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Dr. Randhawa (R) with F&M Bank President Henry Walker (L)

Long Beach, California. (November 2, 2017).    At the 7th Annual “People You Can Bank On” Luncheon held today in Long Beach, California, Farmers & Merchants Bank (F&M) presented Dr. Inderpal Randhawa with the 2017 “Dedication” Award.  The Awards are hosted by the bank each year to honor the virtues and characteristics that F&M values in it customers – Honesty, Faith, Loyalty, Integrity, Dedication, Gratitude, Humility, Dependability, Compassion, and Service Above Self.

Dr. Randhawa is a board-certified physician in allergy, immunology, pulmonology, pediatrics and internal medicine.  Early in his career he began to question conventional protocols for the treatment of life-threatening food allergies.   By studying a vast number of genetic and environmental factors, he developed a comprehensive, multi-system approach resulting in individualized, data-driven treatment regimens for allergic patients.   Utilizing this model, over the past 10 years he has successfully treated more than 2,000 patients at a near-perfect success rate, offering food-allergic children the freedom to safely eat foods to which they were once deathly allergic.  This unprecedented model of success led him to found TPIRC, an unconventional clinic and research center where precision medicine and data-analytics drive the treatment of not only food allergy, but also a series of rare and orphan diseases.

When introducing Randhawa, F&M Bank President, Henry Walker, commented, “Many years ago, Dr. Randhawa had the courage to question the status quo.   It is his dedication and ability to think critically to find elusive answers which enables thousands of children across the country with so-called ‘orphan diseases’ . . . to access cutting edge treatment and a better quality of life.”

“I tried to analyze what I was doing that was so different,” Randhawa shared, “. . . it was all data-driven . . . gathering hundreds and hundreds of biomarkers and data points per patient and utilizing that information to drive treatment in a comprehensive, multi-system approach.  It actually was nothing short of remarkable.  Once it was done correctly it saw success after success. . . this is becoming something that I think Long Beach can be very proud of.”

Dr. Randhawa went on to exhort the audience, stating, “Change comes from the people . . . when you look at our communities and society and you question things, remember that change is possible.”

About Dr. Inderpal Randhawa

Dr. Randhawa is a board-certified physician in adult medicine and pediatrics. In addition, he has board certifications in clinical immunology, allergy and pulmonary medicine. He currently serves as the director of the Food Allergy & Intolerance Center at Long Beach Memorial Hospital, the chief physician at Southern California Allergy, Asthma & Pulmonary Specialists, and Associate Director of the Division of Pediatric Pulmonology at Miller Children’s Hospital.  He also acts as the program director and research coordinator in two fellowship programs at the David Geffen UCLA School of Medicine and UCI-Miller Children’s Hospital. In addition to Associate Professor appointments at these two institutions, Dr. Randhawa practices clinical medicine in pulmonary diseases, immune deficiencies, allergy, and transplant medicine. Dr. Randhawa received his medical degree from the Feinberg Northwestern University School of Medicine.  After completing a combined Internal Medicine/Pediatrics residency, he completed training in Clinical Immunology & Allergy at UCLA. He finished his studies in pediatric and adult pulmonology at UC Irvine – Miller Children’s Hospital.  Dr. Randhawa has authored over 100 peer reviewed abstracts and research publications.  He serves on several scientific and clinical advisory boards for national health and disease organizations.  His clinical and research focus on rare and orphan diseases spearheaded the development of TPIRC.


TPIRC is a non-profit clinical care and research center that focuses on the development of cutting-edge, individualized treatment protocols for rare and orphan diseases utilizing comprehensive diagnostic tools and patient-driven research.  The mission is two-fold – to advance treatment discovery at a pace which helps patients today, while building a scalable model of success to accelerate the rate of research discovery for all diseases.  For more information about TPIRC, please visit the website at

About Farmers & Merchants Bank

Founded in Long Beach in 1907 by C.J. Walker, Farmers & Merchants Bank has 24 branches across Orange County, Long Beach and the South Bay. The Bank specializes in commercial and small business banking, business loan programs, home loans, and a robust offering of consumer retail banking products, including checking, savings and youth accounts. Farmers & Merchants Bank is a California state chartered bank with deposits insured by the Federal Deposit Insurance Corporation (Member FDIC) and an Equal Housing Lender. For more information about F&M, please visit the website at

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Last month, the FDA released a Briefing Document (link below) outlining a few limitations in the application of the standard clinical trial model to food allergy treatment such as oral immunotherapy (OIT). For example, the FDA notes that “subjecting severely food-allergic individuals to multiple OFCs [oral food challenges] entails risk to the study subjects and recruitment challenges for study sponsors.” The FDA suggests that alternative models should be considered when evaluating OIT and other treatment options for food allergy.

Additionally, the FDA document notes that “[t]olerance has not been demonstrated in any controlled trial of food AIT [allergen immunotherapy, including OIT] to date.” This should not be conflated with any conclusion about the efficacy of OIT generally. It simply refers to the limitations of clinical trials, which typically require 4 phases of study before FDA approval eligibility, a process that can take 10 years or longer and is achieved only 25% of the time. No food allergy treatment has completed a phase 3 or a phase 4 trial. It’s not surprising, therefore, that clinical trials have not yet demonstrated tolerance. We have not had 10 plus-year studies to truly test that model.

It also should be noted that the FDA “does not approve medical foods” as therapy. As a result, FDA policy likely precludes OIT from ever resulting in FDA approval. Lack of FDA approval does not disqualify OIT as a valid and appropriate treatment, however. Many safe and effective medical treatments lack FDA approval yet still are widely used, including allergy shots.

TPIRC’s unique structure addresses the concerns voiced by the FDA. TPIRC’s OIT program is not a clinical trial. Rather, TPIRC integrates research, patient-specific clinical care, and advocacy. TPIRC doctors have nearly a decade of experience in OIT and have achieved an unmatched 99% success rate. Its nearly 1,000 OIT patients have achieved larger maintenance doses than those following other protocols, including more than 300 peanut graduates safely eating at least 60 peanuts daily. The goal of TPIRC’s protocol is to induce immunological tolerance, where IgE = Zero. In fact, there are hundreds of patients whose IgE based numbers have decreased to 0 for various foods and as a result no longer need to ingest these foods on a regular basis. We are demonstrating that food allergy patients can develop desensitization which can drive toward tolerance in a safe, effective, and user-friendly model.

Stay tuned for upcoming news about our doctors’ innovative approach!

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After treating nearly 700 food allergy OIT patients, a common theme during initial office visits surrounds not just safety but the “risk of reactions” during OIT. Many parents state their child has not had anaphylaxis for years. Others will say reactions occur regularly. Some parents say their children’s allergy testing done at an outside allergist’s office labels them as “high risk” for reactions. This leaves a lot of uncertainty in the discussion.

My discussion with patients and families focuses on the TPIRC model of OIT. The comprehensive nature of analysis not only involves elaborate allergy testing. It also involves a clear evaluation of all allergic systems of the body.   These systems involve the skin, the blood vessels, the lungs, the heart, the liver, and more. It is most important to evaluate all these systems due to the involvement of these systems during different types of allergic reactions. But while all systems are critical, the lungs are one of the most important.

As a board certified pulmonologist, my bias toward excellent lung function prior to starting OIT is based on evidence. A large Australian study published in 2014 brought to light the risk factors of reactions during allergic food exposure. The study, entitled: Safety and clinical predictors of reacting to extensively heated cow’s milk challenge in cow’s milk-allergic children., sought to define the clinical “risk factors” of children allergic to milk who were about to undergo a baked milk challenge. 71 children with confirmed milk protein allergy were set to undergo a baked milk food challenge. Keep in mind the baked milk challenge is not done all at once. It is done in a graded, staged fashion over hours of time with small incremental dose increases. Of the 71 children tested, most passed (51 total, 73%). Of the 27% who did not pass, 4 children actually needed an epinephrine injection to rescue them.

This Australian group studied these 27% who did not pass by comparing them to those who passed and discovered the top “risk factors” associated with having an allergic reaction during food dosing:

  • Any history of asthma, especially asthma requiring preventer therapy (inhaled steroids, singulair)
  • IgE-mediated clinical reactions to more than 3 food groups (separate groups ie nuts, milk, peanut)
  • A history of cow’s milk reactions consistent with severe anaphylaxis

What is the take away message?

If you are considering OIT and your child has the “risk factors” mentioned above, do everything possible to control the lungs before and during treatment. The TPIRC model not only deploys state of the art lung function testing including complete body plethysmography, forced oscillation testing, exhaled nitric oxide and lung clearance index testing. The TPIRC model of OIT ensures patients undergoing OIT are maintained at a normal to super normal level of lung function.

The questions brought forth by this study need to be studied clearly in OIT patients. TPIRC and its OIT model is actively studying these clinical questions and looks forward to publishing its data in 2016.


Inderpal Randhawa, MD



Ann Allergy Asthma Immunol. 2014 Oct;113(4):425-9. doi: 10.1016/j.anai.2014.06.023. Epub 2014 Jul 22.

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