Alumni profile: Dr. Binkley

Jan 12, 2021

Alumni Feature

Disease first described by Dr Karen Binkley recently featured in the New York Times:

https://www.nytimes.com/2020/12/28/magazine/hereditary-angioedema-hae-diagnosis.html?referringSource=articleShare

Dr Karen Binkley

University of Toronto Associate Professor, Department of Medicine Division of Clinical Immunology and Allergy
St Michael’s Hospital, Division of Clinical Immunology and Allergy
Sunnybrook Health Sciences Centre, Drug Safety Clinic
 

Karen BinkleyKaren Binkley Dr Binkley completed her subspecialty fellowship training in Clinical Immunology and Allergy, also at the University of Toronto, in 1990.  Prior to this s he obtained her Honours BSc in Biochemistry at the University of Western Ontario in 1978, undertook two years of graduate studies in molecular biology in the Department of Medical Genetics, and obtained her Doctor of Medicine at the University of Toronto in 1984. She completed her residency in Internal Medicine at the University of Toronto 1987, and then spent a year on staff as a Clinical Associate at Mount Sinai Hospital.

Dr. Binkley, despite being an adjunct affiliate with the University of Toronto she has written over 40 scientific papers for peer reviewed medical journals, many more in other medical publications, and a book - Allergies and Asthma, A Guide for Patients and their Families, available at Indigo’s or her office. She has received international recognition for several different aspects of her research and guidelines development, as follows.

Hereditary Angioedema

Dr. Binkley independently discovered a rare genetic disorder called hereditary angioedema with normal C1 inhibitor. Working with colleagues at Harvard and the University of Montreal, they were able to identify 3 genetic abnormalities associated with the disorder. In 2011 and 2016 she was the sole Canadian researcher to be invited to attend meetings, sponsored by the Hereditary Angioedema Society of America, with experts from around the world, to promote research and determine optimal treatment for this condition. Her research in this area continues with collaboration of national and international colleagues. 

Anaphylaxis and Food Allergy Guidelines

Dr. Binkley initiated and participated in the development of guidelines for the care of patients at risk for anaphylaxis, especially for food allergies, in schools and other child-care settings. Initially working with provincial, and then with colleagues from across Canada, the United States and elsewhere, the guidelines were eventually adopted by the American Academy of Allergy and Clinical Immunology, and are now used around the world.

Discovery of new food, drug and other allergens, drug side effects, and strategies for treatment

Dr. Binkley has published her discovery of several new allergens, including supplemental lactase enzyme (used by patients with lactose intolerance), laminaria (a seaweed derived product, used in gynecologic surgery), certain herbal preparations, and even maple tree sap. She has also identified previously under- or unrecognized side effects of certain medications (ACE inhibitors, hydrochlorothiazide, sibutramine and dutasteride), developed a strategy for re-introducing an important medication to a patient allergic to it, and reported a novel treatment for a rare condition (aquagenic pruritis, in which any exposure to water results in intolerable itching) .

Idiopathic Environmental Intolerance/ Multiple Chemical Sensitivity

Dr. Binkley is also recognized for her research in idiopathic environmental intolerance (formerly called multiple chemical sensitivity syndrome). She was invited to present her studies on this subject at the Fifth Annual Symposium of the Drug Information Association, Advances in Drug Safety, sponsored by the Drug Information Association, Toronto , an international meeting,  Low Level Environmental Exposures – A State of the Science Update, sponsored by the Environmental Sensitivities Research Institute, held in  Seattle, Washington, and at a Multiple Chemical Sensitivity Syndrome Symposium, sponsored by Department of National Defense, Canada, in Ottawa.

Seminal HAEn Publication

Clinical, biochemical, and genetic characterization of a novel estrogen-dependent inherited form of angioedema. Binkley KE, Davis A 3rd. J Allergy Clin Immunol. 2000 Sep;106(3):546-50. doi: 10.1067/mai.2000.108106.

https://www.jacionline.org/action/showPdf?pii=S0091-6749%2800%2949577-1

Other HAEn Publications 

Genetic analysis of Factor XII and bradykinin catabolic enzymes in a family with estrogen-dependent inherited angioedema. Duan QL, Binkley K, Rouleau GA. J Allergy Clin Immunol. 2009 Apr;123(4):906-10. doi: 10.1016/j.jaci.2008.12.010

Estrogen-dependent inherited angioedema. Binkley KE, Davis AE 3rd. Transfus Apher Sci. 2003 Dec;29(3):215-9. doi: 10.1016/j.transci.2003.08.002.

Factor XII mutations, estrogen-dependent inherited angioedema, and related conditions. Binkley KE. Allergy Asthma Clin Immunol. 2010 Jul 28;6(1):16. doi: 10.1186/1710-1492-6-16.

Consensus paper of International Experts (new name HAE with normal C1 inhibitor) Hereditary angioedema with normal C1 inhibitor function: consensus of an international expert panel. Zuraw BL, Bork K, Binkley KE, Banerji A, Christiansen SC, Castaldo A, Kaplan A, Riedl M, Kirkpatrick C, Magerl M, Drouet C, Cicardi M. Allergy Asthma Proc. 2012 Nov-Dec;33 Suppl 1:S145-56. doi: 10.2500/aap.2012.33.3627.

Measurement of Bradykinin Formation and Degradation in Blood Plasma: Relevance for Acquired Angioedema Associated With Angiotensin Converting Enzyme Inhibition and for Hereditary Angioedema Due to Factor XII or Plasminogen Gene Variants. Marceau F, Rivard GE, Gauthier JM, Binkley KE, Bonnefoy A, Boccon-Gibod I, Bouillet L, Picard M, Levesque G, Elfassy HL, Bachelard H, Hébert J, Bork K. Front Med (Lausanne). 2020 Jul 17;7:358. doi: 10.3389/fmed.2020.00358. eCollection 2020