Allergic Diseases


The Division of Allergic Diseases at Mayo Clinic in Minnesota is one of the largest medical specialty groups of its kind, and has a rich history as a leader in the research and treatment of allergic diseases.

Focusing on disease processes, such as bronchial asthma, rhinitis, sinusitis, immunodeficiency, mastocytosis, anaphylaxis, and other allergic diseases, individualized treatment offered to patients integrates the clinical expertise of our physicians and innovative programs in clinical and basic research.

Doctors in Allergic Diseases are organized into a number of special interest groups or clinics which offer more focused patient care and research.

In any given year, the Division of Allergic Diseases performs approximately 100,000 diagnostic allergy skin tests and delivers treatment to thousands of patients, both at Mayo Clinic and in cooperation with local physicians throughout the United States    

EDUCATION

University of Mumbai, KEM Hospital, GS Medical College, Mumbai, India – MB BS

1995 – 2001

University of Missouri, Columbia, Columbia, Missouri – Ph.D., Microbiology and Immunology

2002 – 2008

University of Arkansas for Medical Sciences, Little Rock, Arkansas – Internship

07/2008 – 06/2009

University of Arkansas for Medical Sciences, Little Rock, Arkansas – Resident

07/2009 – 06/2011

University of Texas Medical Branch, Galveston, Texas – Fellow

07/2011 – 06/2013

AWARDS

George L. Ackerman Award – University of Arkansas for Medical Sciences, Little Rock, Arkansas Best Intern in Medicine 2008

George L. Ackerman Award – University of Arkansas for Medical Sciences, Little Rock, Arkansas Best Resident in Medicine 2009

Alpha Omega Alpha – University of Arkansas for Medical Sciences, Alpha Omega Alpha Honor Medical Society, Little Rock, Arkansas 2010

Outstanding Fellow in Allergy and Immunology – University of Texas Medical Branch at Galveston, Galveston, Texas 2013

Teacher of the Year Award – Mayo Fellows Association, Mayo School of Graduate Medical Education, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minnesota Allergy and Immunology 2014

Teacher of the Year Award – Mayo Fellows Association, Mayo School of Graduate Medical Education, Mayo Clinic College of Medicine, Rochester, Minnesota Allergy and Immunology 2016

Teacher of the Year Award – Mayo Fellows Association, Mayo School of Graduate Medical Education, Mayo Clinic College of Medicine, Rochester, Minnesota Allergy and Immunology 2020

PUBLICATIONS

1. Gregg RK, Jain R, Schoenleber SJ, Divekar R, Bell JJ, Lee HH, Yu P, Zaghouani H.  A sudden decline in active membrane-bound TGF-beta impairs both T regulatory cell function and protection against autoimmune diabetes. J Immunol. 2004 Dec 15; 173(12):7308-16. PMID: 15585854     

2. Gregg RK, Bell JJ, Lee HH, Jain R, Schoenleber SJ, Divekar R, Zaghouani H.  IL-10 diminishes CTLA-4 expression on islet-resident T cells and sustains their activation rather than tolerance. J Immunol. 2005 Jan 15; 174(2):662-70. PMID: 15634884     

3. Yu P, Gregg RK, Bell JJ, Ellis JS, Divekar R, Lee HH, Jain R, Waldner H, Hardaway JC, Collins M, Kuchroo VK, Zaghouani H.  Specific T regulatory cells display broad suppressive functions against experimental allergic encephalomyelitis upon activation with cognate antigen. J Immunol. 2005 Jun 1; 174(11):6772-80. PMID: 15905518     

4. Bell JJ, Ellis JS, Guloglu FB, Tartar DM, Lee HH, Divekar RD, Jain R, Yu P, Hoeman CM, Zaghouani H.  Early effector T cells producing significant IFN-gamma develop into memory. J Immunol. 2008 Jan 1; 180(1):179-87. PMID: 18097018     

5. Jain R, Tartar DM, Gregg RK, Divekar RD, Bell JJ, Lee HH, Yu P, Ellis JS, Hoeman CM, Franklin CL, Zaghouani H.  Innocuous IFNgamma induced by adjuvant-free antigen restores normoglycemia in NOD mice through inhibition of IL-17 production. J Exp Med. 2008 Jan 21; 205(1):207-18. Epub 2008 Jan 14. PMID: 18195074   PMCID: 2234380   DOI: 10.1084/jem.20071878

6. Bell JJ, Divekar RD, Ellis JS, Cascio JA, Haymaker CL, Jain R, Tartar DM, Hoeman CM, Hardaway JC, Zaghouani H.  In trans T cell tolerance diminishes autoantibody responses and exacerbates experimental allergic encephalomyelitis. J Immunol. 2008 Feb 1; 180(3):1508-16. PMID: 18209046     

7. Yu P, Haymaker CL, Divekar RD, Ellis JS, Hardaway J, Jain R, Tartar DM, Hoeman CM, Cascio JA, Ostermeier A, Zaghouani H.  Fetal exposure to high-avidity TCR ligand enhances expansion of peripheral T regulatory cells. J Immunol. 2008 Jul 1; 181(1):73-80. PMID: 18566371   PMCID: 2678955  

8. Lee HH, Hoeman CM, Hardaway JC, Guloglu FB, Ellis JS, Jain R, Divekar R, Tartar DM, Haymaker CL, Zaghouani H.  Delayed maturation of an IL-12-producing dendritic cell subset explains the early Th2 bias in neonatal immunity. J Exp Med. 2008 Sep 29; 205(10):2269-80. Epub 2008 Sep 01. PMID: 18762566   PMCID: 2556775   DOI: 10.1084/jem.20071371

9. Divekar RD, Mehta P.  Hepatocellular carcinoma: the facts of the matter. Federal Practitioner. 2009 May.      

10. Zhang J, Lee SM, Shannon S, Gao B, Chen W, Chen A, Divekar R, McBurney MW, Braley-Mullen H, Zaghouani H, Fang D.  The type III histone deacetylase Sirt1 is essential for maintenance of T cell tolerance in mice. J Clin Invest. 2009 Oct; 119(10):3048-58. PMID: 19729833   PMCID: 2752073   DOI: 10.1172/JCI38902

11. Divekar RD, Haymaker CL, Cascio JA, Guloglu BF, Ellis JS, Tartar DM, Hoeman CM, Franklin CL, Zinselmeyer BH, Lynch JN, Miller MJ, Zaghouani H.  T cell dynamics during induction of tolerance and suppression of experimental allergic encephalomyelitis. J Immunol. 2011 Oct 15; 187(8):3979-86. Epub 2011 Sep 12. PMID: 21911603   PMCID: 3186833   DOI: 10.4049/jimmunol.1100531

12. Pillai RR, Divekar R, Brasier A, Bhavnani S, Calhoun WJ.  Strategies for molecular classification of asthma using bipartite network analysis of cytokine expression. Curr Allergy Asthma Rep. 2012 Oct; 12(5):388-95. PMID: 22777399   PMCID: 3573881   DOI: 10.1007/s11882-012-0279-y

13. Cascio JA, Haymaker CL, Divekar RD, Zaghouani S, Khairallah MT, Wan X, Rowland LM, Dhakal M, Chen W, Zaghouani H.  Antigen-specific effector CD4 T lymphocytes school lamina propria dendritic cells to transfer innate tolerance. J Immunol. 2013 Jun 15; 190(12):6004-14. Epub 2013 May 17. PMID: 23686493   PMCID: 3679289   DOI: 10.4049/jimmunol.1203552

14. Divekar R, Ameredes BT, Calhoun WJ.  Symptom-based controller therapy: a new paradigm for asthma management. Curr Allergy Asthma Rep. 2013 Oct; 13(5):427-33. PMID: 23904098   PMCID: 3794434   DOI: 10.1007/s11882-013-0375-7

15. Bhavnani SK, Dang B, Caro M, Bellala G, Visweswaran S, Mejias A, Divekar R.  Heterogeneity within and across Pediatric Pulmonary Infections: From Bipartite Networks to At-Risk Subphenotypes. AMIA Jt Summits Transl Sci Proc. 2014; 2014:29-34 Epub 2014 Apr 07 PMID: 25717396   PMCID: 4333711  

16. Bhavnani SK, Dang B, Visweswaran S, Divekar R, Tan A, Karmarkar A, Ottenbacher K.  How Comorbidities Co-Occur in Readmitted Hip Fracture Patients: From Bipartite Networks to Insights for Post-Discharge Planning. AMIA Jt Summits Transl Sci Proc. 2015; 2015:36-40 Epub 2015 Mar 25 PMID: 26306228   PMCID: 4525217  

17. Sprung J, Larson KJ, Divekar RD, Butterfield JH, Schwartz LB, Weingarten TN.  Refractory intraoperative hypotension with elevated serum tryptase. Asia Pac Allergy. 2015 Jan; 5 (1):47-50 Epub 2015 Jan 28 PMID: 25653920   PMCID: 4313759   DOI: 10.5415/apallergy.2015.5.1.47

18. Divekar R, Kita H.  Recent advances in epithelium-derived cytokines (IL-33, IL-25, and thymic stromal lymphopoietin) and allergic inflammation. Curr Opin Allergy Clin Immunol. 2015 Feb; 15 (1):98-103 PMID: 25479313   PMCID: 4346181   DOI: 10.1097/ACI.0000000000000133

19. Divekar RD, Samant S, Rank MA, Hagan J, Lal D, O’Brien EK, Kita H.  Immunological profiling in chronic rhinosinusitis with nasal polyps reveals distinct VEGF and GM-CSF signatures during symptomatic exacerbations. Clin Exp Allergy. 2015 Apr; 45 (4):767-78 PMID: 25429844   PMCID: 4459602   DOI: 10.1111/cea.12463

20. Bhavnani SK, Dang B, Bellala G, Divekar R, Visweswaran S, Brasier AR, Kurosky A.  Unlocking proteomic heterogeneity in complex diseases through visual analytics. Proteomics. 2015 Apr; 15(8):1405-18. PMID: 25684269   PMCID: 4471338   DOI: 10.1002/pmic.201400451

21. Lal D, Rounds AB, Rank MA, Divekar R.  Clinical and 22-item Sino-Nasal Outcome Test symptom patterns in primary headache disorder patients presenting to otolaryngologists with “sinus” headaches, pain or pressure. Int Forum Allergy Rhinol. 2015 May; 5: (5)408-16. PMID: 25755224   DOI: 10.1002/alr.21502  

22. Pyle RC, Divekar R, May SM, Narla N, Pianosi PT, Hartz MF, Ott NL, Park MA, McWilliams DB, Green JA, Despins KN, Joshi AY.  Asthma-associated comorbidities in children with and without secondhand smoke exposure. Ann Allergy Asthma Immunol. 2015 Sep; 115: (3)205-10. PMID: 26208757   DOI: 10.1016/j.anai.2015.06.027  

23. Divekar R, Butterfield J, Butterfield J.  Urinary 11beta-PGF2alpha and N-methyl histamine correlate with bone marrow biopsy findings in mast cell disorders. Allergy. 2015 Oct; 70 (10):1230-8 Epub 2015 June 24 PMID: 26095439   DOI: 10.1111/all.12668  

24. Divekar R, Patel N, Jin J, Hagan J, Rank M, Lal D, Kita H, O’Brien E.  Symptom-Based Clustering in Chronic Rhinosinusitis Relates to History of Aspirin Sensitivity and Postsurgical Outcomes. J Allergy Clin Immunol Pract. 2015 Nov-Dec; 3 (6):934-40.e3 Epub 2015 July 26 PMID: 26216252   PMCID: 4641837   DOI: 10.1016/j.jaip.2015.06.018

25. Lal D, Rounds AB, Divekar R.  Gender-specific differences in chronic rhinosinusitis patients electing endoscopic sinus surgery. Int Forum Allergy Rhinol. 2016 Mar; 6: (3)278-86. PMID: 26574907   DOI: 10.1002/alr.21667  

26. Divekar R, Butterfield J, Maddox D.  Successful rapid desensitization to temozolomide: A case series. J Allergy Clin Immunol Pract 2016 May-Jun; 4 (3):545-6 Epub 2016 Jan 20 PMID: 26868726   DOI: 10.1016/j.jaip.2015.12.007  

27. Divekar R, Hagan J, Rank M, Park M, Volcheck G, O’Brien E, Meeusen J, Kita H, Butterfield J.  Diagnostic Utility of Urinary LTE4 in Asthma, Allergic Rhinitis, Chronic Rhinosinusitis, Nasal Polyps, and Aspirin Sensitivity. J Allergy Clin Immunol Pract. 2016 Jul-Aug; 4 (4):665-70 Epub 2016 Apr 12 PMID: 27080204   PMCID: 5103699   DOI: 10.1016/j.jaip.2016.03.004

28. Lal D, Golisch KB, Elwell ZA, Divekar RD, Rank MA, Chang YH.  Gender-specific analysis of outcomes from endoscopic sinus surgery for chronic rhinosinusitis. Int Forum Allergy Rhinol. 2016 Sep; 6 (9):896-905 Epub 2016 Apr 15 PMID: 27080452   DOI: 10.1002/alr.21773  

29. Patel B, Divekar R.  Urinary N-methyl histamine levels relate to the presence of angioedema and decrease with the duration of chronic urticaria. J Allergy Clin Immunol Pract 2017 Jan – Feb; 5 (1):201-203 Epub 2016 Nov 09 PMID: 27838330   DOI: 10.1016/j.jaip.2016.09.036  

30. Divekar R, Rank M, Squillace D, Kita H, Lal D.  Unsupervised network mapping of commercially available immunoassay yields three distinct chronic rhinosinusitis endotypes. Int Forum Allergy Rhinol. 2017 Apr; 7 (4):373-379 Epub 2017 Jan 02 PMID: 28042687   DOI: 10.1002/alr.21904  

31. Hartono S, Motosue MS, Khan S, Rodriguez V, Iyer VN, Divekar R, Joshi AY.  Predictors of granulomatous lymphocytic interstitial lung disease in common variable immunodeficiency. Ann Allergy Asthma Immunol. 2017 May; 118 (5):614-620 Epub 2017 Feb 20 PMID: 28254202   DOI: 10.1016/j.anai.2017.01.004  

32. Hagan JB, Laidlaw TM, Divekar R, O’Brien EK, Kita H, Volcheck GW, Hagan CR, Lal D, Teaford HG 3rd, Erwin PJ, Zhang N, Rank MA.  Urinary Leukotriene E4 to Determine Aspirin Intolerance in Asthma: A Systematic Review and Meta-Analysis. J Allergy Clin Immunol Pract. 2017 Jul – Aug; 5 (4):990-997.e1 Epub 2017 Feb 12 PMID: 28202405   DOI: 10.1016/j.jaip.2016.11.004  

33. Patel B, Wi CI, Hasassri ME, Divekar R, Absah I, Almallouhi E, Ryu E, King K, Juhn YJ.  Heterogeneity of asthma and the risk of celiac disease in children. Allergy Asthma Proc. 2018 Jan 1; 39 (1):51-58 PMID: 29279060   PMCID: 5743845   DOI: 10.2500/aap.2018.39.4100

34. Divekar R, Lal D.  Recent advances in biologic therapy of asthma and the role in therapy of chronic rhinosinusitis. F1000Res. 2018; 7:412 Epub 2018 Mar 29 PMID: 29707206   PMCID: 5883390   DOI: 10.12688/f1000research.13170.1

35. Lal D, Hopkins C, Divekar RD.  SNOT-22-based clusters in chronic rhinosinusitis without nasal polyposis exhibit distinct endotypic and prognostic differences. Int Forum Allergy Rhinol. 2018 Jul; 8 (7):797-805 Epub 2018 Feb 13 PMID: 29437297   DOI: 10.1002/alr.22101  

36. Miglani A, Divekar RD, Azar A, Rank MA, Lal D.  Revision endoscopic sinus surgery rates by chronic rhinosinusitis subtype. Int Forum Allergy Rhinol. 2018 Sep; 8 (9):1047-1051 Epub 2018 May 31 PMID: 29851243   DOI: 10.1002/alr.22146  

37. Bhavnani SK, Visweswaran S, Divekar R, Brasier AR.  Towards team-centered informatics: Accelerating innovation in multidisciplinary scientific teams through visual analytics Journal of Applied Behavioral Science. 2019 Mar; 55 (1):50-72      

38. Lal D, Wright BL, Shim KP, Zarka MA, Lee JJ, Chang YH, Ochkur SI, Divekar R, Doyle AD, Jacobsen EA, Kita H, Rank MA.  Eosinophil peroxidase, GATA3, and T-bet as tissue biomarkers in chronic rhinosinusitis. J Allergy Clin Immunol 2019 Jun; 143 (6):2284-2287.e6 Epub 2019 Feb 08 PMID: 30738839   DOI: 10.1016/j.jaci.2019.01.038  

39. Nanda A, Baptist AP, Divekar R, Parikh N, Seggev JS, Yusin JS, Nyenhuis SM.  Asthma in the older adult. J Asthma. 2020 Mar; 57 (3):241-252 Epub 2019 Jan 18 PMID: 30656998   DOI: 10.1080/02770903.2019.1565828  

40. Sheen YH, Kizilbash S, Ryoo E, Wi CI, Park M, Abraham RS, Ryu E, Divekar R, Juhn Y.  Relationship between asthma status and antibody response pattern to 23-valent pneumococcal vaccination. J Asthma. 2020 Apr; 57 (4):381-390 Epub 2019 Feb 20 PMID: 30784333   PMCID: 6702096   DOI: 10.1080/02770903.2019.1575394

41. Neth BJ, Ruff MW, Uhm JH, Johnson DR, Divekar RD, Maddox DE.  Temozolomide desensitization followed by metronomic dosing in patients with hypersensitivity. Cancer Chemother Pharmacol. 2020 Sep; 86 (3):375-382 Epub 2020 Aug 10 PMID: 32778906   DOI: 10.1007/s00280-020-04123-y  

42. Bhavnani SK, Dang B, Penton R, Visweswaran S, Bassler KE, Chen T, Raji M, Divekar R, Zuhour R, Karmarkar A, Kuo YF, Ottenbacher KJ.  How High-Risk Comorbidities Co-Occur in Readmitted Patients With Hip Fracture: Big Data Visual Analytical Approach. JMIR Med Inform. 2020 Oct 26; 8 (10):e13567 PMID: 33103657   PMCID: 7652691   DOI: 10.2196/13567

43. Choby G, O’Brien EK, Smith A, Barnes J, Hagan J, Stokken JK, Strumpf A, Mattos JL, Payne SC, Divekar R.  Elevated Urine Leukotriene E4 Is Associated With Worse Objective Markers in Nasal Polyposis Patients. Laryngoscope. 2021 May; 131 (5):961-966 Epub 2020 Oct 01 PMID: 33001452   DOI: 10.1002/lary.29137  

44. Pitlick MM, Divekar R.  Analysis of spirometry measurements as predictors of aspirin desensitization outcomes. J Allergy Clin Immunol Pract. 2021 Jun; 9 (6):2495-2497.e2 Epub 2021 Feb 02 PMID: 33545401   DOI: 10.1016/j.jaip.2021.01.025  

45. Sitek AN, Ade JM, Chiarella SE, Divekar RD, Pitlick MM, Iyer VN, Wang Z, Joshi AY.  Outcomes among patients with COVID-19 and asthma: A systematic review and meta-analysis. Allergy Asthma Proc. 2021 Jul 1; 42 (4):267-273 PMID: 34187619   DOI: 10.2500/aap.2021.42.210041  

46. Seol HY, Wi CI, Ryu E, King KS, Divekar RD, Juhn YJ.  A diagnostic codes-based algorithm improves accuracy for identification of childhood asthma in archival data sets. J Asthma. 2021 Aug; 58 (8):1077-1086 Epub 2020 May 20 PMID: 32315558   PMCID: 7677164   DOI: 10.1080/02770903.2020.1759624

47. Hagan JB, Ender E, Divekar RD, Pongdee T, Rank MA.  Risk for Postmarket Black Box Warnings in FDA-Approved Monoclonal Antibodies. Mayo Clin Proc Innov Qual Outcomes. 2022 Feb; 6 (1):69-76 Epub 2021 Dec 28 PMID: 35024565   PMCID: 8724853   DOI: 10.1016/j.mayocpiqo.2021.11.009

48. Choby G, Low CM, Levy JM, Stokken JK, Pinheiro-Neto C, Bartemes K, Marino M, Han JK, Divekar R, O’Brien EK, Lal D.  Urine Leukotriene E4: Implications as a Biomarker in Chronic Rhinosinusitis. Otolaryngol Head Neck Surg. 2022 Feb; 166(2):224-232. Epub 2021 May 11. PMID: 33973823   DOI: 10.1177/01945998211011060.