Research Scope

An overview of research focus

The Immunology and Allergy subspecialty in this Department has been in operation since January 1999.  This specialty consists of inpatient and daycare services as well as outpatient clinics, and accepts referral from both public and private sectors throughout the whole territory.  This specialty was the first to set up dedicated and comprehensive outpatient service for childhood asthma and allergy among Hospital Authority hospitals in Hong Kong.

Allergic diseases are among the commonest chronic diseases in children.  Our research team has a long track record in childhood asthma and allergy research.  We reported that one-third of local schoolchildren suffer from some form of allergies such as asthma, allergic rhinitis, eczema and food allergy.  About 20-30% of patients in general paediatric clinics of the Prince of Wales Hospital are followed for allergies.

Over 1,000 children were offered some forms of allergy investigations or treatments, including skin prick and intradermal tests, in vitro allergy diagnostics, food and drug provocations and allergen immunotherapy in the Paediatric Allergy Clinic since our specialty started in 1999.

Clinical Services

This subspecialty provides standard airway monitoring modalities such as peak expiratory flow and spirometric measurements to children with asthma.  We also offer pioneering services on the following respiratory investigations in Hong Kong:

Introduced exhaled nitric oxide measurement (since 2001) by online chemiluminescent analyser as a non-invasive assessment tool for airway inflammation.

Established reference standards for lung function in Chinese preschool children by incentive spirometry (in 2010).

This subspecialty also accepts territory-wide referral for infants, children and adolescents with recurrent or unusual infections or who are otherwise suspected to have immune deficiency or dysregulation.  Our service works closely with the Haematology and Oncology subspecialty of our Department in performing haematopoietic stem cell transplantation for patients with severe primary immunodeficiency diseases, and offers targeted therapies such as intravenous immunoglobulin infusion to those with significant humoral immunodeficiency.

Infectious Disease

Provide infectious disease consultation service to Department of Paediatrics, Prince of Wales Hospital, the Chinese University of Hong Kong which is the only tertiary paediatric unit providing haematopoietic stem cell transplant, paediatric oncology, neonatal and general paediatric services in New Territories East region

A list of research topics

• Epidemiology of childhood asthma and allergy

• Genetics, genomics and gene-environment interaction of asthma and allergy

• Genetic epidemiology in the Chinese population

• Non-invasive diagnostics and monitoring of airway inflammation Emerging respiratory tract infections

• Microbiome at various body sites and interactions between host immunity and respiratory viral and bacterial pathogens

Selected publications 

Allergy and Immunology

1. Wai CYY, Leung NYH, Leung ASY, Ngai SM, Pacharn P, Yau YS, Rosa Duque JS, Kwan YW, Jirapongsananuruk O, Chan WH, Chua GT, Lee QU, Piboonpocanun S, Ho PK, Wong JSC, Li S, Xu KJ, Wong GWK, Chu KH, Leung PSC, Vichyanond P, Leung TF. Comprehending the allergen repertoire of shrimp for precision molecular diagnosis of shrimp allergy. Allergy 2022;77:3041-3051.

2. Xing Y, Wang MH, Leung TF, Wong CK, Roponen M, Schaub B, Li J, Wong GWK. Poultry exposure and environmental protection against asthma in rural children. Allergy 2022;77:2949-2960.

3. Wai CYY, Leung NYH, Leung ASY, Shum Y, Leung PS, Chu KH, Kwan YW, Lee QU, Wong JS, Lam IC, Li PF, Xu KJ, Lam CY, Sun JL, Wong GWK, Leung TF. Cell-based functional IgE assays are superior to conventional allergy tests for shrimp allergy diagnosis. J Allergy Clin Immunol Pract 2021;9:236-244.

4. Li J, Ogorodova LM, Mahesh PA, Wang MH, Fedorova OS, Leung TF, Fernandez-Rivas M, Clare Mills EN, Potts J, Kummeling I, Versteeg SA, van Ree R, Yazdanbakhsh M, Burney PG, Wong GWK. Comparative study of food allergies in children from China, India and Russia: The EuroPrevall-INCO surveys. J Allergy Clin Immunol Pract 2020;8:1349-1359.

5. Leung ASY, Leung NYH, Wai CYY, Xu KJ, Lam MC, Shum Y, Lee TH, Ho MH, Rosa Duque JS, Chua GT, Yau YS, Chan WH, Ho PK, Wong GWK, Leung TF. Characteristics of Chinese fish-allergic patients: findings from double-blind placebo-controlled food challenges. J Allergy Clin Immunol Pract 2020;8:2098-2100.

6. Leung ASY, Wong GWK, Tang MLK. Food allergy in the developing world. J Allergy Clin Immunol 2018;141:76-78.

7. Natsume O, Kabashima S, Nakazato J, Yamamoto-Hanada K, Narita M, Kondo M, Saito M, Kishino A, Takimoto T, Inoue E, Tang J, Kido H, Wong GWK, Matsumoto K, Saito H, Ohya Y; PETIT Study Team. Two-step egg introduction for prevention of egg allergy in high-risk infants with eczema (PETIT): a randomised, double-blind, placebo-controlled trial. Lancet 2017;389:276-286.

8. Wang SS, Hon KL, Kong AP, Tang MF, Sy HY, Chan JC, Leung TF. Eczema phenotypes are associated with multiple vitamin D pathway genes in Chinese children. Allergy 2014;69:118-124.

9. Leung TF, Ko FW, Sy HY, Tsui SKW, Wong GW. Differences in asthma genetics between Chinese and other populations. J Allergy Clin Immunol 2014;133:42-48.

10. Wong GWK, Brunekreef B, Ellwood P, Anderson HR, Asher MI, Crane J, Lai CK; ISAAC Phase Three Study Group. Cooking fuels and prevalence of asthma: a global analysis of phase three of the International Study of Asthma and Allergies in Childhood (ISAAC). Lancet Respir Med 2013;1:386-394.

Infectious Diseases/Microbiology/Vaccinology

1. Hou J-P, Song YP, Leung ASY, Tang MF, Shi M, Wang EY, Tsun JG, Chan RW, Wong GWK, Tsui SK, Leung TF. Temporal dynamics of the nasopharyngeal microbiome and its relationship with childhood asthma exacerbation. Microbiol Spectr 2022;10:e0012922.

2. Wan Y, Zuo T, Xu Z, Zhang F, Zhan H, Chan DF, Leung TF, Yeoh YK, Chan FKL, Chan RS, Ng SC. Underdevelopment of the gut microbiota and bacteria species as non-invasive markers of prediction in children with autism spectrum disorder. Gut 2022;71:910-918.

3. Lau YL, Leung TF, Cetin BS, Dinleyici EC, Huang LM, Halperin S, Hsiao CC, Tapiero B, Tipton M, Campbell JD, Moerman L, Povey M, Bi D, Singh T, on behalf of the Rota-096 Study Group. Safety and reactogenicity of a liquid formulation of human rotavirus vaccine (porcine circovirus-free): A phase III, observer-blind, randomized, multi-country study. Vaccine 2022;40:2184-2190.

4. Song YP, Hou JP, Kwok JS, Weng HY, Tang MF, Wang MH, Leung ASY, Tao KP, Wong GWK, Chan WY, Tsui SKW, Leung TF. Whole-genome shotgun sequencing for nasopharyngeal microbiome in pre-school children with recurrent wheezing. Front Microbiol 2022;12:792556.

5. Li F, Li YY, Liu MJ, Fang LQ, Dean NE, Wong GWK, Yang XB, Longini I, Halloran ME, Wang HJ, Liu PL, Pang YH, Yan YQ, Liu S, Xia W, Lu XX, Liu Q, Yang Y, Xu SQ. Household transmission of SARS-CoV-2 and risk factors for susceptibility and infectivity in Wuhan: a retrospective observational study. Lancet Infect Dis 2021;21:617-628.

6. Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, Zhang W, Wang Y, Bao S, Li Y, Wu C, Liu H, Liu D, Shao J, Peng X, Yang Y, Liu Z, Xiang Y, Zhang F, Silva RM, Pinkerton KE, Shen K, Xiao H, Xu S, Wong GWK; Chinese Pediatric Novel Coronavirus Study Team. SARS-CoV-2 infection in children. N Engl J Med 2020;382:1663-1665.

7. Yau JWK, Hou JP, Tsui SK, Leung TF, Cheng NS, Yam JC, Kam KW, Vishal J, Hon KL. Characterization of ocular and nasopharyngeal microbiome in allergic rhinoconjunctivitis. Pediatr Allergy Immunol 2019;30:624-631.

8. Leung TF, Liu AP, Lim FS, Thollot F, Oh HML, Lee BW, Rombo L, Tan NC, Rouzier R, De Simoni S, Suryakiran P, Hezareh M, Thomas F, Folschweiller N, Struyf F. Comparative immunogenicity and safety of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine and 4vHPV vaccine administered according to two- or three-dose schedules in girls aged 9-14 years: Results to month 36 from a randomized trial. Vaccine 2018;36:98-106.

9. Leung TF, Chan RW, Kwok A, Ho WC, Tao MK, Hon KL, Cheng FW, Li AM, Chan PK. School-based surveillance for influenza vaccine effectiveness during 2014-15 seasons in Hong Kong. Influenza Other Respir Viruses 2017;11:319-327.

10. Tang MF, Sy HY, KwokJS, Tam WH, HonKL, Tung CK, Wong GWK, Tsui SK, Leung TF. Eczema susceptibility and composition of faecal microbiota at 4 weeks of age: a pilot study in Chinese infants. Br J Dermatol 2016;174:898-900.

Grants (Infectious Disease)

1. Study title: Effects of different cooking treatments on allergenicity of tree nuts

Funding source: Hong Kong Institute of Allergy Research Grant 2022

Study period: Jul 2023 to Jun 2024

2. Study title: Development and validation of recipes for double-blinded placebo-controlled food challenge with fish

Funding source: Hong Kong Institute of Allergy Research Grant 2021

Study period: Jun 2021 to May 2022

3. Study title: Hong Kong Institute of Allergy Research Grant 2021

Funding source: Characterization of oligosaccharides and microbiota in breast milk from Chinese mothers

Study period: Aug 2021 to Jul 2022

4. Study title: Diagnostic algorithms for histamine intolerance and IgE-mediated seafood allergy among patients with history of adverse food reactions to seafood

Funding source: Food and Health Bureau - Health and Medical Research Fund

Study period: July 2022 to Dec 2024

Reference number: 09202866

5. Study title: Longitudinal time-trend prevalence of adverse food reaction in Hong Kong preschool children

Funding source: Hong Kong Institute of Allergy Research Grant 2020

Study period: Sep 2020 to Feb 2022

6. Study title: Influences of maternal and neonatal microbiota on eczema development in Hong Kong infants

Funding source: Hong Kong Institute of Allergy Research Grant 2020

Study period: Nov 2020 to Oct 2021

7. Study title: Molecular diagnostics for grass carp and salmon allergy

Funding source: Food and Health Bureau - Health and Medical Research Fund

Study period: Nov 2021 to Apr 2024

Reference number: 08191356

8. Study title: Clinical significance in cross-allergenicity between seawater and freshwater shrimp species in shrimp-allergic patients

Funding source: Food and Health Bureau - Health and Medical Research Fund

Study period: Nov 2021 to Apr 2024

Reference number: 08191436

9. Study title: Immune protection against asthma in a rural environment

Funding source: RGC General Research Fund

Study period: Jan 2021 to Dec 2022

Reference number: 14119320

10. Study title: Novel therapeutic options for common non-communicable diseases in Hong Kong children

Funding source: Commissioned Paediatric Research at Hong Kong Children’s Hospital of Health and Medical Research Fund, Food and Health Bureau (PR-CUHK-3)

Study period: 1 Jul 2021 to 30 Jun 2024

11. Study title: Characterize shrimp allergy and histamine intolerance by double-blind placebo-controlled food challenges

Funding source: Hong Kong Institute of Allergy Research Grant 2019

Study period: Jan 2020 to Dec 2020

12. Study title: Mechanisms of transgenerational influence of ambient pollutants: The Air Pollution Particles in Placenta (APPIP) study

Funding source: Hong Kong Institute of Allergy Research Grant 2019

Study period: Aug 2019 to Jul 2020

13. Study title: Innovative diagnosis and treatment for shrimp allergy

Funding source: RGC Research Impact Fund

Study period: 1 Jun 2020 to 31 May 2025

Reference number: R4035-19F

14. Study title: An integrated omics study of the gut microbiome in infantile food allergy

Funding source: Food and Health Bureau - Health and Medical Research Fund

Study period: 10 Nov 2020 to 9 Nov 2023

Reference number: 07180886

15. Study title: Can early-life airway microbiota be predictive of recurrent wheeze in preschool years?

Funding source: Hong Kong Institute of Allergy Research Grant 2018

Study period: Sep 2018 to Aug 2020

16. Study title: Generation of a comprehensive shrimp allergen panel for component-resolved diagnosis of shrimp allergy

Funding source: Food and Health Bureau - Health and Medical Research Fund

Study period: Sep 2019 to Apr 2022

Reference number: 06170856

17. Study title: A birth cohort study on predictive skin microbial signatures for eczema

Funding source: Food and Health Bureau - Health and Medical Research Fund

Study period: Sep 2019 to Feb 2023

Reference number: 06170466

18. Study title: Timing of solids introduction in Hong Kong children: is early introduction better?

Funding source: Food and Health Bureau - Health and Medical Research Fund Research Fellowship Scheme 2017/2018

Study period: 28 Aug 2019 to 27 Feb 2022

Reference number: 0418004

19. Study title: Hypoallergen-encoding DNA vaccine for the treatment of shellfish allergy

Funding source: AXA Research Fund - Postdoctoral Fellowship 2017

Study period: Sep 2017 to Aug 2019

20. Study title: Clinical value of component-resolved diagnostics in shellfish-allergic patients

Funding source: Hong Kong Institute of Allergy Research Grant 2017

Study period: Jan 2018 to Dec 2018

21. Study title: Interactive effects between rhinovirus infection and aeroallergen exposure for childhood asthma exacerbations

Funding source: Hong Kong Institute of Allergy Research Grant 2017

Study period: Jan 2018 to Jun 2019

22. Study title: Novel laboratory approach for fish allergy diagnosis

Funding source: Innovation and Technology Fund 2017 under the Innovation and Technology Support Programme (Tier 3)

Study period: Feb 2018 to May 2019

Reference number: ITS/082/17

23. Study title: Diagnostic utility of different allergen components for IgE-mediated allergy to freshwater and seawater fishes

Funding source: Hong Kong Institute of Allergy Research Grant 2016

Study period: 1 Jul 2016 to 30 Jun 2017

24. Study title: Multi-centre analysis of immune-regulatory mechanisms that protect from childhood asthma in distinct rural environments

Funding source: European Union Trilateral China-Finland-Germany Research Grant - National Natural Science Foundation of China International Collaborative Project

Study period: Sep 2013 to Dec 2015

Reference number: NSFC-AF-DFG; 6904103

25. Study title: Multi-Centre analysis of immune-regulatory mechanisms that protect from childhood asthma in distinct rural environments

Funding source: European Union Trilateral China-Finland-Germany Research Grant - National Natural Science Foundation of China

Study period: Sep 2013 to Dec 2015

Reference number: NSFC; 6904103

26. Study title: Influenza surveillance and effectiveness of influenza vaccination in Hong Kong children

Funding source: Food and Health Bureau - Health and Medical Research Fund

Study period: Jan 2014 to Jun 2015

Reference number: 13120422