmand confidence..
(00:49):
Welcome back to Don't Feed theFear.
I had the most interesting dayin Albany this spring doing some
advocacy work for foodallergies.
One of the reasons that that daywas so interesting was because I
happened to meet Meenal Lele.
She's the founder of Lil Mixinsand Hanimune Therapeutics, and
someone who is truly shiftingthe landscape of food allergy
prevention and treatment.
I was just so impressed by whoshe is as a person, her
(01:11):
motivation for helping othersand her innovation in the world
of food allergy.
If you're a fan you know that wedon't do short and sweet
conversations.
I always have so many questionsfrom my guests and I wanna do
the deep dive.
So Meenal joins me for thattoday, talking about her
professional experiences and howher own child's food allergy led
her to develop an accessibleevidence-based tool for early
(01:34):
allergen introduction and alsogroundbreaking work on
re-engineering allergens likepeanut to reduce risk and
improve immunotherapy safety.
Meenal also wrote a book calledThe Baby and the Biome about the
role of the gut microbiome infood allergy development and
overall wellness and in mentalhealth, which is something that
she and I enjoy talking aboutvery much, and I think that
(01:54):
you'll enjoy that conversationtoo.
Amanda Whitehouse, PhD (01:58):
Meenal, thank you so much for joining me
here and don't feed the Fear., Igot to meet you in Albany a and
see your advocacy work at theCapitol Building, and I'm so
excited that you were able tomake more time to talk today.
Yeah, absolutely.
I'm excited to be here.
Good.
Well, I know there's so much wewanna talk about.
We were sneaking in all theselittle excited conversations in
between our meetings, jumpingfrom office to office.
So a good thing, we have aplatform for it now, but let's
(02:21):
start, in terms of tellingpeople, who you are and how you
got into what you're doing now?
Meenal Lele (02:27):
Well, yeah, let me, I guess by way of introduction,
I suppose many people think ofthemselves first and foremost as
like a food allergy parent,right?
That is really what drives thislived experience as a, as a
caregiver, is what drives a lotof the work that we do.
Where this all comes fromthough, is I have a long career
in, the medical industry, and Ithink that's a very different
(02:50):
perspective that I bring tothings.
Coming at it, not just as aparent.
But as someone who has builtsolutions and companies in
different aspects of medicine,so I have a dangerous amount of
information about how ourmedical system actually works.
And that is, you know, for thebetter and for the worse.
(03:10):
But when my son first got sick,you know, a lot of people really
think of things at that surfacelevel, which is obvious.
Like, oh, someone is sick, theyneed treatment, they need care.
And my brain immediately wentto.
All of the gaps in our systemthat were going to make that
really difficult.
Not just for him or not for usper se, but for everybody else.
(03:33):
And, one of the weird thingsabout becoming a parent, I
think, or at least for me, wasthat you in a way that you never
did before, you don't just careabout your own kid.
You become very, empathetic withall other parents and all other
children.
And so when.
When this happened to my son, mybrain was really going
(03:53):
immediately to, but what aboutthe kids that you know who won't
have a parent who is studyingthis stuff and who won't know
how to navigate the system?
How are we going to do somethingabout that?
Amanda Whitehouse, PhD (04:05):
Yeah, that's how I feel about what
you're saying.
I want to get everything and allthe information to all the kids
out there, you know, and so manyof them, like you said, will
have barriers.
To accessing the information andthe treatments and the
protection and testing and allof it.
Meenal Lele (04:19):
Yeah, absolutely.
And I think because as a parentyou make so many mistakes,
right?
Even when you're doing yourabsolute best, you make so many
mistakes and you just realizehow random life is and how by
just by sheer coincidence atcertain things work and certain
things don't, you know?
And so that even when we wannabe proud of ourselves for doing
(04:39):
the right thing, we realized alot of that was just chance.
Amanda Whitehouse, PhD (04:42):
Right and luck.
One of the things that comes tomind with that is what you and I
were talking about, in Albanywhen we were doing the advocacy
work how, some of it's chance,some of it was knowledge and
timing with both of us, ouroldest having food allergies and
then getting that LEAP studyinformation and our, our younger
kids not developing theallergies because we then had
learned about early introductionbut I look back on the initial
(05:04):
thing as like my mistakes andwhat I didn't know, and it's
hard to process all of that, Ithink.
Absolutely.
For someone who is not in themedical industry at all, that's
a very broad term, can you say alittle bit more about what kind
of work you were doing prior
Meenal Lele (05:17):
yeah, sure.
Um, through a random series ofevents.
Um, way back in 2008, I had beenon the founding team, or I was
on the founding team of anorthopedic company and we grew
that business, really quite big,and eventually sold it.
And then I left there to be thefirst employee of a vascular
medicine company.
(05:37):
So two actually very differentareas of medicine.
Orthopedics is kind of more ofa, it's in the hospital, but
there's a lot of privatepractice.
The vascular medicine is allhospital based.
Um, and then that companyeventually sold as well.
And the both companies when Ijoined were.
Still in, in infancy.
I mean, the, the first one wasliterally a napkin drawing at an
(05:58):
Italian restaurant.
And the, this, you know, thesecond one, they had prototypes
and other things, but it waspre-human use.
And so, you know, you put.
Like so many things in life, theend product is very different
than, you know, it hides all thestages.
Like you think even making acake, right?
You get this beautiful cakethat's presented and nobody sees
(06:21):
behind the kitchen at like theknives that were thrown at each
other, and the cake flour,that's everywhere and you know,
all the messes that happen.
Um, so you, you, we tend to onlysee the output product, not all
of the.
What had to happen to make thatpossible.
And so really, um, I got areally a, a front seat sort of
(06:41):
perspective, not only on whatdoes it take to bring products
to market, but how in, in the,in everything medical, the
doctors are largely yourcustomer.
And that's a very, verydifferent customer, um, with
very, very different needs thanwhen we think of a quote,
consumer product.
Doctors don't generally get tomake their own decisions, in
(07:03):
many ways, it's a veryconstricted market in that
there's all these constraintsabout payment, right?
So even when a doctor might wantto buy or.
Prescribe, let's say in thiscase, a drug.
They're very constrained by whatinsurance you have.
So you think it's the doctormaking the choice, but it's not,
it's some payer or it's thehospital system or, and in each
(07:25):
case there's all these bitsthat, that are coming together
and you almost have to, to besuccessful, you have to really
see that minefield ahead of timeand plan
Amanda Whitehouse, PhD (07:38):
your strategy through it.
I assume there are others too,the barriers that you were
talking about that you could seethat would lie ahead before you
even got started
Meenal Lele (07:47):
Yeah, absolutely.
Um, I mean the, the biggestbarrier as I actually was
talking to another founder justrecently, they wanted to start
another company that theirtarget market is infants.
I brought up that in the UnitedStates, 60% of infants are on
Medicaid and chip, and thisfounder didn't know that.
(08:07):
But that is such a fundamentalpiece of our system that again,
when we watch TV or we thinkabout consumer products, we're
really thinking about a verysmall sliver of the population
that has the cash and capital todo things and the education to
do things.
All sorts of different thingsagain, that, uh, work together.,
(08:31):
It depends on what kind ofproblem you're trying to solve,
right?
If you just wanna get a productto market that will be
profitable, you might be able todo that.
Just working with 5% of thepopulation, right?
There are, I don't, I don'tknow, hair salons and things
that work if you're, even, ifonly you know, a tiny group of
people is using them, and that'sfine.
(08:52):
Um, in medicine, specificallypreventative medicine.
Preventative medicine, that isalways a universal approach.
So if you're saying from theoutset that you want to do
something that by necessity hasto get to a hundred percent of
people, or realistically, 95%,let's say.
Well.
How will you do that?
(09:13):
Right now you're talking aboutmultiple disparate groups of
people with different needs anddifferent constraints, and so
you have to be thinking ahead oftime about what, and often
you're only allowed to come upwith one solution that has to
work for all of them.
So what does that look like andwhy?
You know, so we, um, so that wasthat.
(09:34):
I think that's just a verydifferent approach to this
market than, um, preventativemedicine is just a very
different beast than everythingelse.
Amanda Whitehouse, PhD (09:41):
Right.
Right.
And so the company is calledHanimune.
And you began with one branch,which is the direct to consumer
marketing of, of in earlyintroductions.
Lil'Mixins.
Allergens, right.
Sense?
Yeah.
So, so tell us why you decidedto start there, or was that the
original plan
Meenal Lele (09:56):
The original plan was always to do both sides, but
you gotta start somewhere.
You gotta do one thing rightbefore you can go get to do your
second thing.
And um, I started with Lil'Mixins'cause it was kind of the
easier one to start with.
It's a easier area in, in.
Some ways to get the ballrolling.
It's definitely the harder oneto succeed, but it's the easier
(10:18):
one to get started.
So we started there.
Amanda Whitehouse, PhD (10:21):
FDA approval and the, the whole
Exactly.
Meenal Lele (10:24):
Prevention fundamentally falls into a
category called dietarysupplements for foods, or it
can, uh, again, I think easy wayto think about it is, um,
prenatal vitamins, which arevitamins.
So they're dietary supplements.
They're not drugs.
They don't have FDA approvals.
And, uh, so similarly you can dosomething in this space'cause
(10:45):
that's really the most costeffective way to solve the
problem.
Um, so you can start there and,but our goal was really to build
and use that to eventually getto the treatment side because
not every child.
You know, we, we now in allergy,or they now in allergy, talk
about primary prevention, whichis the prevention we do with
(11:05):
infants in this universal.
Then there's something we calllike secondary prevention, which
is there's these kids thatdevelop allergy and infancy and
there's a, a thought processthat a specific kind of
intervention could kind of like,while their immune system is
still sort of deciding what todo, flip them back.
To tolerance,.
(11:25):
And then there's this idea of,you know, tertiary prevention
or, or really treatment at thatpoint.
Right.
Um, and so you kind of work yourway down, uh, work your way down
from easiest to hardesttechnically.
Amanda Whitehouse, PhD (11:37):
If people aren't familiar with Lil'
Mixins.
tell them exactly what theproduct is.
Meenal Lele (11:42):
Lil' Mixins is straightforward.
The top seven proteins really,we don't do wheat and milk
because those are already in theinfant diet.
But the other, seven proteinseven big proteins that babies
tend to develop allergies to.
They're in cost-effective,infant safe forms.
Just a concentrated protein.
(12:03):
And the idea is, you make itsuper simple for a parent to
make sure that a baby's eatingtwo grams of that protein in a
sitting.
So there's no thinking involved.
There's just, there's verylittle thinking involved.
And if you can do that in a waythat's, you know, again, cost
effective and easy to reproduce,we can get, more babies to do it
or parents to do it.
Amanda Whitehouse, PhD (12:21):
So they're just little packets,
little dried pouches that youliterally mix in, right?
That's exactly right.
Meenal Lele (12:25):
And, and for more, even more cost effective forms,
we sell them.
We also do these jar formfactors, so you can get almost
six months worth of servings ina single purchase in a single
jar, and then it becomes morecost effective.
Amanda Whitehouse, PhD (12:37):
Okay, so that is to help parents who want
to take advantage, who areeducated.
Hopefully it's becoming more andmore people that early
introductions is the, best wayto prevent allergens and make it
really easy and take thethinking out of it.
Speaker 3 (12:50):
Mm-hmm.
Meenal Lele (12:51):
That's absolutely right.
And the jar form factor, againwith really from the beginning,
because we said if insurance isever to pay for something, they
will not pay for multiplethings.
They will only pay for onething.
So then all of the stuff that aparent needs has to fit into one
thing.
And that was actually, a keydesign constraint.
(13:12):
Which, some parents appreciate,but if you're buying something
over the counter, most parentsreally want the convenience of
the packets.
But insurance will never coverthat.
So, you know, we separate, wehave to separate them because
you don't want it to be unusablewith a child that has one,
right?
So you have multiple jars.
So the, the way we broke it upis basically like peanut eggs
(13:33):
and then the tree nuts.
Amanda Whitehouse, PhD (13:34):
And those, those products are pretty
widely available and you canorder them online now.
Right.
Um, but you've got other thingsin the works.
So take us into that part that,that branch of the business and
where you're at with that.
Meenal Lele (13:46):
So food allergy treatment or all allergy really
is, the way we treat itfundamentally is we desensitize
someone to it.
There are many drugs that are indevelopment right now.
Most drugs, they work bychanging your immune system or
suppressing a piece of yourimmune system.
And so like with all, there isone maybe a lot of people are
familiar with and there's manyin development.
(14:09):
Allergy immunotherapy or theprocess of desensitization.
We are trying to get your immunesystem to stop producing
antibodies.
And the way our immune systemsare designed is that once we
have made this decision tocreate a kind of antibody
against a virus, a bacteria, aparasite, or you know, anything,
we do it forever.
(14:29):
And so this desensitizationprocess is trying to get your
body to rethink that decision,and we know it works.
So food allergies have beendesensitized for over a hundred
years, and many people withallergies also have
environmental allergies.
And so you know the process ofallergy shots is you start with
a little and you slowly increaseand you get your body to stop in
(14:51):
some sense, that's a little handweighty, but you get your body
to stop producing theantibodies.
And the question, the, the issuewith food allergy is that our
immune systems, to a largeextent, are actually in our GI
tract.
And so when we ingest antigensthe foods, we get these very
violent responses And foodallergy can be really dangerous
(15:14):
because of the amount or the, Iguess the number of immune cells
that are involved in variousthings that.
You know, we don't need to getinto, and again, I, forgive me,
I'm really hand waving over alot of things.
So whenever you have doctorslistening, they're gonna be
like, well, that's nottechnically correct, but we're
hand waving here.
So in any case, what we havebeen trying to do is figure out
how to solve the problem of thesafety side of it.
(15:37):
And so we're not fundamentallytrying to do anything different.
We're not trying to say that.
It creates a magical new way ofdesensitization,
desensitization.
Fundamentally, you start with alittle, you get add more and
more until your body changes.
Its your immune system changesits mind.
What we're trying to figure outis how can we get the body to
make that decision with as fewside effects as possible.
(16:01):
One way people now do that isthey suppress their immune
system during desensitizationwith Xolair.
And that in clinical trials hasshown a bunch of, uh, promise.
Our thought process, um, from anengineering perspective was to
say, well, what if we playedaround with the antigen itself?
Is there a way that we could getthe, we could change the antigen
(16:23):
so the body would accept it inorder to use it?
For this purpose of creatingtolerance but not react to it.
And so, um, we've started thisline of proteins called Top nine
Proteins.
Um, they're all still reallysupplements and so they are.
(16:44):
The proteins, the, you know,the, the food proteins.
And in some cases they, um,they're really how, again, it's
all about how it's beingpresented to the immune system.
So we're not saying that they'renot a peanut anymore, right.
It still is fundamentally apeanut.
But we're messing around alittle bit with the, the
delivery mechanisms and kind ofthe form factor to some extent
(17:06):
of the, proteins themselves sothat it gives doctors some kinds
of, basically some options.
Each patient, their differentlevels of severity and different
levels of, and different needs,right?
Like some of, some of our kidsmight want tolerance, some might
just want some protection,different goals.
And so right now, if you justhave a peanut, you don't get to
(17:28):
choose, right?
You just, you have a whole bunchof kids with different goals and
different needs, and you justgot this one peanut.
And so really what we're tryingto do is make these peanuts on
some level available indifferent ways so that it allows
the doctor and the patient todecide what do they need and
what do they want for thepresentation of that peanut.
And that, that allows hopefully.
(17:50):
The doctor to practice their,their therapy of, food allergy
in a way that works for thepatient.
It is not a treatment for foodallergy.
It is a peanut that is presentedin a different way
Amanda Whitehouse, PhD (18:01):
My brain is taking me to.
All of the people that you musthave on your team in order to do
this.
I have no concept of what itmust take on the science end to
do what you're doing then to beall of these foods because
they're, they're just foods,right?
There's the peanut is still apeanut.
Is it way too much for us tograsp or is there a way to
explain it like we'rekindergartners
Meenal Lele (18:23):
It takes a lot of people and a lot we work with
dozens, dozens of people with,at the company.
'cause each person brings aspecific skill in that you would
need for, you know, to solve aspecific problem.
But when I'm talking aboutpresentation, you have different
kinds of immune cells in yourmouth, for example, than you
(18:46):
have in your esophagus and youhave in your gut.
And what we want to do is youcan take a peanut protein, for
example, and you can put it incertain kinds of liquids, and
that will cause the protein toopen in a way that allows it to
(19:07):
interact.
With immune cells in the mouth.
And that is different than theway it would be if you were to
eat it.
'cause remember, when we eatfood, it actually gets digested
by our gut, the acids in ourgut, and, and then when it's
presented to the cells in theintestines and so on, it's
(19:29):
presented in a different formfactor.
Another thing we can do with thepeanut proteins is almost.
A way to think of it is likepredigesting it.
So if you can take a peanutprotein and predigests it in the
way that a person who did nothave allergy would predigests it
(19:51):
before it got to the immunecells, of the intestines, you
can change the immune reactionthat will happen when that
protein.
Gets to the, the lower intestineor the upper intestine.
And it's weird because it's not,not a peanut, it's still the
same peanut.
It's really just, you can dosome minor chemical processes on
(20:14):
it, that sort of, yeah, for lackof better term, I think is maybe
like predigestion is the easiestway to think of it.
And we have found that when the,it is predigested in this way,
it limits the immune responsethat happens to that protein.
having food allergies, not justabout the immune cells.
(20:36):
There's a growing understanding.
Large reason people have foodallergy is that their gut
linings, Is different.
And that's why there's otherfolks that are kind of seeking
microbial treatments likemicrobiome treatments.
That would also affect digestionand things like that.
So again, most people when theythink of food allergy, you think
about the human.
(20:57):
You think, well, what can I doto change how they react to the,
peanut?
And we've just sort of thisquestion of saying, well, how
can I change the peanut tochange how the human will
interact with it?
Amanda Whitehouse, PhD (21:12):
This is fascinating to me.
So the output then, once you doall these chemical processes to
whatever the food is, let'scontinue with the peanut.
Is it, is it a powdered form o fthe peanut that has undergone
this chemical process, what'sthe actual product going to be?
Meenal Lele (21:28):
Yeah, in that case of the, the sort of predigested
forms, and we call, kind of callthem hypoallergenic forms of
these proteins.
'cause again, what we've done isremove those epitopes.
And I, I can explain that in asecond.
Yes, they are powders.
And they're powders largelybecause that's a way to stop the
chemical reaction basically isif you dry out something and
(21:51):
powder it, dehydrate it, you canend the chemical process.
And so it keeps it, it keeps itstable at that point.
Mm-hmm.
Um, and things in liquid becauseof water or anything that it's
dissolved into is a chemicaltoo, right?
Mm-hmm.
So it, there, there's constantlya chemical reaction happening
when anything's in a liquidform.
And so a dry form is stable.
(22:11):
One of the things that we'redoing, as I said, when you're
sort of predigesting it, orwhatnot, is you change the
protein structure in a personwho has an allergy antibodies
bind to specific points on thepeanut.
If you remember the COVID,virus, the spike protein is the
point where our immune systemswould sort of bind to that.
(22:31):
Virus.
Virus is a whole big thing,right?
But we really bind the one spot,one type of protein on that
whole virus.
And so when we were coming upwith drugs and everything, it
was all about that point where,how do we change that action at
that point?
And so food is really similar inthe sense that.
There, there are technically aninfinite number of points on
(22:55):
this food, protein one ourimmune systems could bind to,
but they actually really onlybind to specific points.
And if you remove some of thosespecific points, not all of
them, you can make it so thatyour immune system almost
doesn't recognize the proteinand so it doesn't realize to
mount an immune response againstit.
And again, that is really what.
(23:15):
Many healthy people do is they,they take, when we ingest food
that we're not allergic to, wealter it so that it, by through
our digestion, we alter thosefoods so that our bodies know
not to react to them.
And that is fundamentally inmany ways how our body knows
what, what is a dangerous foodand what is not.
(23:36):
If you think about it.
Your gut It's a closed like bag.
There's like a tube going fromyour mouth down, your system,
right?
And it's a closed system.
And all this stuff has to happeninside of this bag.
And then finally, when it'sbroken down enough, these
molecules cross our gut barrierinto our bloodstream.
And only when they're in ourbloodstream can they be utilized
by all of our cells and movearound through our system.
(23:59):
Right?
But.
The form that a food is in whenit crosses, or a form that
anything is in, and when itcrosses, really determines how
our immune system responds toit.
The things we've been messingaround with is how can we change
that food protein?
Or, or shift it slightly so thatwhen it crosses the barrier for
(24:19):
people with allergy, it's doingso in a way that seems benign to
that person.
Amanda Whitehouse, PhD (24:24):
To help people connect with this, I
think the term that people willunderstand when they're talking
about proteins entering the bodywhen they shouldn't, right.
The way the gut works is itbreaks those down, but that's
when we start talking aboutLeaky gut, right.
Proteins entering directly intothe body when they shouldn't be
through the gut.
Meenal Lele (24:41):
Yeah.
Leaky gut is a.
Hand, wavy term, that means Ithink different things from
different people.
It is a real phenomenon, but Ithink there's a lot of argument
there because many people,again, are just just talking
about different things when theyuse that term.
But let's take the extremeversion of it where you
literally had holes in your gutand whole proteins were just
(25:03):
floating across the barrier andthey're completely intact.
Whole form, right?
Like that would be a very trulyleaky gut with like just no
processing happening inside thegut.
And in that case you have immunecells immediately.
Anything that crosses the gutall the time, like all the stuff
that we agree to not fight.
Mm-hmm.
Our immune system binds to itand then the immune system has
(25:25):
to basically like look forsignals on it.
It looks for two differentsignals.
It looks for, is this somethingmy own body made and does it
have specific.
Combinations of things and, andthen it takes that and it
presents it and says, this iswhat I think this thing is.
(25:46):
And then our immune system fromthere decides what to do, like
attack it or not.
Right?
In the case of a whole intactprotein, again, that extreme
example, it would almost alwayssay like the combination of
factors would be there for theimmune system to present it to
the remaining immune cells, likeT cells.
Mm-hmm.
And say, Hey, this is adangerous thing.
But what I'm talking about a isa little bit different in that,
(26:11):
when we have different bacteriain our, in our mouths, in our
esophagus, and, you know,through our gut, we break down
the proteins and different acidsand so they create these
peptides and, um, but thepeptides, again, the peptides
are, are portions of theprotein.
So that that idea of splitting aprotein is called cleaving it
(26:32):
and where the protein getscleaved and, um.
How many chunks are created,kind of change based on which
bacteria, um, are doing it.
How thick your mucus is canchange how long it's sitting in
the acid.
So how, how much, like, youknow, like a long laundry cycle
or a short laundry cycle, right?
Mm-hmm.
A long cycle you're gonna getmore of the dirt off kind of
(26:55):
thing, right?
We tell everyone, you know,you're supposed to chew 26
times, which I can't even do,but you're supposed to like chew
26 times before you swallow,right?
Same ideas, like, it's like howmuch is it breaking down, um,
before it continues through.
Mm-hmm.
And so, so again, all of thesethings are interrelated but at
the end of the day, what'shappening is that stuff is
crossing the barrier.
And then based on the structureand size and exactly where it
(27:19):
was cleaved, so which peptidechains are passed across to the,
immune cells.
I'm trying not to overcomplicateit, it's just complicated.
You're not over complicated.
It's com it's just complicated,right?
It's like not a straightforwardanswer, you know, I, I think
people want it to be astraightforward analogy and
it's, it's just not that simple.
But, um.
But those are some kind of basicideas.
(27:39):
The, the basic fundamental thingis that like what many things
can change, what gets passedacross.
Also many things can change, youknow, what is the state of the
immune cells, like how triggerhappy are they and things like
that.
As they're, you know, as they'remaking this decision.
And, and that's a real piece ofit actually is like, you know,
we talk about inflammation.
And inflammation in a broadsense can be a little bit like
(28:02):
how biased is your immune systemto.
Being aggressive versus not.
And again, that's like really ametaphor, but um.
But it, but it's not totallywrong.
Um, I think, and so when peopleare in a state of high
inflammation and the same exactinformation is presented, it's
like, it's like when you'rehungry, you know?
(28:23):
Mm-hmm.
And someone says something toyou, you might have a very angry
response as opposed to if youwere like, well sated, then you
can deal with it calmly.
Right.
Um, we have hang Exactly.
Yeah.
So sometimes our immune
Amanda Whitehouse, PhD (28:33):
systems get hangry.
That kind of leads us into oneof the things that you and I
were so excitedly talking about.
Obviously this is all tied to.
Our gut health, which is a verycomplicated process.
It's not as simple as peoplethink I'm gonna go take a bunch
of probiotics.
Right.
It, it's not that simple.
But you and I were taking thatconversation into how this
connects to our mental health aswell.
(28:55):
So again, I know it's not assimple process, but what do you
want people to understand abouthow this all ties together in
terms of, of that piece ofthings and the role of gut
health in our mental health andwellbeing.
Meenal Lele (29:08):
Well, I would say more simply, there's two pieces
to it.
One is that if your gut is notin good health, then the
probability that you are passingthe wrong things across the
barrier, or that they're gettingpassed across the barrier and
you're making your immune systemis making the wrong choices, if
you will, um, that thatprobability is higher, right?
Mm-hmm.
(29:28):
So, it seems pretty clear that.
Even in a person who has foodallergy, if you were able to
truly improve their gut healthalone, you would make that
process of desensitizationpotentially much easier and, and
have fewer side effects.
So that's one piece of it.
Second piece of it is, again.
It's super complex.
I'm not pretending to understandit.
(29:49):
Um, but we know that the stateof our, again, broadly gut
health affects our mental state.
Mm-hmm.
But it's important tounderstand, I think that we
forget it's bidirectional,right?
It's an axis,
Amanda Whitehouse, PhD (30:01):
it's a gut brain axis.
Yes.
Meenal Lele (30:02):
Yeah.
Yes.
And so people tend to thinklike, okay, in that, the way
that's easy for me to understandis like when my stomach is
upset, if I've eaten something,I'm not in a good mood.
But it also works the other waythat if you're mentally not in a
good place, your gut isn't in agood place.
And so that goes back to pointone, which is if your brain can
almost like make your gutleakier.
(30:23):
Right.
Um, and then, then you're gonnado worse with treatment or
you're gonna be more likely toreact even if you're not in
treatment.
Right?
So it, I think it's just such awild, complex system, um, or
interacting set of, of systems,um, that, that the people are
working really, really hard tounderstand today.
And I don't think we understandcompletely, but in that broad
(30:43):
sense, in that, in those broadstroke sense, we know those
things to be true.
And so without.
Really understanding themechanisms of any of this.
We can broadly say that if therewere a way to have ourselves in
better gut health and in abetter mental state, those were,
those would both befundamentally a better place
Amanda Whitehouse, PhD (31:02):
from which to start treatment.
Right?
It's so complex.
I think people feel overwhelmedwith, not knowing what to do
with it or where to go when,when they know it's a thing.
We hear about it all the time.
But I think what you're sayingis, what I want people to
understand too is that it's aholistic process.
Meenal Lele (31:19):
I'll give you this.
I think there's this reallyfascinating just because We
talked to a lot of doctors doingclinical trials.
Speaker 3 (31:25):
Mm-hmm.
Meenal Lele (31:25):
And so this concept, you know, doing an oral
food challenge and we often doblinded food challenges.
And so when somebody hasmultiple food allergies, let's
say you had three foodallergies, right?
Egg, milk, peanut, the way theymight do the challenges actually
have, you do four challenges andyou don't know which what, so
you don't know if today you'rehaving egg, milk, peanut or
placebo.
The fascinating thing is if youtake.
People like this, children, andmany of these studies are done
(31:48):
in children.
The rate at which people reactto the placebo is way higher
than you'd think.
Wow.
And that which really speaks tothe fact that like, so then
you're like, what is that?
Is that anaphylaxis?
Like that's clearly just acompletely psychological
response, right?
Because they're eating somethinglike tapioca starch or oat flour
that they're not allergic to.
(32:09):
And so, but they're clearlyanaphylax, so Right, right.
Real physical symptoms.
Exactly.
So what is that?
And, and so when you're goingthrough treatment.
That's really an open question.
On any given day, you have areaction or at the baseline,
like are you that sensitive orare you that sensitive just
because
Amanda Whitehouse, PhD (32:26):
you're nervous?
Speaker 3 (32:27):
Mm-hmm.
Amanda Whitehouse, PhD (32:28):
Or are you that nervous because you're
that sensitive and it's a spiralthat keeps widening and, and
getting bigger and more intense.
Right.
Totally.
It could be a.
Crazy negative feedback loop.
Yeah.
But it's so hard for people tobreak through that because then
when they hear, oh, well if, ifit's just anxiety, either you're
saying, my reaction isn't real,or I can't just stop being
(32:48):
anxious about it.
Right?
It's not that simple.
I believe you.
I know it's a part of it, but Ican't just stop.
Meenal Lele (32:53):
It's a real thing.
Like I will fully admit to likebeing terrified to go in the
basement at night, right?
Mm-hmm.
I'm a grown person and there'sno one in my basement, and like,
it doesn't matter that I cycle,I, I intellectually understand
that there's nothing in thebasement that's going to get me.
And like sometimes you cannotmake yourself go down those
stairs.
Amanda Whitehouse, PhD (33:13):
Right.
And that's without, I assume, Imean, I could be wrong, but I
don't think you've ever had atraumatic experience or actually
been in danger or harmed in abasement before.
Meenal Lele (33:22):
Right?
No.
No.
And if like, if I needed to gointo the basement, I could,
right.
But I'm just like sitting thereat night or something, you know?
And like if my husband's nothome and I'm a little bit like,
you know, you kind of do thesetrade offs.
They're like, well.
I know there's no one in thebasement, but what if there were
Amanda Whitehouse, PhD (33:38):
Right.
And it's very real.
And I, I just think that's sucha good example because then take
someone, take our kids or, orother people with food allergies
who've had genuinely.
A really scary, very dangerousreaction to something to, to try
to fix that anxiety when it's sohard.
Even just to like, I have thisanxiety about the basement
that's not even really based ona trauma right.
(33:59):
To exactly.
To try to tease out a real truedanger and the anxiety that
follows is so complicated.
Meenal Lele (34:06):
It's really, really hard.
And you, and again, we weretalking about this, that the
crazy thing about food allergyanxiety is that it's not
irrational.
It's every reaction our childrenhave had has been some random
accident.
So it's like a completelyrational fear actually.
So then how do you deal withrational fears?
(34:27):
And this is, you know.
Same thing, like the hardestI've, I've read somewhere that
like the hardest fears to sortof, um, phobias to like work
through are like phobias ofsnakes and spiders and stuff
because they're like deeplyingrained in us and that they're
rational fears.
Like those things do kill you.
Amanda Whitehouse, PhD (34:44):
Yeah.
And, and it's true.
I mean, I'll, I'll speak to thatfrom my work that it is true and
it takes a different, it takes adifferent approach.
You and I could work on talkingthrough whatever's feels scary
about the basement and, and, andwork through it because it's
Right.
There's a, there's an unhelpfulthought process that's happening
around it versus a true actualrisk.
Um, yeah, I think, I think itleaves us, and not just the
(35:05):
people who've experienced it,but us as parents of, of kids
who've had that happen too,
Meenal Lele (35:09):
and I will say that that is really one, one of the
harder pieces of food allergytreatment as a whole, and I, I'm
speaking specifically about, youknow, in my own discussions with
the FDA or the company'sdiscussions is like, it's very
hard to tell sometimes we havethese high false positive rates
of the placebo, but also like.
(35:31):
Why a treatment doesn't work forevery person.
Right?
Because it's really hard,because a lot of people, you
might almost need to give them akind of like, not, it's not a,
placebo isn't the right word,but like a, um.
A less good treatment, a lessstrong treatment, almost to like
give their emotions a chance toget there.
(35:53):
You know, and I, I've, I'vetalked to many doctors who are
starting more and more withtrying to treat patients in this
very low dose way or usesublingual treatment or other
things.
We know that they don't work aswell as oral immunotherapy, but
oftentimes that's not the firstproblem that needs to be solved.
Speaker 3 (36:09):
Right.
Meenal Lele (36:10):
And, um, you know.
I'll give you the example ofspecifically of, so our own
doctor, we were talking to himabout this and he said, you
know, a lot of my patients whatI do, this sounds really crazy.
He's like, but I will treattheir environmental allergies
first.
And even though that delays thewhole process by like a year and
(36:30):
a half, but what it does is sortof build up the psychological
muscle that allergies aretreatable.
And when we start with somethingcompletely unrelated to their
food allergies, and you workthrough that and it kind of just
gets this person just moreaccepting of the idea that they
can have their allergiestreated.
And so then when you go twoyears later to try and treat the
(36:53):
first food allergy, they're justin a better emotional and
psychological place.
And that alone
Amanda Whitehouse, PhD (36:57):
makes it more successful.
Yeah.
And I would add on as apsychologist.
Now that person has trust inevery person in that facility
and the people they see in thewaiting room, in the space
there, in the routine of drivingto that office.
All of that createspsychological safety, which then
creates real physiologicalsafety We had a great doctor who
walked us through the process ina similar way We debated whether
to start with slit forenvironmental or just do
(37:18):
environmental shots because hethought the reactivity might
actually compromise the OIToutcomes.
And I said, if I have to bringhim here.
Every however often for a shot,we're gonna lose him.
He's not gonna buy in, and thenwe're not gonna be able to do
OIT.
And so he worked with us to doslit and it was really effective
for us for the environmentalallergies.
You're making a good point kindof, like you said about
different approaches with theway that you're, um.
(37:39):
Modifying the allergens, right?
We have to have differentapproaches for, for all
different needs, physiological,psychological, all of these
things are different factorsthat are important that don't
lend well to a clinical trialand clear results, but are
important in practice.
Right?
Meenal Lele (37:53):
Right.
In, in the real world, you needa whole grab bag of different
options because each person'sjourney, and even again, I go
back to this, like their goals,um.
The goals change over time also.
Speaker 3 (38:08):
Mm-hmm.
Also,
Meenal Lele (38:08):
right?
Like you could have someone whosays, well, you know, I just,
uh, I don't, I don't need to eatcashews, but I would love to be
protected.
But then they get a, a lotdesensitized to cashew and
suddenly, you know, then maybethe end doesn't look so insane.
And so now they, they changetheir goals.
Um, and that, that has to beokay because Until we get to
(38:30):
some again, until hopefullysomeone gets to some way deeper
root cause explanation or ununderstanding of how to treat,
uh, food allergy and just sortof eradicate it with a pill or
something.
Mm-hmm.
Without thinking about it, um,each person's journey is gonna
be different.
Amanda Whitehouse, (38:45):
Definitely.
Well, thank you for working sohard on something that's going
to add another really importantpiece to that grab bag of
options that we will have tochoose from.
I feel like there's so much morewe could talk about for so long,
but, why don't I let you tellpeople where they can find the
Lil' Mixins where, where theycan follow you if they're
curious
Meenal Lele (39:01):
yes, LIl' Mixins.
You can find, um, you know, attarget.com and on our website on
Amazon, like the usuals.
Mm-hmm.
Um, in the next couple years,more and more, um, pediatricians
will be able to prescribe themand along with other, um, early
allergen introduction mm-hmm.
Products to their patients.
And, um, as far as these sort ofaltered proteins, our, our goal
(39:24):
really is to.
Make sure doctors have access tothem.
Um, you know, like anything, itwould not be ideal for patients
to try and treat themselves.
And so, but, um, our goal thereis really to make sure that when
doctors want to offer differentthings to patients, they have
that, you know, again, just.
Harping on the peanut, they havethat peanut in different form
(39:45):
factors so that they're able touse it, um, the way they and the
patient decide is right.
So I think ho hopefully over thenext, you know, two to five
years, nothing in medicine goesfast.
More and more doctors will have,access, to those and the ability
to use them.
Definitely talk to your doctorabout it.
We work with a, a number ofacademic centers now and
hopefully get into more privatepractice soon.
Amanda Whitehouse, PhD (40:06):
Good.
Well, thank you for all of thatbecause it's really important
and it sounds like it takes aspecial person with a special
combination of experience andknowledge and background, like
you have to take on such aoverwhelming project.
Meenal Lele (40:19):
It is a, it is an overwhelming project and There
are a lot of patient advocates,and I feel what's interesting
about this,, entire journey hasbeen that these are patient
advocate solutions, right?
Mm-hmm.
Like if I, I'm, I'm approachinga lot of the problem of food
allergy, yes, from theperspective technically what has
to happen, But really you'retrying to solve the patient's
problem, which can be, again,one of convenience or cost or
(40:40):
psychological fear or somethingelse, right?
Which is generally not how,Products in the, in the medical
space are developed.
These are, these are realpatient advocacy solutions.
Amanda Whitehouse, PhD (40:50):
I love that we need so much more of
that and I'm glad that you're ontop of it.
Thanks.
Meenal Lele (40:55):
I think it sounds like, um, speaking of patient
advocacy, you and I might runinto each other again soon at in
some patient advocacy.
Conferences and things and Ilook forward to
Amanda Whitehouse, PhD (41:04):
talking to you more there.
Yeah.
Yeah.
I hope we keep, continue tocross paths, but thank you for
joining us here today and we'llkeep people posted on your work
in the future as it progresses.
Awesome.
Thank you so
Meenal Lele (41:13):
much for having me.
It was so interesting for me tomeet Meenal and to talk to her
here on the show and hear aboutthe work she's doing to make
food allergy prevention andtreatment safer, more effective,
and more inclusive.
So if today's conversationresonated with you or sparked
curiosity, here are three actionsteps you can take to follow up
on what you've learned.
Number one, Learn more aboutearly allergen introduction by
(41:36):
checking out Lil Mixins website,www.lilmixins.com.
Or you can find them onInstagram at Lil Mixins.
And you can also search onlinefor the guide that was created
by food allergy prevention.organd FARE called Preventing Food
Allergies in Infants.
And I'll put the link to that inthe show notes as well.
(41:58):
Number two, I'm such a badpodcast host.
I had so much I wanted to askMele that I didn't even get to
talking about her book, the Babyand the Biome during the
episode, but I highly recommendit.
I know many of you are reallyinterested in all of this
research that's unfolding aboutthe connection between gut
microbiome, allergies, mentalhealth and wellness overall, and
this is a wonderful resource foryou to check out about that.
(42:20):
It's available wherever you buybooks, and it's linked in the
show notes.
And number three, if you havequestions about how the topics
that we talked about today applyto you specifically, I want to
encourage you to talk to yourhealthcare team about them.
There's so much information outthere, more and more coming out
every day, and there's still alot of conflicting information
that people are getting aboutearly introduction of food
(42:42):
allergens and the benefits ofit.
It's potential for decreasingthe incidence of food allergies
and about immunotherapy, how itworks, who's a candidate for it.
Obviously all of these areindividual questions for you to
ask your doctor, but I do hopethat this conversation has
gotten you thinking about them.
Thank you for being here., Ifyou're enjoying the show, please
don't forget to subscribe andgive me a rating or leave a
(43:03):
review if you're finding ithelpful.
the content of this podcast isfor informational and
educational purposes only, andis not a substitute for
professional medical or mentalhealth advice, diagnosis, or
treatment.
If you have any questions aboutyour own medical experience or
mental health needs, pleaseconsult a professional.
I'm Dr.
Amanda Whitehouse.
(43:24):
Thanks for joining me.
And until we chat again,remember don't feed the fear.
one of the weird things about becoming a parent,
I think, or at least for me, wasthat in a way that you never did
before, you don't just careabout your own kid.
You become very, empathetic withall other parents and all other
children.
When this happened to my son, mybrain was really going
immediately to, but what aboutthe kids who won't have a parent
(00:21):
who is studying this stuff andwho won't know how to navigate
the system?
How are we going to do somethingabout that?
Speaker (00:27):
Welcome to the Don't Feed the Fear podcast, where we
dive into the complex world offood allergy anxiety.
I'm your host, Dr.
Amanda Whitehouse, food allergyanxiety psychologist and food
allergy mom.
Whether you're dealing withallergies yourself or supporting
someone who is, join us for anempathetic and informative
journey toward food allergy calmand confidence..
(00:49):
Welcome back to Don't Feed theFear.
I had the most interesting dayin Albany this spring doing some
advocacy work for foodallergies.
One of the reasons that that daywas so interesting was because I
happened to meet Meenal Lele.
She's the founder of Lil Mixinsand Hanimune Therapeutics, and
someone who is truly shiftingthe landscape of food allergy
prevention and treatment.
I was just so impressed by whoshe is as a person, her
(01:11):
motivation for helping othersand her innovation in the world
of food allergy.
If you're a fan you know that wedon't do short and sweet
conversations.
I always have so many questionsfrom my guests and I wanna do
the deep dive.
So Meenal joins me for thattoday, talking about her
professional experiences and howher own child's food allergy led
her to develop an accessibleevidence-based tool for early
(01:34):
allergen introduction and alsogroundbreaking work on
re-engineering allergens likepeanut to reduce risk and
improve immunotherapy safety.
Meenal also wrote a book calledThe Baby and the Biome about the
role of the gut microbiome infood allergy development and
overall wellness and in mentalhealth, which is something that
she and I enjoy talking aboutvery much, and I think that
(01:54):
you'll enjoy that conversationtoo.
Amanda Whitehouse, PhD (01:58):
Meenal, thank you so much for joining me
here and don't feed the Fear., Igot to meet you in Albany a and
see your advocacy work at theCapitol Building, and I'm so
excited that you were able tomake more time to talk today.
Yeah, absolutely.
I'm excited to be here.
Good.
Well, I know there's so much wewanna talk about.
We were sneaking in all theselittle excited conversations in
between our meetings, jumpingfrom office to office.
So a good thing, we have aplatform for it now, but let's
(02:21):
start, in terms of tellingpeople, who you are and how you
got into what you're doing now?
Meenal Lele (02:27):
Well, yeah, let me, I guess by way of introduction,
I suppose many people think ofthemselves first and foremost as
like a food allergy parent,right?
That is really what drives thislived experience as a, as a
caregiver, is what drives a lotof the work that we do.
Where this all comes fromthough, is I have a long career
in, the medical industry, and Ithink that's a very different
(02:50):
perspective that I bring tothings.
Coming at it, not just as aparent.
But as someone who has builtsolutions and companies in
different aspects of medicine,so I have a dangerous amount of
information about how ourmedical system actually works.
And that is, you know, for thebetter and for the worse.
(03:10):
But when my son first got sick,you know, a lot of people really
think of things at that surfacelevel, which is obvious.
Like, oh, someone is sick, theyneed treatment, they need care.
And my brain immediately wentto.
All of the gaps in our systemthat were going to make that
really difficult.
Not just for him or not for usper se, but for everybody else.
(03:33):
And, one of the weird thingsabout becoming a parent, I
think, or at least for me, wasthat you in a way that you never
did before, you don't just careabout your own kid.
You become very, empathetic withall other parents and all other
children.
And so when.
When this happened to my son, mybrain was really going
(03:53):
immediately to, but what aboutthe kids that you know who won't
have a parent who is studyingthis stuff and who won't know
how to navigate the system?
How are we going to do somethingabout that?
Amanda Whitehouse, PhD (04:05):
Yeah, that's how I feel about what
you're saying.
I want to get everything and allthe information to all the kids
out there, you know, and so manyof them, like you said, will
have barriers.
To accessing the information andthe treatments and the
protection and testing and allof it.
Meenal Lele (04:19):
Yeah, absolutely.
And I think because as a parentyou make so many mistakes,
right?
Even when you're doing yourabsolute best, you make so many
mistakes and you just realizehow random life is and how by
just by sheer coincidence atcertain things work and certain
things don't, you know?
And so that even when we wannabe proud of ourselves for doing
(04:39):
the right thing, we realized alot of that was just chance.
Amanda Whitehouse, PhD (04:42):
Right and luck.
One of the things that comes tomind with that is what you and I
were talking about, in Albanywhen we were doing the advocacy
work how, some of it's chance,some of it was knowledge and
timing with both of us, ouroldest having food allergies and
then getting that LEAP studyinformation and our, our younger
kids not developing theallergies because we then had
learned about early introductionbut I look back on the initial
(05:04):
thing as like my mistakes andwhat I didn't know, and it's
hard to process all of that, Ithink.
Absolutely.
For someone who is not in themedical industry at all, that's
a very broad term, can you say alittle bit more about what kind
of work you were doing prior
Meenal Lele (05:17):
yeah, sure.
Um, through a random series ofevents.
Um, way back in 2008, I had beenon the founding team, or I was
on the founding team of anorthopedic company and we grew
that business, really quite big,and eventually sold it.
And then I left there to be thefirst employee of a vascular
medicine company.
(05:37):
So two actually very differentareas of medicine.
Orthopedics is kind of more ofa, it's in the hospital, but
there's a lot of privatepractice.
The vascular medicine is allhospital based.
Um, and then that companyeventually sold as well.
And the both companies when Ijoined were.
Still in, in infancy.
I mean, the, the first one wasliterally a napkin drawing at an
(05:58):
Italian restaurant.
And the, this, you know, thesecond one, they had prototypes
and other things, but it waspre-human use.
And so, you know, you put.
Like so many things in life, theend product is very different
than, you know, it hides all thestages.
Like you think even making acake, right?
You get this beautiful cakethat's presented and nobody sees
(06:21):
behind the kitchen at like theknives that were thrown at each
other, and the cake flour,that's everywhere and you know,
all the messes that happen.
Um, so you, you, we tend to onlysee the output product, not all
of the.
What had to happen to make thatpossible.
And so really, um, I got areally a, a front seat sort of
(06:41):
perspective, not only on whatdoes it take to bring products
to market, but how in, in the,in everything medical, the
doctors are largely yourcustomer.
And that's a very, verydifferent customer, um, with
very, very different needs thanwhen we think of a quote,
consumer product.
Doctors don't generally get tomake their own decisions, in
(07:03):
many ways, it's a veryconstricted market in that
there's all these constraintsabout payment, right?
So even when a doctor might wantto buy or.
Prescribe, let's say in thiscase, a drug.
They're very constrained by whatinsurance you have.
So you think it's the doctormaking the choice, but it's not,
it's some payer or it's thehospital system or, and in each
(07:25):
case there's all these bitsthat, that are coming together
and you almost have to, to besuccessful, you have to really
see that minefield ahead of timeand plan
Amanda Whitehouse, PhD (07:38):
your strategy through it.
I assume there are others too,the barriers that you were
talking about that you could seethat would lie ahead before you
even got started
Meenal Lele (07:47):
Yeah, absolutely.
Um, I mean the, the biggestbarrier as I actually was
talking to another founder justrecently, they wanted to start
another company that theirtarget market is infants.
I brought up that in the UnitedStates, 60% of infants are on
Medicaid and chip, and thisfounder didn't know that.
(08:07):
But that is such a fundamentalpiece of our system that again,
when we watch TV or we thinkabout consumer products, we're
really thinking about a verysmall sliver of the population
that has the cash and capital todo things and the education to
do things.
All sorts of different thingsagain, that, uh, work together.,
(08:31):
It depends on what kind ofproblem you're trying to solve,
right?
If you just wanna get a productto market that will be
profitable, you might be able todo that.
Just working with 5% of thepopulation, right?
There are, I don't, I don'tknow, hair salons and things
that work if you're, even, ifonly you know, a tiny group of
people is using them, and that'sfine.
(08:52):
Um, in medicine, specificallypreventative medicine.
Preventative medicine, that isalways a universal approach.
So if you're saying from theoutset that you want to do
something that by necessity hasto get to a hundred percent of
people, or realistically, 95%,let's say.
Well.
How will you do that?
(09:13):
Right now you're talking aboutmultiple disparate groups of
people with different needs anddifferent constraints, and so
you have to be thinking ahead oftime about what, and often
you're only allowed to come upwith one solution that has to
work for all of them.
So what does that look like andwhy?
You know, so we, um, so that wasthat.
(09:34):
I think that's just a verydifferent approach to this
market than, um, preventativemedicine is just a very
different beast than everythingelse.
Amanda Whitehouse, PhD (09:41):
Right.
Right.
And so the company is calledHanimune.
And you began with one branch,which is the direct to consumer
marketing of, of in earlyintroductions.
Lil'Mixins.
Allergens, right.
Sense?
Yeah.
So, so tell us why you decidedto start there, or was that the
original plan
Meenal Lele (09:56):
The original plan was always to do both sides, but
you gotta start somewhere.
You gotta do one thing rightbefore you can go get to do your
second thing.
And um, I started with Lil'Mixins'cause it was kind of the
easier one to start with.
It's a easier area in, in.
Some ways to get the ballrolling.
It's definitely the harder oneto succeed, but it's the easier
(10:18):
one to get started.
So we started there.
Amanda Whitehouse, PhD (10:21):
FDA approval and the, the whole
Exactly.
Meenal Lele (10:24):
Prevention fundamentally falls into a
category called dietarysupplements for foods, or it
can, uh, again, I think easy wayto think about it is, um,
prenatal vitamins, which arevitamins.
So they're dietary supplements.
They're not drugs.
They don't have FDA approvals.
And, uh, so similarly you can dosomething in this space'cause
(10:45):
that's really the most costeffective way to solve the
problem.
Um, so you can start there and,but our goal was really to build
and use that to eventually getto the treatment side because
not every child.
You know, we, we now in allergy,or they now in allergy, talk
about primary prevention, whichis the prevention we do with
(11:05):
infants in this universal.
Then there's something we calllike secondary prevention, which
is there's these kids thatdevelop allergy and infancy and
there's a, a thought processthat a specific kind of
intervention could kind of like,while their immune system is
still sort of deciding what todo, flip them back.
To tolerance,.
(11:25):
And then there's this idea of,you know, tertiary prevention
or, or really treatment at thatpoint.
Right.
Um, and so you kind of work yourway down, uh, work your way down
from easiest to hardesttechnically.
Amanda Whitehouse, PhD (11:37):
If people aren't familiar with Lil'
Mixins.
tell them exactly what theproduct is.
Meenal Lele (11:42):
Lil' Mixins is straightforward.
The top seven proteins really,we don't do wheat and milk
because those are already in theinfant diet.
But the other, seven proteinseven big proteins that babies
tend to develop allergies to.
They're in cost-effective,infant safe forms.
Just a concentrated protein.
(12:03):
And the idea is, you make itsuper simple for a parent to
make sure that a baby's eatingtwo grams of that protein in a
sitting.
So there's no thinking involved.
There's just, there's verylittle thinking involved.
And if you can do that in a waythat's, you know, again, cost
effective and easy to reproduce,we can get, more babies to do it
or parents to do it.
Amanda Whitehouse, PhD (12:21):
So they're just little packets,
little dried pouches that youliterally mix in, right?
That's exactly right.
Meenal Lele (12:25):
And, and for more, even more cost effective forms,
we sell them.
We also do these jar formfactors, so you can get almost
six months worth of servings ina single purchase in a single
jar, and then it becomes morecost effective.
Amanda Whitehouse, PhD (12:37):
Okay, so that is to help parents who want
to take advantage, who areeducated.
Hopefully it's becoming more andmore people that early
introductions is the, best wayto prevent allergens and make it
really easy and take thethinking out of it.
Speaker 3 (12:50):
Mm-hmm.
Meenal Lele (12:51):
That's absolutely right.
And the jar form factor, againwith really from the beginning,
because we said if insurance isever to pay for something, they
will not pay for multiplethings.
They will only pay for onething.
So then all of the stuff that aparent needs has to fit into one
thing.
And that was actually, a keydesign constraint.
(13:12):
Which, some parents appreciate,but if you're buying something
over the counter, most parentsreally want the convenience of
the packets.
But insurance will never coverthat.
So, you know, we separate, wehave to separate them because
you don't want it to be unusablewith a child that has one,
right?
So you have multiple jars.
So the, the way we broke it upis basically like peanut eggs
(13:33):
and then the tree nuts.
Amanda Whitehouse, PhD (13:34):
And those, those products are pretty
widely available and you canorder them online now.
Right.
Um, but you've got other thingsin the works.
So take us into that part that,that branch of the business and
where you're at with that.
Meenal Lele (13:46):
So food allergy treatment or all allergy really
is, the way we treat itfundamentally is we desensitize
someone to it.
There are many drugs that are indevelopment right now.
Most drugs, they work bychanging your immune system or
suppressing a piece of yourimmune system.
And so like with all, there isone maybe a lot of people are
familiar with and there's manyin development.
(14:09):
Allergy immunotherapy or theprocess of desensitization.
We are trying to get your immunesystem to stop producing
antibodies.
And the way our immune systemsare designed is that once we
have made this decision tocreate a kind of antibody
against a virus, a bacteria, aparasite, or you know, anything,
we do it forever.
(14:29):
And so this desensitizationprocess is trying to get your
body to rethink that decision,and we know it works.
So food allergies have beendesensitized for over a hundred
years, and many people withallergies also have
environmental allergies.
And so you know the process ofallergy shots is you start with
a little and you slowly increaseand you get your body to stop in
(14:51):
some sense, that's a little handweighty, but you get your body
to stop producing theantibodies.
And the question, the, the issuewith food allergy is that our
immune systems, to a largeextent, are actually in our GI
tract.
And so when we ingest antigensthe foods, we get these very
violent responses And foodallergy can be really dangerous
(15:14):
because of the amount or the, Iguess the number of immune cells
that are involved in variousthings that.
You know, we don't need to getinto, and again, I, forgive me,
I'm really hand waving over alot of things.
So whenever you have doctorslistening, they're gonna be
like, well, that's nottechnically correct, but we're
hand waving here.
So in any case, what we havebeen trying to do is figure out
how to solve the problem of thesafety side of it.
(15:37):
And so we're not fundamentallytrying to do anything different.
We're not trying to say that.
It creates a magical new way ofdesensitization,
desensitization.
Fundamentally, you start with alittle, you get add more and
more until your body changes.
Its your immune system changesits mind.
What we're trying to figure outis how can we get the body to
make that decision with as fewside effects as possible.
(16:01):
One way people now do that isthey suppress their immune
system during desensitizationwith Xolair.
And that in clinical trials hasshown a bunch of, uh, promise.
Our thought process, um, from anengineering perspective was to
say, well, what if we playedaround with the antigen itself?
Is there a way that we could getthe, we could change the antigen
(16:23):
so the body would accept it inorder to use it?
For this purpose of creatingtolerance but not react to it.
And so, um, we've started thisline of proteins called Top nine
Proteins.
Um, they're all still reallysupplements and so they are.
(16:44):
The proteins, the, you know,the, the food proteins.
And in some cases they, um,they're really how, again, it's
all about how it's beingpresented to the immune system.
So we're not saying that they'renot a peanut anymore, right.
It still is fundamentally apeanut.
But we're messing around alittle bit with the, the
delivery mechanisms and kind ofthe form factor to some extent
(17:06):
of the, proteins themselves sothat it gives doctors some kinds
of, basically some options.
Each patient, their differentlevels of severity and different
levels of, and different needs,right?
Like some of, some of our kidsmight want tolerance, some might
just want some protection,different goals.
And so right now, if you justhave a peanut, you don't get to
(17:28):
choose, right?
You just, you have a whole bunchof kids with different goals and
different needs, and you justgot this one peanut.
And so really what we're tryingto do is make these peanuts on
some level available indifferent ways so that it allows
the doctor and the patient todecide what do they need and
what do they want for thepresentation of that peanut.
And that, that allows hopefully.
(17:50):
The doctor to practice their,their therapy of, food allergy
in a way that works for thepatient.
It is not a treatment for foodallergy.
It is a peanut that is presentedin a different way
Amanda Whitehouse, PhD (18:01):
My brain is taking me to.
All of the people that you musthave on your team in order to do
this.
I have no concept of what itmust take on the science end to
do what you're doing then to beall of these foods because
they're, they're just foods,right?
There's the peanut is still apeanut.
Is it way too much for us tograsp or is there a way to
explain it like we'rekindergartners
Meenal Lele (18:23):
It takes a lot of people and a lot we work with
dozens, dozens of people with,at the company.
'cause each person brings aspecific skill in that you would
need for, you know, to solve aspecific problem.
But when I'm talking aboutpresentation, you have different
kinds of immune cells in yourmouth, for example, than you
(18:46):
have in your esophagus and youhave in your gut.
And what we want to do is youcan take a peanut protein, for
example, and you can put it incertain kinds of liquids, and
that will cause the protein toopen in a way that allows it to
(19:07):
interact.
With immune cells in the mouth.
And that is different than theway it would be if you were to
eat it.
'cause remember, when we eatfood, it actually gets digested
by our gut, the acids in ourgut, and, and then when it's
presented to the cells in theintestines and so on, it's
(19:29):
presented in a different formfactor.
Another thing we can do with thepeanut proteins is almost.
A way to think of it is likepredigesting it.
So if you can take a peanutprotein and predigests it in the
way that a person who did nothave allergy would predigests it
(19:51):
before it got to the immunecells, of the intestines, you
can change the immune reactionthat will happen when that
protein.
Gets to the, the lower intestineor the upper intestine.
And it's weird because it's not,not a peanut, it's still the
same peanut.
It's really just, you can dosome minor chemical processes on
(20:14):
it, that sort of, yeah, for lackof better term, I think is maybe
like predigestion is the easiestway to think of it.
And we have found that when the,it is predigested in this way,
it limits the immune responsethat happens to that protein.
having food allergies, not justabout the immune cells.
(20:36):
There's a growing understanding.
Large reason people have foodallergy is that their gut
linings, Is different.
And that's why there's otherfolks that are kind of seeking
microbial treatments likemicrobiome treatments.
That would also affect digestionand things like that.
So again, most people when theythink of food allergy, you think
about the human.
(20:57):
You think, well, what can I doto change how they react to the,
peanut?
And we've just sort of thisquestion of saying, well, how
can I change the peanut tochange how the human will
interact with it?
Amanda Whitehouse, PhD (21:12):
This is fascinating to me.
So the output then, once you doall these chemical processes to
whatever the food is, let'scontinue with the peanut.
Is it, is it a powdered form o fthe peanut that has undergone
this chemical process, what'sthe actual product going to be?
Meenal Lele (21:28):
Yeah, in that case of the, the sort of predigested
forms, and we call, kind of callthem hypoallergenic forms of
these proteins.
'cause again, what we've done isremove those epitopes.
And I, I can explain that in asecond.
Yes, they are powders.
And they're powders largelybecause that's a way to stop the
chemical reaction basically isif you dry out something and
(21:51):
powder it, dehydrate it, you canend the chemical process.
And so it keeps it, it keeps itstable at that point.
Mm-hmm.
Um, and things in liquid becauseof water or anything that it's
dissolved into is a chemicaltoo, right?
Mm-hmm.
So it, there, there's constantlya chemical reaction happening
when anything's in a liquidform.
And so a dry form is stable.
(22:11):
One of the things that we'redoing, as I said, when you're
sort of predigesting it, orwhatnot, is you change the
protein structure in a personwho has an allergy antibodies
bind to specific points on thepeanut.
If you remember the COVID,virus, the spike protein is the
point where our immune systemswould sort of bind to that.
(22:31):
Virus.
Virus is a whole big thing,right?
But we really bind the one spot,one type of protein on that
whole virus.
And so when we were coming upwith drugs and everything, it
was all about that point where,how do we change that action at
that point?
And so food is really similar inthe sense that.
There, there are technically aninfinite number of points on
(22:55):
this food, protein one ourimmune systems could bind to,
but they actually really onlybind to specific points.
And if you remove some of thosespecific points, not all of
them, you can make it so thatyour immune system almost
doesn't recognize the proteinand so it doesn't realize to
mount an immune response againstit.
And again, that is really what.
(23:15):
Many healthy people do is they,they take, when we ingest food
that we're not allergic to, wealter it so that it, by through
our digestion, we alter thosefoods so that our bodies know
not to react to them.
And that is fundamentally inmany ways how our body knows
what, what is a dangerous foodand what is not.
(23:36):
If you think about it.
Your gut It's a closed like bag.
There's like a tube going fromyour mouth down, your system,
right?
And it's a closed system.
And all this stuff has to happeninside of this bag.
And then finally, when it'sbroken down enough, these
molecules cross our gut barrierinto our bloodstream.
And only when they're in ourbloodstream can they be utilized
by all of our cells and movearound through our system.
(23:59):
Right?
But.
The form that a food is in whenit crosses, or a form that
anything is in, and when itcrosses, really determines how
our immune system responds toit.
The things we've been messingaround with is how can we change
that food protein?
Or, or shift it slightly so thatwhen it crosses the barrier for
(24:19):
people with allergy, it's doingso in a way that seems benign to
that person.
Amanda Whitehouse, PhD (24:24):
To help people connect with this, I
think the term that people willunderstand when they're talking
about proteins entering the bodywhen they shouldn't, right.
The way the gut works is itbreaks those down, but that's
when we start talking aboutLeaky gut, right.
Proteins entering directly intothe body when they shouldn't be
through the gut.
Meenal Lele (24:41):
Yeah.
Leaky gut is a.
Hand, wavy term, that means Ithink different things from
different people.
It is a real phenomenon, but Ithink there's a lot of argument
there because many people,again, are just just talking
about different things when theyuse that term.
But let's take the extremeversion of it where you
literally had holes in your gutand whole proteins were just
(25:03):
floating across the barrier andthey're completely intact.
Whole form, right?
Like that would be a very trulyleaky gut with like just no
processing happening inside thegut.
And in that case you have immunecells immediately.
Anything that crosses the gutall the time, like all the stuff
that we agree to not fight.
Mm-hmm.
Our immune system binds to itand then the immune system has
(25:25):
to basically like look forsignals on it.
It looks for two differentsignals.
It looks for, is this somethingmy own body made and does it
have specific.
Combinations of things and, andthen it takes that and it
presents it and says, this iswhat I think this thing is.
(25:46):
And then our immune system fromthere decides what to do, like
attack it or not.
Right?
In the case of a whole intactprotein, again, that extreme
example, it would almost alwayssay like the combination of
factors would be there for theimmune system to present it to
the remaining immune cells, likeT cells.
Mm-hmm.
And say, Hey, this is adangerous thing.
But what I'm talking about a isa little bit different in that,
(26:11):
when we have different bacteriain our, in our mouths, in our
esophagus, and, you know,through our gut, we break down
the proteins and different acidsand so they create these
peptides and, um, but thepeptides, again, the peptides
are, are portions of theprotein.
So that that idea of splitting aprotein is called cleaving it
(26:32):
and where the protein getscleaved and, um.
How many chunks are created,kind of change based on which
bacteria, um, are doing it.
How thick your mucus is canchange how long it's sitting in
the acid.
So how, how much, like, youknow, like a long laundry cycle
or a short laundry cycle, right?
Mm-hmm.
A long cycle you're gonna getmore of the dirt off kind of
(26:55):
thing, right?
We tell everyone, you know,you're supposed to chew 26
times, which I can't even do,but you're supposed to like chew
26 times before you swallow,right?
Same ideas, like, it's like howmuch is it breaking down, um,
before it continues through.
Mm-hmm.
And so, so again, all of thesethings are interrelated but at
the end of the day, what'shappening is that stuff is
crossing the barrier.
And then based on the structureand size and exactly where it
(27:19):
was cleaved, so which peptidechains are passed across to the,
immune cells.
I'm trying not to overcomplicateit, it's just complicated.
You're not over complicated.
It's com it's just complicated,right?
It's like not a straightforwardanswer, you know, I, I think
people want it to be astraightforward analogy and
it's, it's just not that simple.
But, um.
But those are some kind of basicideas.
(27:39):
The, the basic fundamental thingis that like what many things
can change, what gets passedacross.
Also many things can change, youknow, what is the state of the
immune cells, like how triggerhappy are they and things like
that.
As they're, you know, as they'remaking this decision.
And, and that's a real piece ofit actually is like, you know,
we talk about inflammation.
And inflammation in a broadsense can be a little bit like
(28:02):
how biased is your immune systemto.
Being aggressive versus not.
And again, that's like really ametaphor, but um.
But it, but it's not totallywrong.
Um, I think, and so when peopleare in a state of high
inflammation and the same exactinformation is presented, it's
like, it's like when you'rehungry, you know?
(28:23):
Mm-hmm.
And someone says something toyou, you might have a very angry
response as opposed to if youwere like, well sated, then you
can deal with it calmly.
Right.
Um, we have hang Exactly.
Yeah.
So sometimes our immune
Amanda Whitehouse, PhD (28:33):
systems get hangry.
That kind of leads us into oneof the things that you and I
were so excitedly talking about.
Obviously this is all tied to.
Our gut health, which is a verycomplicated process.
It's not as simple as peoplethink I'm gonna go take a bunch
of probiotics.
Right.
It, it's not that simple.
But you and I were taking thatconversation into how this
connects to our mental health aswell.
(28:55):
So again, I know it's not assimple process, but what do you
want people to understand abouthow this all ties together in
terms of, of that piece ofthings and the role of gut
health in our mental health andwellbeing.
Meenal Lele (29:08):
Well, I would say more simply, there's two pieces
to it.
One is that if your gut is notin good health, then the
probability that you are passingthe wrong things across the
barrier, or that they're gettingpassed across the barrier and
you're making your immune systemis making the wrong choices, if
you will, um, that thatprobability is higher, right?
Mm-hmm.
(29:28):
So, it seems pretty clear that.
Even in a person who has foodallergy, if you were able to
truly improve their gut healthalone, you would make that
process of desensitizationpotentially much easier and, and
have fewer side effects.
So that's one piece of it.
Second piece of it is, again.
It's super complex.
I'm not pretending to understandit.
(29:49):
Um, but we know that the stateof our, again, broadly gut
health affects our mental state.
Mm-hmm.
But it's important tounderstand, I think that we
forget it's bidirectional,right?
It's an axis,
Amanda Whitehouse, PhD (30:01):
it's a gut brain axis.
Yes.
Meenal Lele (30:02):
Yeah.
Yes.
And so people tend to thinklike, okay, in that, the way
that's easy for me to understandis like when my stomach is
upset, if I've eaten something,I'm not in a good mood.
But it also works the other waythat if you're mentally not in a
good place, your gut isn't in agood place.
And so that goes back to pointone, which is if your brain can
almost like make your gutleakier.
(30:23):
Right.
Um, and then, then you're gonnado worse with treatment or
you're gonna be more likely toreact even if you're not in
treatment.
Right?
So it, I think it's just such awild, complex system, um, or
interacting set of, of systems,um, that, that the people are
working really, really hard tounderstand today.
And I don't think we understandcompletely, but in that broad
(30:43):
sense, in that, in those broadstroke sense, we know those
things to be true.
And so without.
Really understanding themechanisms of any of this.
We can broadly say that if therewere a way to have ourselves in
better gut health and in abetter mental state, those were,
those would both befundamentally a better place
Amanda Whitehouse, PhD (31:02):
from which to start treatment.
Right?
It's so complex.
I think people feel overwhelmedwith, not knowing what to do
with it or where to go when,when they know it's a thing.
We hear about it all the time.
But I think what you're sayingis, what I want people to
understand too is that it's aholistic process.
Meenal Lele (31:19):
I'll give you this.
I think there's this reallyfascinating just because We
talked to a lot of doctors doingclinical trials.
Speaker 3 (31:25):
Mm-hmm.
Meenal Lele (31:25):
And so this concept, you know, doing an oral
food challenge and we often doblinded food challenges.
And so when somebody hasmultiple food allergies, let's
say you had three foodallergies, right?
Egg, milk, peanut, the way theymight do the challenges actually
have, you do four challenges andyou don't know which what, so
you don't know if today you'rehaving egg, milk, peanut or
placebo.
The fascinating thing is if youtake.
People like this, children, andmany of these studies are done
(31:48):
in children.
The rate at which people reactto the placebo is way higher
than you'd think.
Wow.
And that which really speaks tothe fact that like, so then
you're like, what is that?
Is that anaphylaxis?
Like that's clearly just acompletely psychological
response, right?
Because they're eating somethinglike tapioca starch or oat flour
that they're not allergic to.
(32:09):
And so, but they're clearlyanaphylax, so Right, right.
Real physical symptoms.
Exactly.
So what is that?
And, and so when you're goingthrough treatment.
That's really an open question.
On any given day, you have areaction or at the baseline,
like are you that sensitive orare you that sensitive just
because
Amanda Whitehouse, PhD (32:26):
you're nervous?
Speaker 3 (32:27):
Mm-hmm.
Amanda Whitehouse, PhD (32:28):
Or are you that nervous because you're
that sensitive and it's a spiralthat keeps widening and, and
getting bigger and more intense.
Right.
Totally.
It could be a.
Crazy negative feedback loop.
Yeah.
But it's so hard for people tobreak through that because then
when they hear, oh, well if, ifit's just anxiety, either you're
saying, my reaction isn't real,or I can't just stop being
(32:48):
anxious about it.
Right?
It's not that simple.
I believe you.
I know it's a part of it, but Ican't just stop.
Meenal Lele (32:53):
It's a real thing.
Like I will fully admit to likebeing terrified to go in the
basement at night, right?
Mm-hmm.
I'm a grown person and there'sno one in my basement, and like,
it doesn't matter that I cycle,I, I intellectually understand
that there's nothing in thebasement that's going to get me.
And like sometimes you cannotmake yourself go down those
stairs.
Amanda Whitehouse, PhD (33:13):
Right.
And that's without, I assume, Imean, I could be wrong, but I
don't think you've ever had atraumatic experience or actually
been in danger or harmed in abasement before.
Meenal Lele (33:22):
Right?
No.
No.
And if like, if I needed to gointo the basement, I could,
right.
But I'm just like sitting thereat night or something, you know?
And like if my husband's nothome and I'm a little bit like,
you know, you kind of do thesetrade offs.
They're like, well.
I know there's no one in thebasement, but what if there were
Amanda Whitehouse, PhD (33:38):
Right.
And it's very real.
And I, I just think that's sucha good example because then take
someone, take our kids or, orother people with food allergies
who've had genuinely.
A really scary, very dangerousreaction to something to, to try
to fix that anxiety when it's sohard.
Even just to like, I have thisanxiety about the basement
that's not even really based ona trauma right.
(33:59):
To exactly.
To try to tease out a real truedanger and the anxiety that
follows is so complicated.
Meenal Lele (34:06):
It's really, really hard.
And you, and again, we weretalking about this, that the
crazy thing about food allergyanxiety is that it's not
irrational.
It's every reaction our childrenhave had has been some random
accident.
So it's like a completelyrational fear actually.
So then how do you deal withrational fears?
(34:27):
And this is, you know.
Same thing, like the hardestI've, I've read somewhere that
like the hardest fears to sortof, um, phobias to like work
through are like phobias ofsnakes and spiders and stuff
because they're like deeplyingrained in us and that they're
rational fears.
Like those things do kill you.
Amanda Whitehouse, PhD (34:44):
Yeah.
And, and it's true.
I mean, I'll, I'll speak to thatfrom my work that it is true and
it takes a different, it takes adifferent approach.
You and I could work on talkingthrough whatever's feels scary
about the basement and, and, andwork through it because it's
Right.
There's a, there's an unhelpfulthought process that's happening
around it versus a true actualrisk.
Um, yeah, I think, I think itleaves us, and not just the
(35:05):
people who've experienced it,but us as parents of, of kids
who've had that happen too,
Meenal Lele (35:09):
and I will say that that is really one, one of the
harder pieces of food allergytreatment as a whole, and I, I'm
speaking specifically about, youknow, in my own discussions with
the FDA or the company'sdiscussions is like, it's very
hard to tell sometimes we havethese high false positive rates
of the placebo, but also like.
(35:31):
Why a treatment doesn't work forevery person.
Right?
Because it's really hard,because a lot of people, you
might almost need to give them akind of like, not, it's not a,
placebo isn't the right word,but like a, um.
A less good treatment, a lessstrong treatment, almost to like
give their emotions a chance toget there.
(35:53):
You know, and I, I've, I'vetalked to many doctors who are
starting more and more withtrying to treat patients in this
very low dose way or usesublingual treatment or other
things.
We know that they don't work aswell as oral immunotherapy, but
oftentimes that's not the firstproblem that needs to be solved.
Speaker 3 (36:09):
Right.
Meenal Lele (36:10):
And, um, you know.
I'll give you the example ofspecifically of, so our own
doctor, we were talking to himabout this and he said, you
know, a lot of my patients whatI do, this sounds really crazy.
He's like, but I will treattheir environmental allergies
first.
And even though that delays thewhole process by like a year and
(36:30):
a half, but what it does is sortof build up the psychological
muscle that allergies aretreatable.
And when we start with somethingcompletely unrelated to their
food allergies, and you workthrough that and it kind of just
gets this person just moreaccepting of the idea that they
can have their allergiestreated.
And so then when you go twoyears later to try and treat the
(36:53):
first food allergy, they're justin a better emotional and
psychological place.
And that alone
Amanda Whitehouse, PhD (36:57):
makes it more successful.
Yeah.
And I would add on as apsychologist.
Now that person has trust inevery person in that facility
and the people they see in thewaiting room, in the space
there, in the routine of drivingto that office.
All of that createspsychological safety, which then
creates real physiologicalsafety We had a great doctor who
walked us through the process ina similar way We debated whether
to start with slit forenvironmental or just do
(37:18):
environmental shots because hethought the reactivity might
actually compromise the OIToutcomes.
And I said, if I have to bringhim here.
Every however often for a shot,we're gonna lose him.
He's not gonna buy in, and thenwe're not gonna be able to do
OIT.
And so he worked with us to doslit and it was really effective
for us for the environmentalallergies.
You're making a good point kindof, like you said about
different approaches with theway that you're, um.
(37:39):
Modifying the allergens, right?
We have to have differentapproaches for, for all
different needs, physiological,psychological, all of these
things are different factorsthat are important that don't
lend well to a clinical trialand clear results, but are
important in practice.
Right?
Meenal Lele (37:53):
Right.
In, in the real world, you needa whole grab bag of different
options because each person'sjourney, and even again, I go
back to this, like their goals,um.
The goals change over time also.
Speaker 3 (38:08):
Mm-hmm.
Also,
Meenal Lele (38:08):
right?
Like you could have someone whosays, well, you know, I just,
uh, I don't, I don't need to eatcashews, but I would love to be
protected.
But then they get a, a lotdesensitized to cashew and
suddenly, you know, then maybethe end doesn't look so insane.
And so now they, they changetheir goals.
Um, and that, that has to beokay because Until we get to
(38:30):
some again, until hopefullysomeone gets to some way deeper
root cause explanation or ununderstanding of how to treat,
uh, food allergy and just sortof eradicate it with a pill or
something.
Mm-hmm.
Without thinking about it, um,each person's journey is gonna
be different.
Amanda Whitehouse, (38:45):
Definitely.
Well, thank you for working sohard on something that's going
to add another really importantpiece to that grab bag of
options that we will have tochoose from.
I feel like there's so much morewe could talk about for so long,
but, why don't I let you tellpeople where they can find the
Lil' Mixins where, where theycan follow you if they're
curious
Meenal Lele (39:01):
yes, LIl' Mixins.
You can find, um, you know, attarget.com and on our website on
Amazon, like the usuals.
Mm-hmm.
Um, in the next couple years,more and more, um, pediatricians
will be able to prescribe themand along with other, um, early
allergen introduction mm-hmm.
Products to their patients.
And, um, as far as these sort ofaltered proteins, our, our goal
(39:24):
really is to.
Make sure doctors have access tothem.
Um, you know, like anything, itwould not be ideal for patients
to try and treat themselves.
And so, but, um, our goal thereis really to make sure that when
doctors want to offer differentthings to patients, they have
that, you know, again, just.
Harping on the peanut, they havethat peanut in different form
(39:45):
factors so that they're able touse it, um, the way they and the
patient decide is right.
So I think ho hopefully over thenext, you know, two to five
years, nothing in medicine goesfast.
More and more doctors will have,access, to those and the ability
to use them.
Definitely talk to your doctorabout it.
We work with a, a number ofacademic centers now and
hopefully get into more privatepractice soon.
Amanda Whitehouse, PhD (40:06):
Good.
Well, thank you for all of thatbecause it's really important
and it sounds like it takes aspecial person with a special
combination of experience andknowledge and background, like
you have to take on such aoverwhelming project.
Meenal Lele (40:19):
It is a, it is an overwhelming project and There
are a lot of patient advocates,and I feel what's interesting
about this,, entire journey hasbeen that these are patient
advocate solutions, right?
Mm-hmm.
Like if I, I'm, I'm approachinga lot of the problem of food
allergy, yes, from theperspective technically what has
to happen, But really you'retrying to solve the patient's
problem, which can be, again,one of convenience or cost or
(40:40):
psychological fear or somethingelse, right?
Which is generally not how,Products in the, in the medical
space are developed.
These are, these are realpatient advocacy solutions.
Amanda Whitehouse, PhD (40:50):
I love that we need so much more of
that and I'm glad that you're ontop of it.
Thanks.
Meenal Lele (40:55):
I think it sounds like, um, speaking of patient
advocacy, you and I might runinto each other again soon at in
some patient advocacy.
Conferences and things and Ilook forward to
Amanda Whitehouse, PhD (41:04):
talking to you more there.
Yeah.
Yeah.
I hope we keep, continue tocross paths, but thank you for
joining us here today and we'llkeep people posted on your work
in the future as it progresses.
Awesome.
Thank you so
Meenal Lele (41:13):
much for having me.
It was so interesting for me tomeet Meenal and to talk to her
here on the show and hear aboutthe work she's doing to make
food allergy prevention andtreatment safer, more effective,
and more inclusive.
So if today's conversationresonated with you or sparked
curiosity, here are three actionsteps you can take to follow up
on what you've learned.
Number one, Learn more aboutearly allergen introduction by
(41:36):
checking out Lil Mixins website,www.lilmixins.com.
Or you can find them onInstagram at Lil Mixins.
And you can also search onlinefor the guide that was created
by food allergy prevention.organd FARE called Preventing Food
Allergies in Infants.
And I'll put the link to that inthe show notes as well.
(41:58):
Number two, I'm such a badpodcast host.
I had so much I wanted to askMele that I didn't even get to
talking about her book, the Babyand the Biome during the
episode, but I highly recommendit.
I know many of you are reallyinterested in all of this
research that's unfolding aboutthe connection between gut
microbiome, allergies, mentalhealth and wellness overall, and
this is a wonderful resource foryou to check out about that.
(42:20):
It's available wherever you buybooks, and it's linked in the
show notes.
And number three, if you havequestions about how the topics
that we talked about today applyto you specifically, I want to
encourage you to talk to yourhealthcare team about them.
There's so much information outthere, more and more coming out
every day, and there's still alot of conflicting information
that people are getting aboutearly introduction of food
(42:42):
allergens and the benefits ofit.
It's potential for decreasingthe incidence of food allergies
and about immunotherapy, how itworks, who's a candidate for it.
Obviously all of these areindividual questions for you to
ask your doctor, but I do hopethat this conversation has
gotten you thinking about them.
Thank you for being here., Ifyou're enjoying the show, please
don't forget to subscribe andgive me a rating or leave a
(43:03):
review if you're finding ithelpful.
the content of this podcast isfor informational and
educational purposes only, andis not a substitute for
professional medical or mentalhealth advice, diagnosis, or
treatment.
If you have any questions aboutyour own medical experience or
mental health needs, pleaseconsult a professional.
I'm Dr.
Amanda Whitehouse.
(43:24):
Thanks for joining me.
And until we chat again,remember don't feed the fear.
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